To achieve gains in strength, workouts need to be at least 20 to 30 minutes long, take place a minimum of 2 to 3 times per week, and

continue to add weight or repetitions as strength improves. There is no additional benefit to strength training more than 4 times per week.5

Floor Core Strengthening

Step 1
Instruct the child to lie on his back with knees bent and feet on the floor, pull the belly button toward the floor, squeeze the bottom tightly and lift so that only the head, shoulders and feet are on the ground. The body should be straight like a board. Hold this for three to five seconds, and lower. Begin with one to five repetitions, increasing to 15 as the child can tolerate. Increase from one set to two sets when 15 repetitions are able to be performed.

Bridges
Lie on your back with your feet flat on a balance board, knees bent, legs together, arms at your sides, and abs engaged. EXHALE: Keep your abs engaged as you push your hips straight up toward the ceiling, lifting your glutes and lower back off the floor. INHALE: Slowly lower your hips back down to the start position to complete one rep. Don't put any pressure in your head or neck; balance your weight between your feet (on the board), your shoulder blades, and your arms. Only bridge your hips up as high as you can go while maintaining balance, control and good form.

Step 2
Flip over onto the stomach, and balance on the elbows and toes, again, keeping the body straight like a board. Squeeze or contract the body so that it is nice and tight, hold for 10 seconds. Increase in five-second increments as can tolerate with a goal of one minute. Repetitions can be added as can tolerate

Step 3
Roll onto back, and repeat Step 1, but this time, raise the right leg while it is straight, so that it is parallel to the left leg, being careful not to drop the right hip. Keep the tummy nice and tight. Hold for three seconds. Repeat with the left leg and hold for three seconds. Start with one to five repetitions on each side, increasing the sets by one each time five repetitions can be performed with relative ease.

Step 4
Roll onto the left side and support the body on the left elbow, keeping the body straight and tight. Hold for 10 seconds, increasing by five-second increments until a goal of 30 seconds is able to be performed. Repeat on the right side.

Step 5
Standing with feet shoulder width apart, toes pointed straight ahead, slowly lower into a squat. Do not bend the knees more than 90 degrees. Begin with one to five repetitions. Add another set with the goal of three sets of 10 repetitions.

Balance Core Strenghtening

Step 1
Stand on one foot and balance for as long as possible. Switch to the other foot and repeat. To make this more difficult, try swinging the opposite leg around to shift the balance a bit. Try it with closed eyes. To add another level of difficulty a ball can be thrown during the balance a bit out of easy reach. This can be done to the left side, to the right, overhead, down low, up high-anything to create a reaching off balance where the trunk needs to stabilize.

Step 2
Stand in the center of a wobble board and try to keep the edges from hitting the ground. This can be performed forward and back, as well as side to side. Begin with the goal of balancing for 10 seconds with the goal of one full minute. Sets may be added with improvement.

Step 3
Hop on the left foot forward and back five times and then side to side five times. Repeat on the right foot. Increase repetitions in increments of five until 25 repetitions is achieved.

Crunches
Starting Position
Lie on the floor or a mat on your back, with knees bent and hands behind head. Feet should be flat on the ground. Keep a space between your chin and chest (looking diagonal towards the ceiling).

Action
EXHALE: Raise your chest until your shoulder blades lift off the floor. INHALE: Slowly lower back to floor.

Special Instructions
Don't use your hands and arms to help lift you up - use abdominals and hips.

Swimming
Starting Position
Lie facedown, arms and legs outstretched a few inches above floor, head in line with spine.

Action
Raise left arm and right leg off floor. Lower and repeat with right arm/left leg. Return to start and

repeat the series.

Special Instructions
Don't lower arms or legs completely until the end of the set. Don't hold your breath. Muscles Worked: Lower back

Stability Ball Training

Step 1
Sit on the ball and gently bounce up and down. As simple as this seems, this develops the core musculature.

Step 2
Sitting on the ball, lift the right knee and left arm up toward the ceiling being careful to keep the ball in place. Switch and lift the left knee and right arm. Repeat this in a marching fashion 10 repetitions, increasing to 25 repetitions.

Step 3
Sitting on the ball, rotate the lower body in a clockwise manner 10 times and then back the other way 10 times. Increase this to 25 times in each direction.

Step 4
Walk the feet away so that the lower back is in the middle of the ball. Do a partial sit-up from this position. If control of the ball cannot be maintained, lie on the floor with feet on the ball and perform the sit-up from this position. Start with five repetitions. Increase to 25 with increments of five repetitions each.

Step 5
Lie down on the floor with the ball between the ankles, bend the legs to 90 degrees at the hip, and lift the hips off the floor. Begin with five repetitions with a goal of 25 repetitions

HIP STRENGTHENING EXERCISES

 Karate kicks at a bolster; Relay races while holding a balloon or small ball between the legs

Dirty Dog
The dirty dog is a beginner level body weight exercise for the hips and abs. It is a simple exercise that involves externally rotating the hip from a kneeling position. To perform the dirty dog, kneel on a mat or carpet and place your hands on the floor in front of you. Straighten your elbows and flatten your back so that it is parallel to the floor. Adjust the placement of your hands and knees so each knee is directly in line with your hip bones and each hand is in line with your shoulders. Then, lift your left knee an inch from the floor and swing it outwards without changing the bent angle of your knee. Do not change the flatness of your back or move your shoulders. Return the left knee to the floor. Repeat on the right.

