I was walking around the clinic yesterday and noticed a therapist getting a child to stand in a bucket. I of course had to stop and see what they were doing because I was intrigued. I had all sorts of ideas in my own mind as to why they were doing this but I wanted to see what was happening in reality, not just in my imagination!
It turns out they were working on balance reactions, and encourage use of ankle and hip strategies to decrease an over reliance on a stepping strategy. By having her reach outside her base of support and return to midline she has to rely on her core and leg muscles to keep her balance rather then just stepping to change her base of support.
The bucket we are using has a little bit of room in it that she can adjust her stance but she isn’t able to step as her primary balance reaction. What would be ideal for her is if we had a bucket that came up higher (closer to her hips) and as she was more successful, we could lower it down so that we were opening up more degrees of freedom for her to control.
For example, if it came up to her hips, she would have boundaries to tell her when she was leaning too far and get used to using her core and leg muscles for that narrowed range. By slowly lowering it she is having to control a little bit more of her body until she is able to rely on all of her balance reactions during her day to day life to help her stay upright!
Another use for this is to work on rotation. You can do this with the same set up but have them reach across their body, or look off to one side. For some kids, rotation at their hips and trunk can be challenging so they will turn their whole body instead. Again, it has to do with controlling degrees of freedom and not unlocking too many joints at one time. With the feet held stable, their only option for turning is to turn from the body. If this is hard for someone, start small. Don’t have them try to look all the way behind them, start with reaching across the body to give a high five or use a book and move it off to the side to look at while the pages are being turned. (All of these ideas can be used for the balance activity above also!)
