Trouble Standing With Feet Together? Balance Training for Cerebral Palsy | Athetoid CP #8

I’m continuing this series with my co-instructor, Ne’Quan 👨🏾‍🦱💙 Ne’Quan has spastic athetoid cerebral palsy, and I was his physical therapist from age 9 through age 26. When we began filming this playlist, he was 27 — and at this point, we are simply dear friends. Although Ne’Quan is an adult, the motor challenges he experiences are the same challenges I address across the lifespan. The strategies used in this series apply to young children and adults alike — what changes is how the task is presented. With younger clients 👧🏽👦🏼, these skills are often built through play. With Ne’Quan, we work directly using verbal cues, repetition, task progression, and long-established trust. 🧠 What This Video Focuses On In this session, we work on narrowing the base of support while standing by bringing the feet together. Because of the fluctuating tone seen with athetoid cerebral palsy, maintaining balance can be very challenging. Ne’Quan often stabilizes by activating his glute muscles strongly, which causes his legs to externally rotate and his feet to turn outward. For this activity, I ask him to bring his heels together and narrow his stance as much as possible. Even getting the heels together while the toes remain apart is a meaningful balance challenge. We then: • Maintain the narrow stance • Count down to create a clear time goal • Encourage him to stand independently without leaning You’ll notice that I stay close for safety and cue him when he begins to rely on support. He does not stand perfectly still — and that is exactly the point. This exercise shows the constant postural adjustments required to maintain balance when the base of support is narrowed. 🧠 Why Narrowing the Base of Support Matters Standing with the feet together challenges the body to: • Control postural sway • Maintain alignment through the hips and trunk • Reduce reliance on wide stance stability • Improve upright balance control These skills help support standing endurance, walking control, and functional mobility across the lifespan. 💡 Therapy Tip When we practiced this in the clinic, we often used two helpers. • One person assisted with balance support • The other positioned the feet together Once the feet were placed, the goal was to see how long Ne’Quan could maintain balance independently. If your client cannot bring their feet together yet, you can modify the task by: • Drawing a chalk square on the floor • Using tape or paper as a visual boundary Then ask the individual to place both feet inside the square to gradually narrow the stance. 📌 About Ne’Quan • Walks in daily life with someone nearby for safety 🚶🏾‍♂️ • Does not speak; communicates using gestures, signs, an alphabet board, and a switch-accessed communication device 💬📱 • Strong receptive language skills • Limited hand control affecting fine-motor and self-help tasks 🤲🏽 • Functionally most similar to GMFCS Level III ⏱️ Chapters 00:00 Introduction & Meet Ne’Quan 00:23 Ne’Quan Introduces Himself 00:38 Athetoid CP & Balance 01:05 Standing With Feet Together 01:30 Attempting To Narrow The Stance 01:50 Holding Balance 02:00 Countdown Challenge 02:20 Therapy Tip: Positioning The Feet 02:45 Modification Ideas 03:05 Closing 🎥 Watch All of Ne’Quan’s Videos (Playlist) https://www.youtube.com/playlist?list=PLAkJbMrHyKjNPEoC-A5MaSjxfr_omXGDS 🌐 More Resources Website: https://www.pediatricPTexercises.com Facebook: Pediatric Physical Therapy Exercises Email: amysturkey@gmail.com 💬 Captions / Accessibility I’ve reviewed and corrected the captions for clarity. To turn on captions: click CC. To change caption language: Settings → Subtitles/CC → choose a language or Auto-translate 🌍 📚 Books by Amy Sturkey (Amazon) Children’s Books P is for Poop and Pee Accidents — https://www.amazon.com/dp/B0BLSRJ483 A is for Anxiety — https://www.amazon.com/dp/B09LXQ3W6V A is for Attention Deficit Hyperactivity Disorder — https://www.amazon.com/dp/B08QH9H5HR C is for Cerebral Palsy — https://www.amazon.com/dp/B088TSJCYP D is for Down Syndrome — https://www.amazon.com/dp/B079P8HH49 A is for Autism — https://www.amazon.com/dp/B071F4FFTB Professional Pediatric Physical Therapy Exercise Books Pediatric Physical Therapy Exercises for the Hips — https://www.amazon.com/dp/0998156736 Pediatric Physical Therapy Exercises for the Knees — https://www.amazon.com/dp/0998156760 Pediatric Physical Therapy Exercises for the Ankles — https://www.amazon.com/dp/B08TX2ZCFD