HeartSpacePT

HeartSpacePT HeartSpacePT Shelley Mannell PT has over 25 years experience in pediatric Physical Therapy.

HeartSpace provides Physical Therapy clinic services to babies, children and adolescents with motor and sensory challenges at our Kids Therapy Circle location. Shelley has been a clinical faculty member at McMaster University and has developed HeartSpace Yoga and Meditation for children with special needs. She has co-created Dynamic Core for Kids, an approach to treating core strategy in children

with challenges. As well as clinical work, Shelley teaches continuing education courses for pediatric therapists internationally. HeartSpace has Michelle Duncanson PT who provides home-based services in Niagara and Kristyn Watters PT who serves children at home in the Hamilton area.

In the 2026 article "Impact of optimized AFOs on functional outcomes in children with spastic cerebral palsy" a small sa...
06/10/2026

In the 2026 article "Impact of optimized AFOs on functional outcomes in children with spastic cerebral palsy" a small sample of 10 children with spastic diplegia GMFCS levels I - III were studied. Functional impact was assessed when wearing standard AFOFC (= AFO-footwear combination) and then AFOFC designed using Optimal Segment Kinematics and Alignment to Rehabilitation (OSKAR).
Clinical takeaways:
*Total score on the Pediatric Balance Scale was significantly higher in the OSKAR AFOFC
*There was no difference between the AFOs in the Six Minute Walk Test or the Standardized Walking Obstacle Course.
Things I'm thinking about:
*Optimizing alignment at base of support in standing has a positive impact on postural control in children with CP
https://pubmed.ncbi.nlm.nih.gov/42029660/

This 2025 study "Muscle Tone and Stiffness Comparison in Ambulatory Children With Unilateral Spastic Cerebral Palsy: Imp...
06/04/2026

This 2025 study "Muscle Tone and Stiffness Comparison in Ambulatory Children With Unilateral Spastic Cerebral Palsy: Implications for Postural Balance and Functional Mobility" investigated symmetry in muscle activation in children with unilateral CP.
Clinical takeaways:
*Symmetry of lumbar extensor biomechanics correlated with better outcomes
*The authors noted that the results emphasized the crucial role of trunk control in rehabilitation strategies for ambulatory children with UCP
Things I'm still thinking about:
What tools do therapists use to understand and develop intervention to address postural control in children with CP?
Are we sure that the tools we are using reflect the dynamic systems nature of postural control?
https://pubmed.ncbi.nlm.nih.gov/39724873/

I'm off to St John's NL today - looking forward to meeting a wonderful group of therapists for another Creating Connecti...
05/27/2026

I'm off to St John's NL today - looking forward to meeting a wonderful group of therapists for another Creating Connections course. After that I'm continuing on to London and Venice and Milan - oh my!

Further to our discussion of the interconnected systems in CP - "Lower urinary tract symptoms in children with mild to m...
05/27/2026

Further to our discussion of the interconnected systems in CP - "Lower urinary tract symptoms in children with mild to moderate spastic cerebral palsy: Associations with functional level, trunk and respiratory parameters". If you guessed , you are correct.
Clinical takeaways:
*LUTS is common in children with CP GMFCS levels I - III
*Severity of LUTS increases with increasing GMFCS level
*Decreased trunk control, trunk muscle strength and endurance, respiratory functions and chest mobility were all associated with an increase in LUTS
IMO when we understand systems, we understand that isolated muscle training is inadequate to address motor control.
The authors of the study conclude:
"Isolated pelvic floor training alone may not be sufficient to improve lower urinary tract health in children with CP, but instead, a holistic rehabilitation approach that supports motor function, trunk stability and respiratory capacity should be adopted."
Things I'm thinking about:
*For ALL children experiencing LUTS, a holistic rehabilitation approach that supports motor function, sensory processing, trunk stability and respiratory capacity should be adopted.
https://pubmed.ncbi.nlm.nih.gov/40744762/

Celebrating PT Month here in Canada with a heartfelt shout-out to the incredible work Physiotherapists do every single d...
05/22/2026

