Bracing and orthotic management for children with disabilities is often overlooked in physical education. Orthotics may be defined as custom-made devices that are fabricated to address musculoskeletal deformities, deficits, or discrepancies, while attempting to increase function or regain mobility of a specific musculoskeletal structure.

Orthotic wearing schedules, maintenance, and compliance are among some of the most important components leading to successful orthotic interventions or treatment plans. Physicians, orthotists, and therapists work diligently to select the most appropriate orthotic device for a child while considering his or her diagnosis, physical limitations, level of cognition, gait abnormalities, range of motion (ROM), skin sensitivities, and environmental factors. Because children wearing orthotic devices spend most of their time in school settings, it is important for adapted physical educators to understand the basic components of orthotic management in order to meet treatment goals, increase physical function, and most importantly to ensure the safety of the child.

Wearing Schedules

Typically, orthotic braces are prescribed to maintain alignment, prevent further deformity, and facilitate independence during functional activities. Orthotists and therapists generally instruct orthotic patients to wear the device during all physical activities, and recommend disuse of the orthosis during several activities of daily living such as bathing and sleeping. Adapted physical educators should keep the following factors in mind when working with special needs students who wear custom-made orthotics:

Bracing and orthotic management for children with disabilities is often overlooked in physical education. Orthotics may be defined as custom-made devices that are fabricated to address musculoskeletal deformities, deficits, or discrepancies, while attempting to increase function or regain mobility of a specific musculoskeletal structure.

Orthotic wearing schedules, maintenance, and compliance are among some of the most important components leading to successful orthotic interventions or treatment plans. Physicians, orthotists, and therapists work diligently to select the most appropriate orthotic device for a child while considering his or her diagnosis, physical limitations, level of cognition, gait abnormalities, range of motion (ROM), skin sensitivities, and environmental factors. Because children wearing orthotic devices spend most of their time in school settings, it is important for adapted physical educators to understand the basic components of orthotic management in order to meet treatment goals, increase physical function, and most importantly to ensure the safety of the child.

Wearing Schedules

Regular or adapted physical education teachers, physical therapists, and occupational therapists could all use Special Olympic (SO) lead-up skills as objectives for children with disabilities IEPs.

Linking movement skills to Special Olympics offers the following benefits:

1. Extends teacher instructional knowledge toward teaching sports to children with disabilities;
2. Links skills to functional activities;
3. Helps develop basic skills for more successful participation and inclusion in team sports;
4. SO offers life-long sports opportunities. By law ISDs must make a plan and IEP objectives will help prepare children with disabilities for life after school that includes recreation. Adapted PE, PE, PT, and OT starting at age 12 to graduation (21 years old need) must prepare them for continued physical activities;
5. SO competition offers a chance to highlight the athlete’s achievements to friends, family, teachers, and volunteers; and
6. The SO event (opening ceremony, competition, awards, food, dance) is a great avenue for everyone involved to congregate in a fun way, express joy, love, and care toward each other as we celebrate with the athletes.

The Individual Skills Competition (ISC) events for various sports, allow the athlete to practice important fundamental skills that ultimately lead up to organized sporting events. In the complete document attached to this introduction that you are invited to download, we share our experience having presented 10 sports each having several lead-up skills to perform. We have shared several Individual Education Program (IEP) objectives for each sport. Note that, some of the IEP objectives are lead-up components to the ISC, meaning that some SO athletes cannot perform all the skills needed to finish the event. For example, in swimming, athletes are expected to swim a distance of 15 meters. But perhaps we have a student, “Jo” who has Cerebral Palsy and can only swim 10 meters before getting fatigued and unable to finish the race. In this case, Jo’s objective might be to increase his distance by perhaps 20%, 2 out of 3 times. Jo is then working toward finishing the race. Every athlete will have unique abilities and the IEP objectives should reflect where progress and improvement is needed and can realistically be achieved.

This workout program is designed to give physical educators the tools needed to increase mobility, strength, and endurance for children with cerebral palsy (CP). Suggestions about body characteristics, stretching ideas, and workout strategies will also be presented. We share four complete workout programs designed on a continuum from less able to higher functioning such as for children who use wheelchairs, walkers to crutches or canes.

As with any exercise program, intensity, duration, and frequency need to be optimized.
To help ensure the endurance component, children should maintain their heart rate at 60 to 80% of their max for 35 minutes.  Note: if students are exercising in a wheelchair or lying horizontal, reduce their maximum heart rate by 20 to 30 beats per minute.  For example, a girl 10 years old who uses a wheel chair, would have a target range of 220 – 20 or 30 = 190 or 180 x .6 to .8  = 114 to 152 or 108 to 144 beats per minute.  Exercises should be three or more times a week.  Remember, when doing weight lifting, move quickly from set-to-set or machine-to-machine to help maintain a higher heart rate.

Key Aspects to Remember and Look For

People say “a picture” is worth 1,000 words and often helps to explain ideas. Well, the authors hope this is true because, in this article several illustrations will be presented depicting how to set up inclusive activities. Follow these simple suggestions and equipment ideas and you’ll create an environment that fosters inclusion.

In general, the transition of ideas from the written word to actual practice is difficult. Applying inclusion ideas to the gymnasium often seems almost impossible. After years of teaching inclusion classes at the university, we understand that students quickly forget what was learned in the classroom and fall back on old behaviors. In fact, most future physical educators are ingrained with “sports” activities that have rules, specific equipment, and one set of standards, which is the opposite of inclusion.

Because most games and skills taught and played are for the middle 68% of the population – it’s perhaps understandable to try to make the biggest group happy – little thought is given to the high-end and the low-end ability levels. The children with advanced abilities are bored to death with the rinky-dink un-challenging games, while the lower-end are frustrated and over-challenged because they are unable to do the skills. In both cases, children are not being challenged at their unique level.