We only provide intensive therapy services that are research backed and evidence based.
Research provides the way forward for the most modern up-to-date, effective treatments and therapies available.
As Professor Iona Novak puts it... "...the weight of the internet is often towards these unproven interventions rather than proven interventions..."
A consultation with our team will determine the suitability for a custom program. Please see below for information pertaining to PITS funded intensive therapy sessions.
STRIDE is an intensive walk/step training program also known as Locomotor Training. This program is specifically designed for children and young adults with neurological conditions and injuries. Locomotor training can include partial body weight support, overground walk training and the possible use of functional electrical stimulation (neuroprosthetics). Specialised equipment and techniques are used to provide this therapy. STRIDE is delivered by credentialed therapists highly experienced in specialised methods and techniques of locomotor training.
STRIDE - locomotor training (intensive therapy)
The STRIDE protocols are directly informed by research that was undertaken by the team at Healthy Strides. In our recently published article in Developmental Medicine Children Neurology 2020 titled “Locomotor and Robotic Assistive Gait Training for Children with Cerebral Palsy”, objective data demonstrates that in children with cerebral palsy who are dependent on physical assistance and equipment throughout the day, locomotor training in combination with overground walking improves walking speed, gross motor skills, functional mobility independence and goal attainment.
Whilst the evidence is specifically for children with cerebral palsy, STRIDE is still relevant for children with other neurological conditions or injuries because it is based on the principles of motor learning and neuroplasticity. Locomotor training works because it is based on how the body learns and re-learns new motor skills. We now know that if there is focused attention on specific skills that is practiced consistently and repetitively in a fun and interactive environment with incremental challenges – we can re-teach the brain to make new pathways.
Essentially, this describes Therapy369: 3 sessions a week for 6 weeks whilst incorporating the 9 principles of neuroplasticity. This dosage represents the minimum time that is needed to promote functional change with lasting effect (up to 6 months).
REACH is our intensive upper limb program that focuses on developing specific skills such as school skills, play, dressing and other everyday activities. This is known as intensive bimanual therapy and targets improved coordination of both hands in structured task practice embedded in play and functional activities.
Task specific and goal directed training along with bimanual skills training have a high level of evidence. Evidence shows that intensive programs can improve functional upper limb skills, especially directly after medical interventions such as botulinum toxin (Botox) injections and upper limb surgery.
To optimise the practice that is needed to develop the skills, we utilise the latest in upper limb technology for neurological therapy. This includes functional electrical stimulation and sensor technology. The sensor technology promotes self-directed movement in an engaging and motivating way with a variety of therapy video games and challenges.
In a publication published in Australian Occupational Therapy Journal in 2020 titled “What is the threshold dose of upper limb training for children with cerebral palsy to improve function? A systematic review”, approaches described above have been shown to be the most effective. In this article, it was also shown that three individual goals can be achieved with a therapy dose of 14 to 25 hours. This is in line with our Therapy369 with Reach sessions occurring 3 times a week over 6 weeks whilst incorporating the 9 principles of neuroplasticity.
ACTIVATE is an intensive therapy program that utilizes a range of therapeutic supports to learn a skill, promoting independence and participation. This may include targeted and task specific strength training and functional electrical stimulation. Most importantly, each program is individualised and goal focused. The ACTIVATE program may focus on skills that range from floor mobility such as crawling to sitting and standing balance and standing transfers.
ACTIVATE - individualised task specific training (intensive therapy).
Research supports the effectiveness of focused and specific activity based interventions to learn or relearn a skill. This is the basis of motor learning and neuroplasticity where it is understood that consolidated mass practice of specific tasks has the potential to change neurological pathways.
In the article published in Physical and Occupational Therapy in Pediatrics in 2019 titled “Defining Functional Therapy in Research Involving Children with Cerebral Palsy: A systematic review”, the key ingredients for effective and functional therapy “emphasises the learning of motor abilities that are meaningful.”
Therapies must be goal directed, focused on independence in activity or participation, are task specific and most importantly, require active involvement of the child or individual with a “hands-off” approach. These key ingredients are essential in promoting the best outcome and is why it is considered under the National Disability Insurance Scheme to be “evidence based” and “value for money”. Such an approach increases the likelihood for effectiveness which ultimately means a better outcome.
This contrasts with therapies such as Neurodevelopmental Therapy or NDT (passive form) which has been shown to be ineffective in improving motor skills or non-evidence based approaches such as Cuevas Medek Exercise (or CME) and Dynamic Movement Intervention (or DMI) which are largely “hands on” approaches and departs far from the current research and evidence recommendations (Novak et al 2019: State of the Evidence Traffic Lights: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy).
ACTIVATE works because it is based on the latest evidence on how the body learns and re-learns new motor skills. We now know that if there is focused attention on specific skills that is practiced consistently and repetitively in a fun and interactive environment with incremental challenges – we can re-teach the brain to make new pathways. The outcome of this is enhanced participation and this is always the ultimate goal.
Kindy Moves is a truly unique and innovative program developed by The Healthy Strides Foundation. It is an intensive school readiness program for preschool aged children aged between 2 and 5 years with complex physical needs. Developed by the very latest research (funded by Telethon7), this program ensures that children have the best opportunity to improve their life, giving them the best start for a brighter future.
