Low Tone - Hypotonia

Hypotonia is a state of low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength.

Low tone/hypotonia refers to the muscles’ ability to sustain a contraction. Muscle strength refers to the muscles’ power. Low muscle tone cannot be changed, but improving strength can compensate for the underlying low tone to help support the child through daily tasks and play.

Characteristics of low tone/hypotonia:

Joint hypermobility & instability
Slouched sitting posture
“W” sitting
Difficulty holding head upright (propping head with hand)
Difficulty sitting for long periods of time
Props self up with hand/arm while sitting on floor
May fatigue quickly; preference for sedentary activities
May appear clumsy with gross motor activities
May have difficulty climbing, running, jumping, or hopping when compared to peers.

Physical Therapy

Treatment

Core Exercises:

While lying on his/her back, have your child kick their legs up in the air
Wall kicks - have your child lie on their back with their head up against the wall, have them bring their legs up to the wall and touch it
Sit-ups with knees bent, have your child pull-to-sit
Planks
Push-ups - either on the knees or their toes
Sit on an unsupported surface without back support (bench, small ball, chair)
Play in tall kneel
Crawling - on all fours, reaching for objects, throwing objects

Shoulder strengthening and stability:

Planks
Push ups
Crawling
Working on a vertical surface
Leaning on elbows while lying on belly

Activities to improve strength and endurance:

Encourage climbing, rock wall climbing, monkey bars, and climbing/crawling/pulling up a slide.
Use big movement/heavy work activities such as wheel-barrow, bear, crab, and hill walking.
Practice jumping activities such as double leg jump, frog jump, and side jumps.
Occupational and physical therapy treatment to strengthen and improve motor planning will help the child perform age appropriate skills.