Cerebral Palsy and the fisted hand

A fisted hand. Could it be "mapped" in the brain just like a fist would appear...a ball without fingers?

Our brain has an image or a neurological "map" that represents the different parts of our body. They've named this "map" a Homunculus and is actually quite a comical looking character. It doesn't really look like what we would expect. It has all the body parts but the proportions don't match what we see as ourselves. For example a Homunculus has huge hands in comparison to the size of the torso because of the complexity of the motor functions they do.  

What would a neurological "map" look like when a child has Cerebral Palsy? More specifically what would the hands look like when they are constantly tight and fisted? Would the hands be much smaller in the brains image because of the restrictions from spasticity? Is it possible the brain has "mapped" the hand as one unit, just as a fist would appear? Would the child’s brain even recognize the fact that there are five fingers available that can work independently of each other if it was mapped as a fist?

When my daughter was very young, even as young as 4 or 5 months old, we noticed when she’d reach toward an object her hand wouldn’t open. It stayed in a tiny fisted ball. We started to stretch her hands open daily to try and help her use her hands more effectively, but it didn’t seem to make much difference. She would still reach with a fist to touch objects, or if she did open her hand slightly, all the fingers would work as one unit like they were attached to each other all the way down to the tips. 

It never crossed my mind that her brain might not recognize that her fingers were separate from each other or that they even existed at all! If her brain didn't have them "mapped"  then it also couldn't send any messages to them either.

It wasn’t until I was in my ABM NeuroMovement training that I understood what a real possibility it was that her brain didn't know her fingers existed.  She never had the experience of moving them individually and freely, no exploration of them at all, so how could they be "mapped" that way? Her hand had always been in a tight fist for the first few years of her life. I just assumed since I can clearly see she has fingers she must know that too, but she didn't. This was a mind blowing realization for me.

Through my ABM NeuroMovemovent training I learned how to bring awareness to her hand and help her differentiate between each finger, "mapping" more and more over time to help her hand become more of the full image of what we can see. She has Spastic Quadriplegia Cerebral Palsy, Polymicrogyria (over 90% of her brain is malformed), and a devastating seizure disorder that causes regression... BUT even with those huge obstacles she can now point using only her index finger, hold her markers to colour and paint. She can even pick up small objects with a pincer grasp. Over time with ABM NeuroMovement lessons, I believe we've changed what the image of her hand looks like in her brain. It's no longer that little fisted ball...her "map" of her hand now has fingers!

  While my main focus writing this has been on the hand specifically and the concept of needing to map fingers into a brains fisted image, it’s very important to note that movement and organization in the hand also stems from the rest of the body. We can’t just focus on the hand. In ABM lessons we understand to improve fine motor or further "mapping" of the hand... we must also include the organization of how the arm,  shoulders, chest and the rest of the body all work together. It all plays a roll in how we organize our movements in the hand. Each body part isn’t a separate floating piece and shouldn’t be treated as such. We must look to organize our movement as a whole being and by approaching it this way we can upgrade our whole system to work more effectively together.

I’m so happy for my daughter that she has some independence to do the things that she loves. I'll continue to give her ABM NeuroMovement lessons to feed her brain with rich new information to help her to continue to grow and "map" more of her body. I also love helping the families I work with to experience this too.

To learn more about how ABM NeuroMovement lessons can help your child or to book lessons please contact Renée, ABM NeuroMovement Practitioner at renee@moveintegrate.com or 403-483-9769

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