Activity based restorative therapy considerations for children: medical and therapeutic perspectives for the pediatric population

Activity-Based Rehabilitation (ABR) is a treatment approach that focuses on activating the neuromuscular system below the site of injury, aiming to restore function rather than compensate for its loss. ABR uses conventional therapeutic approaches, but at a higher frequency and intensity. There is increased focus on provided stimulation below the level of injury to optimize the nervous system for recovery and enhance the physical integrity of the body For children, ABR considers their developing nervous systems and aims to advance functions in line with typical development, integrating play-based therapy to improve participation and compliance.

• 1
  ABR, when initiated early and implemented intensively, can lead to significant developmental progression in children with SCI, facilitating the acquisition of developmentally appropriate skills.
• 2
  ABR principles, when applied in both acute and chronic SCI cases, can positively impact neurological recovery and function by integrating interventions above and below the level of injury.
• 3
  The intensity of ABR is vital to recovery post injury, and utilizing principles including FES, weight bearing, locomotor training, massed and task specific practice to activate the nervous system below the level of injury and optimize the nervous system for recovery.