Gross Motor Skills

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What are gross motor skills?

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

How can gross motor skills can be affected following brain injury?

Following brain injury a child's ability to use their muscles may be affected, due to altered brain signals. This may be seen in a number of ways, including:

• Muscles may become stiff and difficult to move (see spasticity)
• Movement may become jerky or clumsy and difficult to coordinate www.wemove.org/kidsmove/
• Muscles may become difficult to turn on (paralysis)
• Planning and execution of movement becomes difficult (motor planning problems), see dyspraxia

A child's ability to perform motor skills depends on a number of factors, including muscle strength and 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 practising or relearning gross motor skills in the years following their brain injury. Alterations in the control of muscles and movement patterns due to brain injury can lead to changes in the soft tissues (including muscles) such as shortening. These changes may influence your child's ability to learn or perform gross motor skills in the following ways:

1. Learning new skills

Your child may require more practice to learn new skills than other children.

2. Growth spurts

Growth spurts can worsen your child's tendency to have tight muscles and therefore, it is important to monitor muscle length during growth spurts. Children are regularly reviewed in the brain injury clinic to monitor the effects of their growth.

3. Joint pain

If your child changed posture,or movement patterns (for example, if the knee flicks back during walking), they may develop pain. Practice of gross motor skills can assist your child to move in the best way possible for them.

4. Splints/Orthoses*

Splints and orthoses will become too small as your child grows. It is important that your child has regular reviews of any splints/orthoses, to review their size and suitability for your child.

What is the treatment?

1. Physiotherapy

• Train gross motor skills
• Address muscle shortening through casts, splints and stretches
• Assess and treat joint pain
• Review and recommend splints/orthoses

2. Rehabilitation Specialist

• Assess and treat joint pain
• Review and recommend splints/orthoses
• Use medications to reduce spasticity (see botulinum toxin injections & oral baclofen)

3. Orthotist

• Review and recommend orthoses

What can you do?

• Monitor your child's muscle length, particularly calf muscles, hamstrings and the muscles around the hip. Ask your physiotherapist 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, Rehabilitation Specialist and orthotist for any splints or orthoses you child wears.
• Always attend clinic appointments for your child.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/