MOVE International
Question 10:
How Does Mobility Help?
The MOVE (Mobility Opportunities Via Education)® Program is designed to help individuals who are non-ambulatory improve their abilities to sit, stand and walk while participating in functional activities. Prompts, ranging from hip belts to foot straps, are used as necessary and faded as soon as possible.
Students/clients are placed in a functional sitting position. Leaning forward about 10 degrees with their feet flat on the floor makes it easier to:
- Use their hands and arms in functional activities.
- Breathe, making it easier to coordinate breathing and swallowing when eating.
- Sit on a toilet to void.
- Cough and clear their own lungs, thus improving respiratory health.
The addition of weight bearing and moving in an upright position has further benefits.
Cardiovascular fitness improves because the heart has to pump harder to distribute the blood around an upright body and is strengthened by this effort. Movement, as we all know, helps to oxygenate the blood.
Bone health improves because pressure or weight on the bones keeps them healthy and helps prevent osteoporosis and deformities. Habitually incorrect positioning of the spine may cause scoliosis, or curvature of the spine, by too high, too low or uneven muscle tone. This can be prevented, or at least delayed, by proper support and positioning of the body and by giving the individual the opportunity to learn to control his muscles. The hip joint is a ball and socket joint. In babies, the socket (acetabulum) is small and doesn’t curve very far around the ball (of the femur). The development of the socket is a result of pressure or weight bearing on the joint. When a baby fails to walk or crawl at the regular time, the joint doesn’t develop normally; when muscle tone is abnormal, it is easier for the femur to be pulled out of the hip socket. As part of the MOVE Program, students are placed in a weight bearing position, thus helping to prevent dislocation of the hips or to stop them from getting any worse.
Bowel functioning often improves, due both to the exercise they get and to their correct body alignment when sitting on the toilet. Also, because it is easier to place a student on the toilet once they have the sitting skills, they are taken to the toilet more often rather than changed on a changing table and so are more likely to become toilet conditioned.
As a person gains motor skills, he becomes easier to look after at home and at school. An individual who can stand for 30 seconds can be helped out of his wheelchair and be pivoted onto a regular chair or his bed. A person who can stand for one minute or more, can have his diaper removed while standing up before sitting on the toilet. This means the caretaker will never have to lift or carry him. This is important as the student grows taller and heavier.
As mobility skills improve, a person has better access to the community. A young person who can walk 50 feet with one hand held can walk from the house to a car, sit in the car and then walk into a restaurant or theater. The family is more likely to include this child in family outings if they do not have to use a van with a lift, load and unload equipment, or carry him; the wheelchair can be left at home. People who can sit on a regular toilet can use public restroom facilities, another important consideration on longer trips out.
Also, there are great benefits for the teacher. She sees progress in her students as they becoming more functional in everyday settings. The MOVE Program gives her a framework by which to measure student success and gives her the feeling that she is teaching her students something of value and importance.
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