Improving mobility through Targeted Training


Sarah Bew describes how Targeted Training, alongside physiotherapy, can improve movement control and mobility.

Children with mobility problems may have difficulties with sitting, standing or walking and may be dependent on others or mobility aids to get around. At The Movement Centre we try to optimise every child’s movement control to gain as much mobility as possible.

The Movement Centre provides a specialist therapy called Targeted Training. The therapy draws on specialist physiotherapy and bioengineering. A child will start Targeted Training with support at the appropriate level and progress downward as far as possible as control is gained, this may be improved head, trunk or lower limb control. As a result of improved movement control children can gain new functional skills and independence, which can have a huge impact on their lives.

Targeted Training therapy can be suitable for children with cerebral palsy, global developmental delay, those who have an acquired brain injury, Down syndrome and other genetic disorders. We work closely with families and the course of therapy is tailored to each child’s specific needs. With the addition of a course of Targeted Training therapy a child with cerebral palsy is three to four times more likely to gain gross motor function than with conventional physiotherapy alone. It is noteworthy that increased functional skills and independence can mean there is less of a need for future equipment, medical intervention and carers. Targeted Training therapy works best in addition to regular physiotherapy.

Courses are usually 6-12 months in length, combining the use of a specialist standing frame and physiotherapy. It is different from other therapies because it works by placing a child in an upright position and the standing frame provides stability and support. The support happens directly beneath the area where movement control is a challenge. As progress is made the level of support may be lowered. This process mirrors the way in which movement control is naturally developed, from the head downwards.

Mobility is a key element to a child’s independence and even small gains in controlled movement can be life changing for individuals. If a child has no head control, they are completely dependent on everyone around them, however if they gain control over their own head movements this can open up opportunities such as learning to use an electric wheelchair that is controlled by a switch system on the head support. Controlling your own movements allows such an increase in freedom and sense of independence.

Many of the children who attend The Movement Centre have difficulties with their core stability. Using our specialist equipment and segmental approach, we simplify the learning of trunk control. Once control has improved children may then be able to roll independently, commando crawl or bottom shuffle, allowing them to explore their environment.

Where a child gains pelvic control, this opens up the world of crawling or walking on their knees, in reality this may mean they can move around a room and choose a toy from a different location rather than ‘only’ having the toy that has been placed near them; or get themselves into places they shouldn’t!

Specialist standing frames also allow us to work with children on their lower limb control and in some instances, we have been privileged to help them to stand independently and gain their first steps. A child’s first step is a huge moment for them, and their families and the implications on their future mobility can be immeasurable.

If you would like more information or details on how to refer a child to us, please visit our website:

Sarah Bew
Author: Sarah Bew

Sarah Bew
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Sarah Bew
Clinical Specialist Physiotherapist at the Movement Centre
Sarah joined The Movement Centre after qualifying as a physiotherapist in 2009. She carries out assessments, gives advice and recommendations, and lead on the delivery of therapy at The Movement Centre.
The Movement Centre W:
F: TMCOswestry
I: @themovementcentre4tt


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