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High Five camp helps strengthen weakened hands, arms

Aug. 16, 2018, 9:36 AM

At the High Five Constraint Camp, Jack Lowman, 8, practices eating with his left hand, which is weaker than his right due to cerebral palsy. (photo by John Russell)

Jack Lowman pulls his plate closer to the table’s edge so that his goldfish and apple slices — his camp snack — are closer to him. With his left hand, he paws at a goldfish, and once able to pinch it with his fingers, draws it slowly toward his mouth.

A seemingly simple task is a little harder for Jack, 8, who has cerebral palsy, a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth.

His left hand lacks the strength and coordination he needs to swiftly and easily perform certain tasks. But in three short years, he has come a long way.

“When we adopted Jack from China, he did not use his left hand at all. It was like his brain didn’t recognize he had the ability,” said Jack’s mother, Rainer Lowman. “He was in China the first six years of his life with no medical or therapeutic intervention.”

At the International Adoption Clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt, the clinic’s medical director, Alice Rothman, MD, MPH, recommended that Jack attend the High Five Constraint Camp. During the weeklong intensive constraint-induced movement therapy camp, pediatric occupational therapists place a soft cast on a child’s dominant arm and hand to restrict movement. With the dominant, stronger arm and hand casted, the child trains the weaker arm and hand to become stronger.

“We block use of that arm/hand so they have to use their weaker side. Prior to camp, most of these children completely neglect their affected side and have very minimal functional use of that arm. With this forced use, they are able to build stronger brain pathways and connections. This helps to improve their awareness, strength and coordination to be able to use that hand in everyday tasks,” said Lindsey Ham, OTR/L, CHT, lead occupational therapist for High Five Constraint Camp.

“Our goals of camp are improving awareness and strengthening the weaker side. All of our activities are focused on sensory/tactile experiences, fine motor, grip strength and gross motor skills.”

Constraint Camp was originally established in 2009 by Jennifer Pearson, OTR/L.

Ham has led the High Five camp along with Stephanie Epperson, OTR/L, since 2015, which provides two four-hour sessions, one for children ages 4 to 7 and a second for children ages 8 to 12.

Campers rub Layla, a pet therapy dog, to practice using their less dominant arms and hands. (photo by John Russell)

The camp, offered at Vanderbilt’s Pediatric Rehabilitation Clinic at Vanderbilt Health One Hundred Oaks, has a new theme each day.

One theme this year was space. The campers made constellations out of marshmallows and pretzel sticks to work on fine motor skills.

A highlight for many of the campers is time spent petting and walking therapy dog, Layla.

Types of conditions that often benefit from this type of therapy include cerebral palsy, brachial plexus, traumatic brain injury, brain cancer and stroke.

“This offers an intensive week of therapy, four hours at a time. With a group of peers, it’s a better environment,” Ham said.

“They cheer each other on, and they get to see they are not the only ones. A lot of them do the camp as an adjunct to therapy. You can see their change in function from year to year. It’s fun to see their progression during camp.”

Jacks favorite part? “The food,” he says. “You have goldfish, marshmallows and chicken nuggets.”

“Even with just one week of camp (the first year) we could see a difference — the strength of the hand, the flexibility and he was just so much more confident when he tried to use it. He felt so accomplished,” said Lowman, whose family adopted another child, Blake, 3, from China.

He also has cerebral palsy and will attend the High Five camp next summer.

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