Early Intervention

Hyptonia Care Pathway

Sunday, November 11
1:45 PM - 3:15 PM
Location: Ballroom E/F/G - Convention Center

Four electronic databases were searched from 1996 to March 2017. Level of evidence and study conduct was evaluated using American Academy of Cerebral Palsy and Developmental Medicine criteria. Traffic lighting classification identified interventions that were green (proven effective), yellow (possibly effective) or red (proven ineffective or contraindicated). Thirty-seven articles were included. Nine studies measured orthotic interventions while four distinct studies published over nine articles measured treadmill interventions. Remaining studies measured impact of compression garments, massage, motor and sensori-motor interventions, positioning and mobility interventions.
Green light evidence supports treadmill training (to promote ambulation and gait characteristics) and massage (to positively affect muscle tone, motor development and use of vision) for infants with Down syndrome. These interventions are considered Yellow (possibly effective) for other populations. Green light evidence supports impact of orthoses on foot alignment for ambulatory children with hypotonia, while impact on gait characteristics is Yellow light and motor development may be negatively impacted (Red light) in pre-ambulatory children. All other interventions rated Yellow (possibly effective) and therapists should monitor using sensitive outcome measures.


Learning Objectives:

Ginny Paleg, Maryland

Physical Therapist

Ginny Paleg (ginny@paleg.com) is a pediatric PT from Silver Spring, Maryland. For the past 14 years, she has worked for her local school system in their early intervention program. Ginny earned her Masters Degree in Physical Therapy at Emory University and her DScPT at the University of Maryland Baltimore. This year she published a systematic review on interventions for children with central hypotonia and led the team that created the Hypotonia Care Path for the AACPDM. Ginny specializes in assessment and interventions for children at the GMFCS Levels IV and V. She is certified in HINE and GMA.


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Maureen Story, PT, OT

Physical Therapist/Occupational Therapist
Sunny Hill Health Centre for Children

Maureen Story is a Physical and Occupational Therapist who works at Sunny Hill Health Centre for Children in Vancouver, B.C. She was part of the team that developed and implemented the Positioning and Mobility Clinic at Sunny Hill Health Centre for Children. She is a clinical instructor at the University of B.C. She has been involved in international health projects in both India and China. She provided training and guidance to the staff at Guangzhou Children’s Hospital to assist them in developing the first pediatric seating clinic in mainland China. Maureen is the Chair of the International Seating Symposium Vancouver.


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Hyptonia Care Pathway

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