Celebrating PT Month here in Canada with a heartfelt shout-out to the incredible work Physiotherapists do every single day. PediPTs are a special bunch — heart, knowledge, and endless dedication, all wrapped up in playful, purposeful care.
To mark the occasion, HeartSpacePT's annual spring sale is back! Save 25% on all online courses and course bundles from May 22–25, 2026 — just use code HEART25 at checkout.
Check them all out and grab your learning opportunities before the sale ends!
https://heartspacept.thinkific.com/collections

Our next article regarding systems in CP is "Examination of the relationship between respiratory muscle strength, postur...
05/20/2026

Our next article regarding systems in CP is "Examination of the relationship between respiratory muscle strength, postural control, functional exercise capacity, and daily living activities in individuals with spastic cerebral palsy: A case-control study". The study used a variety of standardized outcome measures.
Clinical takeaways:
*The authors concluded "Respiratory muscle strength is a key determinant of trunk stability, balance, functional capacity, and ADL performance in spastic CP."
*They recommended systematic assessment and incorporation of respiratory muscle training in rehab for children with CP.
Things I'm thinking about:
*Respiratory muscle training can be an easy addition to intervention for any child experiencing a postural control challenge
*Respiratory muscle training should also be undertaken for any child as part of their pre-op preparation
https://pubmed.ncbi.nlm.nih.gov/42057323/

Follow along over the next few weeks as we weave together a series of articles regarding postural control in children wi...
05/15/2026

Follow along over the next few weeks as we weave together a series of articles regarding postural control in children with CP. Today is "Ultrasound‑derived diaphragmatic kinematic and morphometry
parameters in children with cerebral palsy". The authors studied a variety of parameters in children with CP and compared these to typical controls.
Clinical takeaways:
*Study examined excursion, thickness and contraction/relaxation velocity of the respiratory diaphragm (RD)
*After adjusting for cofounding variables, inspiratory findings were not significant
*BUT reduced expiratory excursion and shorter expiratory time remained as the persistent impairments in respiratory function in children with CP
Things I'm still thinking about:
*We understand the RD is a primary muscle of central stability
*This information further contributes to our understanding of the postural control differences that children with CP experience
*Our intervention for children with CP should include respiratory muscle training whenever possible
https://pubmed.ncbi.nlm.nih.gov/42020792/

Stay tuned for details of the spring sale on all online courses May 22-25, in honour of PT month in Canada! Or sign up ...
05/12/2026

Stay tuned for details of the spring sale on all online courses May 22-25, in honour of PT month in Canada! Or sign up for my newsletter and be the first to get the deets and best discounts! https://heartspacept.com

This 2026 article "Functional Motor Assessment and Rehabilitation in Joubert Syndrome: A Narrative Review and Conceptual...
05/07/2026

This 2026 article "Functional Motor Assessment and Rehabilitation in Joubert Syndrome: A Narrative Review and Conceptual Framework for Pediatric Neurorehabilitation" discussed 10 studies on the topic.
Clinical takeaways:
*Functional assessments used as outcome measures were generally based on GMFM-88 and WeeFIM
*These functional assessments DID NOT FULLY CAPTURE the multidimensional nature of motor impairment particularly in relation to regulatory and sensorimotor domains.
*There is a need for more sensitive, syndrome specific assessment tools
Things I'm still thinking about:
*The vast majority of the neuromotor and neurodiverse children experience differences in regulatory and/or sensory domains
*All children deserve functional assessments that reflect the dynamic systems nature of motor control to assist in development of intervention support.
This is the reason I developed a systems model of postural control operationalized to support therapists in the clinic.
https://pubmed.ncbi.nlm.nih.gov/42073090/

04/27/2026

- Supporting how someone moves through the world — not changing who they are. That's the heart of an NDT approach to autism.

This World Autism Month, save 20% on Treating Movement Challenges in Children with Autism Spectrum Disorder: NDT for ASD. Use code WAM20 at checkout — offer ends April 30.

See REFLECTIONS Link in bio for more info or click here where you can: https://loom.ly/IlovFH4

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