KINDY MOVES - intensive therapy (Ages 2-5 yrs).
Throughout 2019 and 2020, our clinical and research teams developed, provided and evaluated outcomes in 50 children with complex physical disabilities, equating to a combined total of 1540 hours of specialised therapy in the areas of communication, hands skills and gross motor skills.
The program is unique in that it combines proven therapy techniques into the one program whilst set within the gold standard framework of being goal directed and family-centred. As such, it is the first of its kind, uniquely combining all of these approaches into a fun and intensive therapy delivery model, developed in partnership with consumers. Consumer involvement throughout its development and evaluation confirms the need for the program in our community.
In addition to consumer involvement, the formal evaluation of the program (through higher degree research at Curtin University) also demonstrates evidence of the effectiveness in improving socialisation, communication, gross motor skills, fine motor skills and confidence not just immediately after the program but most importantly, beyond the program demonstrating long lasting effects that are observable at home and in the community.
Given the evidence of why this unique program is needed, it is essential for research to now transition to becoming a program that is available to the wider community. This ensures that children with complex physical disabilities can gain access to this program supporting the vital need for school readiness in children with complex physical disabilities in Western Australia.
Children with physical disabilities experience significant social isolation compared to their peers. For many children, this results in feeling left behind at school as well as in their community. PARTICIPATE is a program that has been designed using the latest research in childhood disability that aims to promote inclusion and community for better health and well-being to ultimately enhance quality of life. PARTICIPATE aims to modify the activity and equipment to promote inclusion for people with all abilities.
Research confirms that children with complex physical needs require safe, supportive, social and family-centred contexts with mechanisms like specialised health professionals, friends and fun forming the essential ingredients for promoting inclusion, community and participation.
PARTICIPATE embraces these essential ingredients and as such, is positioned to have significant impact by optimising inclusion, community and participation in children with complex physical needs.
We do this by providing after school activity and sporting groups set within the community. The unique feature of this group is that it will be led by specialised health professionals and will not only be open to children with physical disabilities but also to their friends or siblings. This approach moves away from the traditional approach of groups for children with disabilities only.
Rather, to promote inclusion and community, we will adapt and modify the environment and equipment to enable children of all abilities to be included. This is vital in promoting true inclusion within our communities and an understanding of diversity and acceptance for people of all abilities.
This not only has a positive short-term impact with carry over into school but also has long-term implications for the entire school experience. In the long-term, research suggests that by ensuring a positive start to school (for the child, family and educators), there are a host of positive ramifications for the remaining of their school life.
PARTICIPATE is available for children that have already attended our other programs such as STRIDE, REACH or ACTIVATE. This ensures that our team already knows each child’s individual needs and requirements so that the group can be specifically tailored and adapted.
The Healthy Strides Foundation provides goal directed intensive evidence based therapy
programs that aim to improve quality of life for meaningful participation.
PITS is a goal directed intensive therapy program that is provided following an intervention at the Perth
Children’s Hospital (for example: post botox/orthopaedic surgery/iRehab).
The Healthy Strides team can provide a focused upper limb or lower limb program.
Research has shown that focused and specific therapy delivered in intensive blocks can
improve functional upper and lower limb skills, especially directly after medical interventions
such as botulinum toxin (Botox) injections and upper and lower limb surgery.
Our upper limb and lower limb programs utilise the latest technology that promotes and
encourages independent movement. The use of equipment can include the Tyromotion Pablo,
Functional Electrical Stimulation, standing and walking frames.
Healthy Strides will provide a minimum of 2 sessions per week for a number of weeks
determined by PITS funding. Each session is provided by a therapist and is 50 minutes in
duration. A progress report will also be provided to your consultant outlining the goals, therapy
provided and outcome from your child’s individualised sessions.
You can find more information at our website www.healthystridesfoundation.com.au
To commence your PITS sessions, simply inform the Cerebral Palsy Liaison Officer or the
iRehab team that you would like your PITS sessions with The Healthy Strides Foundation.
You can then email us on firstname.lastname@example.org or call us on (08) 6109 2938.
"Some approaches may have negative outcomes or be less beneficial than alternatives, for example, the use of excessive external facilitation or physical guidance while the child is learning to move is not recommended and handling techniques used to inhibit muscle tone are not effective and should not be used e.g. reflex-inhibiting postures. Evidence supports that moving the child's legs or arms passively or utilising a whole-body vibration plate will not help them learn to move and that passive stretching of muscles is insufficient to keep muscles from getting tight.
Motor learning principles support that the child needs to produce and react to their own sensory feedback from their movements to be able to learn how to do these better; excessive external sensory input may disrupt this process. Evidence does not support the effectiveness of generalized developmental stimulation approaches for improving motor outcomes in children with neurological disorders."
Early intervention evidence for infants with or at risk of cerebral palsy: an overview of systematic reviews.
Authors: Diane L Damiano and Egmar Longo
Developmental Medicine and Child Neurology 2021 doi:10.1111/dmcn.14855