Crawling while dragging one side

Hello!

[When should it be a concern/what to look out for]

I have a kiddo that had Grade3-4 IVH, that is resolving. He crawls quickly but tends to drag his right side a little with increased right trunk flexion while crawling. What is a good way to tell if this is due to strength/muscular issues or if there are underlying concerns such as any assessments that can be done via telehealth.

He is able to climb the stairs and often goes up with his left leg, but is starting to use his right leg more. He can use his right leg on the stairs with gentle tactile cues to hold his left leg down. He also has a preference to pull to stand through L 1/2 kneeling but is capable of using his right leg.

Thank you in advance!!

I don’t have a great answer but it seems like it might be strength. Maybe look at reflexes? I know it’s probably hard. Also maybe have parents move the extremities through ranges and have them do left vs right and let you know if they feel any differences like catching or resisting? You could also do girth measurements of the leg. Check righting reactions of the trunk and neck. Not sure if this helps at all but just thinking through my fingers!

@PT4kidz80 @magicmomentstherapy @PTJulie @PTMelissa @Swtintle @Tinytotspt @dixita88 @Emily_Whigham_Heisey do any of you have suggestions for :point_up:

Crawling differences between right and left side are sometimes related to tightness of trunk muscles. Testing elongation of R vs L on a very small peanut ball (milliard brand 24 “) where there feet are planted but righting and elongation can occur in the frontal or coronal plane would be my first step of assessment as well as an activity to do daily to equalize those muscles :slight_smile:
Let me know :slight_smile:
Sincerely
Jennifer Aguillard PT PCS
Magic Moments Physical Therapy

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Their * muscles

Hi @Blaire.10, welcome!

Due to the diagnosis of IVH and from what you’re describing, I would want to explore if there is a generalized hemiparesis. Have his mom put him in sitting with his shirt off and look for scapular and trunk asymmetries. Also, in the quadruped position, does he have any scapular winging on the right side? I would also look at active range of motion of his upper extremities and bilateral hand use. If you see difficulty with bilateral and manipulation hand skills, an asymmetrical trunk, and decreased movement (or movement of the UE that is not fluid), I would suspect weakness.

Keep us updated :heart:

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