Dynamic Movement Intervention (DMI) - SO, what is it?
First and foremost, we would like to congratulate our very own Physical Therapist, Chloe Isaacs, PT, DPT, CIMI-2 on the recent completion of her certification in DMI Therapy and for being the FIRST in the state of Kentucky to become certified and bringing this method of treatment to Marshall Pediatric Therapy. Chloe is a graduate of the University of Kentucky where she received her Doctorate in Physical Therapy.
In this post, we will not only introduce you to all things associated with DMI, but we will show you a few examples of DMI techniques first-hand from one of Marshall’s current patients, our sweet friend, Lillie. We are confident that the discovery and implementation of this technique have been a “missing link” for the overall effectiveness of some therapeutic treatments. We are excited to see how this form of intervention will help shape the world of pediatric therapy and future patients.
DMI Therapy. What is it and how exactly could it help benefit MY child?
DMI or Dynamic Movement Intervention is defined as “a therapeutic technique that is used in both Physical Therapy and Occupational Therapy to help treat children with motor delays by improving automatic postural responses and promoting progress towards developmental milestones." The goal of DMI is to provoke a specified active motor response from the child in response to defined dynamic exercises prescribed by the therapist. This comprehensive intervention incorporates current research on neurorehabilitation, technologies, and methodologies. DMI stimulates neuroplasticity to facilitate new neuronal connections and the development of motor milestones.
Who is DMI Therapy for?
Regardless of the level of cognition and extent of neurological deficit or damage, affected children benefit from DMI motor intervention as it pertains to stimulating neuroplasticity in the developing brain. Children diagnosed with any type of motor delay including conditions such as:
Children at risk, such as those who are born prematurely can also benefit from this therapy due to the strong neuroplastic changes that this treatment stimulates within the developing brain.
What happens during DMI?
After a brief assessment, the therapist will identify areas of deficit, which will guide the treatment. The therapist chooses exercises that will challenge the child’s neurological system to the highest level of skill as well as exercises that develop the core and foundational milestones. Exercises involve movement against gravity, progressively more challenging support, provocation of desired movements, as well as postural and strength challenges.
During a treatment session the child will complete many different exercises which provide novel and varied sensory and motor challenges and each exercise is repeated around 5 times. Exercises may be repeated from session to session until the movements become automatic, which results in improved balance and function. Exercises are conducted on a tabletop or the floor based on the child’s abilities.
DMI Therapy works well in conjunction with other therapeutic techniques and therapy equipment. These are often combined in a treatment session to provide better alignment and enhance optimal outcomes.
What does DMI focus on?
1. Gross Motor Skills – Improving the gross motor skills of children from birth by developing automatic motor movement. (Promotes Neurological Maturity)
2. Gradual Progression – Continuously increasing the challenge to encourage the child to respond with greater independence.
3. Alignment and Postural Control - All exercises focus on optimal anatomical alignment and stimulate postural control and verticality.
4. Range of Motion - Muscle and joint range of motion is achieved by movement (Dynamical and functional stretching).
5. Balance – Improved balance is a common thread through most DMI exercises.
6. Functional Movements – Improving actions and skills that lead to attaining milestones such as rolling, sitting, standing, and walking.
7. Somatosensory Development - The strong sensory information provided by the exercises sends afferent messages to the brain to create specialized synapses that fine-tune balance, muscle control, and movement.
8. Modifying Tone, Primitive Reflexes, and Abnormal Patterns of Movement - DMI strives to provide normalized movement patterns to children with neurological dysfunction to assist with the integration of disruptive primitive reflexes.
9. Global Development - DMI focuses on gross motor skills, however, many other skills develop as a byproduct of this intensive intervention
One really great component of DMI is the encouragement of the parent’s involvement and participation in order for the treatment to be the most successful. At Marshall, we are advocates for this approach as well. The success of one’s individual therapy journey far surpasses what is introduced and accomplished in the clinic setting itself. When a parent is willing to learn and takes therapy techniques home that are assigned by our professional clinicians, they are continuing to challenge the child to reach milestones at a much quicker pace.
"You always want to help challenge the child at their highest cognitive level. If you aren’t challenging the brain enough, especially during its prime developmental years, the brain is not able to successfully create neuro-pathways. It’s always important to remember that If you aren’t going out of your comfort zone, you aren’t going to see the change.” - Chloe Isaacs, PT, DPT, CIMI-2
Neuro pathways help to send signals from one side of the brain to the other. There are three types of neurons. Motor = controls one’s muscles Sensory = stimulated by our senses (sight, smell, taste, touch, hearing), and inter-neurons = help connect the neurons together. When there’s a disruption in the connection, this is when the child might experience difficulty with certain skills that require the intervention of therapy.
We want to introduce you to one of our current patients and friends, Lillie, and her awesome mother, Brittany, who have opened up to share their pediatric journey and testimony so far. To advocate for Marshall, and for DMI. Brittany shares that traveling the distance from Mt. Sterling to receive services at Marshall Pediatric Therapy is "WELL WORTH IT!"
Lillie is a little over two years old and has been coming to Marshall since November 2022. A brief glimpse at her diagnosis: Lillie was born 35 weeks premature and has the genetic disorders of both Trisomy X and Trisomy 18. Due to these conditions, Lillie has some onset setbacks developmentally that we are working through.
Nearly 1 in 1000 females are born with Trisomy X, in which instead of two chromosomes, they are born with three. Though this condition is identified as genetic, it’s usually not something that is inherited, it is rather due to genetic error at random
Symptoms associated with Trisomy X:
Delayed development of speech and language skills
Delayed motor skills such as sitting up and walking
Behavior problems developed later on such as ADHD, Anxiety, and Depression
Problems with fine motor and gross motor skills, memory, judgment, and processing of information
Other symptoms might include:
Activity of seizures
Widely spaced eyes
Curved pinky fingers
Weak muscle tone (Hypotonia)
Problems with their kidneys
Premature ovarian failure
Trisomy 18 is also referred to as Edwards Syndrome, also a chromosomal condition that is associated with many abnormalities in multiple parts of the body including:
Slow growth rate
Low birth rate
Abnormalities of organs that develop prior to birth
A small or abnormally shaped head
Smaller jaw and mouth
An alarming statistic is that children with Trisomy 18/Edwards Syndrome often times present so many life-threatening medical complications, that they oftentimes die before birth, or within one month after birth. 5-10% of children diagnosed with Trisomy 18 live past their one year and those that do, experience a high level of severe intellectual disabilities.
We are so grateful to be part of sweet Lillie's journey as a culmination of innovation and reliable resources that provide hope and peace of mind. When you are a patient at Marshall, you are treated like FAMILY!
Interested in booking an initial evaluation with one of our clinical experts!? We've got you covered here!
Are you a clinician and Interested in becoming certified in DMI Therapy? Learn more here.