by Ryan Rubio, SPT
Introduction
Finding activities for pediatric patients that are both therapeutic and enjoyable enough to keep a child engaged can be difficult as I discovered on my clinical rotation in the Durham Public School System. While trying to come up with creative intervention ideas, I began to incorporate elements of my background in martial arts, which I discovered could be both fun and help children progress towards their therapy goals.
Martial arts training can improve balance, coordination, breathing, upper and lower extremity strength, flexibility, focus, discipline, social skills, and self-confidence. These aspects make it a great sporting activity to recommend to pediatric physical therapy patients with a wide variety of physical and cognitive deficits. My capstone project advocates for the use of martial arts as a pediatric therapy intervention, and it provides several tools for school-based or pediatric physical therapists.
Project Overview
Unfortunately, there is limited research on the effects of martial arts training on children with developmental disabilities. I was able to find some literature that looked at the effects of martial arts in children with autism spectrum disorder, developmental coordination disorder, epilepsy, and attention deficit hyperactivity disorder. Here is the evidence table on the studies I found, many of which were either poorly designed, provided low levels of evidence, or did not demonstrate statistically significant improvement in the outcome measures pre- and post-intervention. What is significant to note is that nearly all the studies showed positive trends, and that both children and parents reported being pleased with the results of the martial arts lessons.
Case reports and anecdotal evidence supports the use of martial arts as a low risk, relatively low cost adjunct to physical therapy. I interviewed Amy Sturkey, a physical therapist who regularly uses karate instruction with her clients. She has had great success with this and swears by the benefits of martial arts-themed PT. She does not base her recommendations on any formal research, but rather on the positive results she has seen firsthand.
I am also confident in recommending martial arts based on my experience in the school system. In a short time I saw children progress towards their goals, start to come out of their shells, and engage in their therapy sessions. I truly believe that martial can be a perfect activity for the majority of pediatric patients that we see.
Resources
I have created several tools for pediatric physical therapists to encourage them to consider recommending martial arts training for their patients. Laurie Ray, who is one of my advisers, has offered to help distribute these resources to school-based therapists. On a website, I present these materials:
- A voicethread presentation detailing the benefits of martial arts for pediatric patients
- A video in which I demonstrate some basic martial arts techniques that therapists can use in their treatment sessions
- A brochure for therapists to give to parents whose children may benefit from martial arts
The voicethread and video are intended as a learning tool for pediatric physical therapists in a variety of practice settings. The brochure is intended for a broader audience, all of whom can advocate for the use of martial arts as a method of promoting an inclusive physical activity (read the health literacy assessment here). This brochure can be utilized by physical education teachers, adaptive physical education teachers, classroom teachers, physical therapists, and occupational therapists to inform children and their parents as to the potential benefits of this activity.
I have also created a survey in order to receive feedback on the effectiveness and usefulness of these tools. I am hopeful that more children will get involved in martial arts and benefit from the various rewards that it can offer, just as I did all those years ago.
Special thanks
I want to acknowledge the contributions of my capstone committee members Melissa Scales, Laurie Ray, and Karen McCulloch; my former CI Shelley Rhudy; Amy Sturkey for her time and invaluable input; Mike Gross for helping me with the voicethread technology; and my wife Jessamyn, who did amazing work with the design of my power point, brochure, website, and video presentation. I couldn’t have done it without her.
6 Responses to “The Benefits of Martial Arts for Pediatric Patients”
Ryan Rubio
Thanks Debbie! I’m glad you enjoyed the project, and I hope to share this with as many PTs as possible. I believe that this sport can provide so many benefits to the children we see, and I am encouraged that experienced therapists seem to agree with me.
Debbie Thorpe
Ryan
Congratulations…wonderful project! I really enjoyed looking at your evidence table. I found it interesting that most of the evidence is in children with DCD. However, I find martial arts very valuable to train balance, posture and balance in children with cerebral palsy. You demonstration video was great. Very appropriate for therapists that have no martial arts experience like me!
You might want to consider a different title for your presentation prior to posting on your website. We know that martial arts is not physical therapy unless the techniques are administered by a PT, however, the title may be misleading to the lay public. Just a thought. This would be a nice thing to share with Dan G. Good luck. I think you will make a creative pediatric PT is you so choose:)
Debbie
Ryan Rubio
Thanks for the kind words Cathy! I am glad you enjoyed the capstone and that you will be able to use some of my suggestions. That is a major compliment to me, and it makes me feel like I worked on a project that has value. I will be sure to pass your comments on to my wife. We both love positive feedback.
Cathy Howes
Congratulations Ryan. I enjoyed viewing your Capstone. Way to take one of your passions and integrate it into your career! If we look at the ICF model of disability, you have absolutely provided suggestions to increase activity and participation and environmental modifications for children with disabilities! How fun for them and the PT as well. I can’t wait to integrate some of your suggestions and share the information with families. Tell your wife that she did a nice job on helping your materials look so wonderful. Cathy
Ryan Rubio
Noelle-
Thanks for the comments, and I am glad you enjoyed the presentation. There were a couple of girls that I used some basic techniques with, but none that I gave one-on-one martial arts lessons to. I specifically remember getting a girl to practice SLS by having her kick a target. These girls were receptive to it, more so I think because it was something different, and not because they were specifically excited by the idea of martial arts. But I think both males and females should be encouraged to try martial arts. Boys are typically more into it, but more and more girls are taking lessons.
I had no real barriers to implementing this intervention. For the two boys who received more focused karate lessons, I asked their mothers for permission. I also made sure to emphasize that if I ever heard that they were using what I taught them inappropriately, the lessons would stop. Thankfully, I never had an issue. One boy had a very short attention span, so it was difficult to get him to focus at first, but he started to do better once I gave him a target to aim for when he did his techniques.
Just based on my (limited) experience, I think kids who are socially withdrawn would benefit. I was very shy and not into team sports when I was a kid, and martial arts was perfect for me. I was interacting with people, but there was no team whose performance hinged on my abilities. So the pressure I felt from sports like soccer and basketball was gone. This is why I also swam for so long. You are on a team, but for the most part the events are individual performances. The 10 year old boy who had spina bifida really was having major social issues. He was withdrawing, and he felt isolated from his classmates. He was letting his schoolwork slide and deliberately not alerting his teachers if he needed to be taken to the bathroom. During the time I spent with him, he opened up and was happier than normal. So I think kids who lack self-confidence or who have poor self-image would greatly benefit from this intervention, whether they have a developmental disability or not.
Noelle Martin
Ryan,
Great capstone project! I really like the website and all of your products that you have attached to it. It makes it easy and effective to have all of these materials in one place. I’m sure the school based PTs will heavily utilize this website and information! Thinking back to my school based PT rotation, we had some kids that would have loved this intervention. As you stated, this mode of therapy is appealing to kids and breaks them out of their shell so to speak. This is also great information for PTs and SPTs to know so that we can try these techniques, share the information, and refer these patients and their families to the proper resources. I will definitely keep this information in mind! Did you implement martial arts with any girls? If so, were they receptive to it? Were you faced with any barriers when using this type of treatment? Based on your experiences, do you have any guidelines or suggestions on how to identify kids who would benefit and appeal to this type of intervention?
Thanks for sharing this great therapeutic approach! Great job!
Noelle