647 The Superhero in You: Engaging Pediatric Patients in Therapeutic Exercises

Abstract

Abstract Introduction Engaging pediatric burn survivors in necessary range of motion exercises can be challenging. For younger children, difficulty understanding the reasoning behind prescribed exercises, fear and anxiety can all lead to refusal to participate. Traditional rote range of motion exercises do not engage the child’s sense of curiosity and adventure and seem more like medicine than play. We have developed a range of motion exercise program based on well-known superhero actions. For children who need to address active wrist extension and digit extension, they become “Iron Man” (Example included), “Hulk Smash” lets us work on grip and active composite flexion while becoming “Spiderman” encourages digit isolation. “Superman”, “Wonder Woman” and “Batman” allow utilization of total body movements but can be focus on shoulder flexion or abduction and cross body movements. Methods Traditional superhero movements were assessed to determine similarity to traditional therapy exercises. Exercises were drawn with the extremities performing the desired movements. Pediatric patients are introduced to these exercises and encouraged to act out the superhero movements with therapist directing the desired end range and directionality of movements. Results These characters are well known and loved by pediatric patients. In many instances, a fearful patient may become an active therapy participant through these engaging activities. Goal attainment becomes more fun and less when children are engaged in a purposeful play task. Caregivers can carry these exercises well beyond the therapy session to encourage day long exercise which is essential for contracture prevention and remediation. A recent feedback comment from the parent of a 4-year-old burn survivor specifically focused on these exercises. “Absolutely phenomenal. The therapist did “superhero” moves with my son and got him to open and close his hands. I was so relieved that the movement was normal” Conclusions Modifying instruction methods to include familiar and fun techniques can increase therapy participation and can decrease the fear experienced by young burn survivors when faced with moving an injured extremity.