Kids Health Info

Brain injury - Gross Motor Skills

  • Gross motor skills are large movements such as walking, running and crawling. A child's ability to perform motor skills depends on several things including muscle strength, coordination and flexibility. After a brain injury, brain signals may change. This can affect a child's ability to use their muscles properly. There are several health professionals who can work together to help your child use these muscles better to regain their gross motor skills.

    What are gross motor skills?

    Gross motor skills are large movements of the body that use large muscles to produce coordinated movements, for example walking, running, sitting, throwing and crawling. Children learn new gross motor skills by practising them until the skill is mastered.

    How can gross motor skills be affected after a brain injury?

    The effects may be seen in a number of ways, including:

    • muscles may become stiff and difficult to move
    • movements may be jerky or clumsy and difficult to coordinate
    • muscles may become difficult to turn on (paralysis)
    • planning and execution of movement becomes difficult (motor planning problems). Read the Kids Health Info factsheet Brain Injury - Dyspraxia for more information about motor planning difficulties.

    A child's ability to perform motor skills depends on several things including muscle strength, coordination and flexibility. Children who have had a brain injury can have long term difficulties with gross motor skills.

    What issues may arise for your child?

    Your child may need to continue practicing or re-learning gross motor skills in the years after their brain injury. Changes to their control of muscles and movement after a brain injury can cause changes, such as shortening, in soft tissues including muscles. These changes may affect your child's ability to learn or perform gross motor skills in the following ways:

    • Learning new skills: your child may need more practice than other children to learn new skills.
    • Growth spurts: growth spurts can worsen your child's tendency to have tight muscles. Therefore, it is important to monitor muscle length during growth spurts. Children will be seen regularly in the brain injury clinic to monitor the effects of their growth.
    • Joint pain: if your child changes posture or movement patterns (e.g. if the knee flicks back, or hyper-extends, during walking), they may experience pain. Practicing gross motor skills can help your child move in the best and most comfortable way possible for them.
    • Splints/Orthoses: splints and orthoses will become too small as your child grows. It is important that your child has regular reviews of the size and suitability of any splints or orthoses.

    Treatment

    Physiotherapy and occupational therapy

    Trained physiotherapists and occupational therapists can assist your child in a number of ways:

    • by teaching motor skills
    • by helping to reduce muscle shortening through casts, splints and stretches
    • by assessing and treating joint pain
    • by reviewing current and recommending new splints or orthoses

    Rehabilitation specialist

    Another specialist your child may see is a rehabilitaion specialist.  This person can help by:

    • assessing and treating joint pain
    • reviewing and recommending splints or orthoses
    • using medication to reduce spasticity (see Kids Health Info factsheet  Intrathecal baclofen)

    Orthotist

    An orthotist can review current orthoses and make recommendations for new orthoses.

    What can you do?

    • Monitor your child's muscle length, particularly calf muscles, hamstrings and the muscles around the hip. Ask your physiotherapist to show you how to do this.
    • Encourage your child to practice gross motor skills and to perform them to the best of their ability.
    • Always follow the routine recommended by your physiotherapist, occupational therapist, rehabilitation specialist and orthotist for any splints or orthoses your child wears.
    • Always attend clinic appointments for your child.

    Key points to remember

    • Gross motor skills are skills that use the large muscles of the body.
    • After a brain injury, altered brain signals may affect a child's ability to use their muscles.
    • Your child may need to continue practicing or re-learning gross motor skills in the years after their brain injury.

    For more information

     

    Developed by the RCH Paediatric Rehabilitation Service.Based on information from the Brain Injury Service at Westmead Children's Hospital (with permission).  First published February 2007. Updated November 2010.

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.