Wheelbarrow walking is one of the best techniques for children with low tone or neuromotor dysfunction. This technique can help improve:
core strengthening, and
upper extremity strengthening
Materials needed - Motivating toys or activities to walk forward to. For example:
Toys of high interest
Ask the child to put his/her hands on the floor under the shoulder
Take the child’s legs and lift them (so their hands are pushing down the floor).
Use your hands to support the child’s legs/ hips while the child walks on their hands to get their favorite toy. Make sure the child is lifting their head and looking at the toy.
Wheelbarrow walking can be made easier or harder depending on how you place your hands to provide support.
Easiest position (support at hip)
The easiest position for wheelbarrow walking is when the therapist or parent holds the child’s hips when their hands are on the floor and makes them walk forward with their hands.
Harder position (support at the thighs)
When the child has achieved the easiest position, we can grade to the harder position.
Now the therapist or parent will hold the child at the thighs whose hands are on the floor and make them walk forward with their hands.
In this position the child requires more stability on the muscles of the hands, arms, shoulders, core, and hips.
Hardest position (support at foot)
As and when the child’s strength and stability progress, s/he is ready for the next level of strength building (the hardest position).
The therapist or the parent will now hold the child at the ankles to help him/ her walk with their hands. If the child arches their back, revisit the previous step; else, progress steadily further on by gradually increasing the distance covered.
How to grade the wheelbarrow walking more harder
Add a slope or unevenness to the ground. Ensure the ground is not too rough.
Go up a ramp
Do the activity outdoors (on grass or sand)
Increase distance of walking with their hands
Be careful the child does not fall forward and hit their head on the ground.
Ensure the child is not uncomfortable with the procedure. The child must feel safe during the process of learning.
Based on the child’s strength, more support may be needed. Be open to provide adequate support.
Limit to a short distance initially, to avoid fatigue.
Avoid being an overachiever! Remember it’s all about building strength and it takes time.