Stretching exercises or passive range of motion (ROM) exercises are important to maintain flexibility or range of movement in the upper limb joints for children with epilepsy. It also assists with overall circulation and creates awareness of the lower limbs.

Safety precautions when exercising

  • Ensure that you had been taught the recommended exercises by an Occupational Therapist before carrying them out

  • Position your child comfortably in either sitting or lying

  • Keep your movements slow to allow muscles to relax; moving quickly may increase stiffness

  • Do not force the movement if the muscle or joint is stiff – move the arm within the safe range as recommended by your therapist

  • Observe for signs of pain or discomfort – if pain occurs, stop and check in with your therapist before continuing further

Your exercise regime

Each stretching exercise should be repeated 5-10 times

Hold the stretch at the end for 20-30 seconds

Repeat exercises every day – check in with your therapist on the recommended number of sets per day

Passive stretches

​Hip

Passive hip flexor and quadriceps stretch

Aim: To stretch tight tissue over the child’s anterior thigh and knee with the assistance of a caregiver.

Instruction: Position the child lying on their tummy with the knee bent. Place your hands on the front of the child’s thighs while cradling the knee, while another hand supports the lower back. Gentle lift the knee away from the supporting surface, applying a gentle stretch on the front of the child’s thigh. Ensure the hip does not roll in or out.

Passive hip adductor stretch

Aim: To stretch tight tissue over your inner thighs and knees with the assistance of a caregiver.

Instruction: Position the child lying on their back with hips and knee straight. Place your hands on the side of their thighs and gently move the lower limb towards you, applying a gentle stretch on the child’s inner thigh muscles. Ensure the hip does not roll in or out. Try to keep the other leg in a neutral position.

Precautions: Take care when stretching tight tissue around the inner thigh as excessive stretch or overpressure may cause tearing of the thin tissue around the inner thigh. Stop the exercise and check with your physiotherapist if you notice that your child is in pain during the stretch.


​Knee ​

Passive supine hamstring stretch

Aim: To stretch or maintain length in the muscles at the back of the child’s thighs (hamstrings) with the assistance of a caregiver.

Instructions: Position the child lying on their back with their hip and knee bent. Place your open palm on the child’s thigh and calves. Gently lift the child’s leg to straighten the knee as much as possible. The child should feel a gentle stretch in the back of their thigh.

Precautions:

  1. Seek medical clearance for patients with recent spinal cord or orthopaedic leg injuries.

  2. Apply stretch using gentle pressure only. Do not stretch if child is resisting as there is a risk of injury to the joint.

  3. Stop if child is in pain and check with your physiotherapist before continuing.


​Ankle ​

Prone soleus stretch

Aim: To stretch or maintain range in child’s calf muscles.

Instructions: Position the child lying down on their tummy. Place your hand around the child’s heel with your palm along the length of the foot and gently push the foot downwards with the knees bent. Ensure that the ankle does not roll in or out.

Supine soleus stretch

Aim: To stretch or maintain range in child’s calf muscles.

Instructions: Position the child lying down on their back. Place your hand around the child’s heel with your palm along the length of the foot and gently push the foot upwards with the knees bent. Ensure that the ankle does not roll in or out.

Supine gastrocnemius stretch

Aim: To stretch or maintain range in child’s calf muscles.

Instructions: Position the child lying on their back with your hand stabilising their knee. Place your other hand around the child’s heel with your palm along the length of the foot and gently push the foot upwards with the knees straight. Ensure that the ankle does not roll in or out.

Precautions:

  1. Apply stretch using gentle pressure only. Do not stretch if child is resisting as there is a risk of injury to the joint.

  2. Stop if child is in pain and check with your physiotherapist before continuing.

Ref: K21

Check out other articles on seizure and epilepsy in children:

Epilepsy and Seizures: Causes, Types and How to Manage

Seizure and Epilepsy Action Plan

Epilepsy: Treatment and Diet Tips

Child Neurological Conditions: Care Tips Resource

Epilepsy Exercises: Upper Limb Stretching

Caring for a Special Needs Child: Tips to Avoid Burnout