Lying Hip External Rotation

The lying hip external rotation is another body weight exercise that works each hip in isolation. You lie sideways to do this exercise so that you can externally rotate your top hip. To perform the lying hip external rotation exercise, lie on your right side with your head propped up by your right arm. Align your left leg directly on top of your right and bend them slightly. Squeeze your abs tight and place your left palm flat on the floor in front of you to support your sideways position. You do not want to roll forward or backward during this exercise. Next, raise your left knee away from your right but keep your feet touching. Repeat on the other side.

Standing Hip Abduction

The standing hip abduction exercise works both your abductors and deep external rotators, which include your gluteus maximus, gluteus medius, gluteus minimus, piriformis and obturator externus. An exercise band provides the resistance for this exercise. Before you do the exercise, tie a straight exercise band into a circle with a knot to make it about a foot long or use a small circular band. Secure the band around the outside of your ankles and stand up straight. Relax your arms at your sides. Then with your left foot pointing straight ahead, lift your right leg out to the right and rotate your leg from the hip joint so your toes turn out. Do not simply turn your foot out at the ankle. Bring your right foot back next to the left. Repeat with the left leg.

Hip Flexor
Stand with feet slightly apart, toes forward, hands on hips or one hand on a wall/chair for support. Shift weight to right leg, keeping knee slightly bent and spine straight. EXHALE: Gradually lift the left leg, keeping it bent at 90 degrees. Lift knee as high as possible, trying to get thigh parallel to floor or higher. Hold here for 2 counts. INHALE: Slowly lower leg to ground without letting foot rest on the floor. Complete all reps and switch sides. Make sure you aren't leaning back when lifting leg. Also, try to make the entire movement very slow and controlled.

Banana
Lie on floor with legs together, arms extended overhead, belly button pulled in toward spine. Keeping head between arms, slowly raise upper body and legs off floor to form a gentle bananalike curve. Hold for a slow 30 counts. Don't hold your breath! Try to keep breathing steady and even. Concentrate on holding abs in.

DORSIFLEXION

weight shifting with feet flat in all directions and progressing to performing on a balance board. Heel walking is also a challenging way to work dorsiflexion. Tapping the foot to play music on a mat piano or shaking bells; Drawing in shaving cream with the feet; or Hitting switches with the feet
Quadriceps Exercise: Movements to work the quadriceps in weight-bearing (closed-

chain exercises) can include step-ups, partial squats, sit to stand, and leg presses. Openchain exercises include seated knee extensions (long-arc quads), supine straight-leg raises, or end-range knee extensions with a small ball or roll under knee (short arc quad). Fun ways to exercise: Kicking a ball or balloon while sitting; Seated pushing a scooter or rolling chair backward; Using a bicycling or stepping machine; or Pumping legs on a swing. Exercise. Bridges, in which the child is in hooklying and pushes through his or her feet to lift buttocks off surface, are a simple exercise to engage the hip extensors. This exercise can be progressed to being performed single legged. Hip extension can also be performed in quadruped or prone lying with the hip extended through the available range of motion. Partial squats are great for overall lower-extremity strengthening. A squat motion while the back is leaning against the wall (wall slides) is easier to perform than a squat. Or, a child can perform a stand-to-sit movement but rise just prior to sitting. Backward walking is also a wonderful functional strengthening exercise, and it can be progressed by adding resistance with elastic tubing around the trunk or on inclines. Gait training on a treadmill can also offer strength training for children with weakness against gravity. The treadmills movement facilitates hip extension and can offer movement through greater ranges of motion. Fun ways to exercise: Backward kicking to knock over objects; Climbing activities on stairs and obstacles; Kicking and splashing water in prone in a pool or tub; or Backward walking through an obstacle cours Spinal Extensors for perfect gait (gait training ) The child will lie prone and then will lift his or her upper body and legs off the surface

(flying like Superman), and hold for up to 30 seconds. This exercise can be progressed by extending the arms overhead or leaning over the edge of the table and extending beyond the height of the table. Thoracic extensors (middle and lower trapezius and rhomboids) can also be exercised seated for children who cannot tolerate prone by elevating arms above head and extending back. Fun ways to exercise: Doing prone activities on a scooter, sling swing, or platform swing to push off a wall, reach, and knock down objects; Wheelbarrow walking; or Swimming with support under the belly in a pool. ABDOMINALS : FOR PERFECT POSTURE AND BALANCE Exercise: Sit-ups are the most-often-thought-about abdominal exercise. To engage the rectus abdominis, the child needs to lift his or her head and shoulder off the surface; the obliques can be added with rotational movements. Challenging a childs trunk control can be done with numerous exercises besides the typical sit-up or curl-up. Rotation exercises in sitting, in which the child rotates his or her trunk while holding a ball or bar with both hands, can be done. Progress by adding weight through a medicine ball or cuff weight attached to the bar, or by adding varying angles of flexion and extension with rotation. In supine, lifting and lowering the legs off the surface works the lower abdominals. Fun ways to exercise: Playing catch with a medicine ball, and moving the location of where to throw and the level from which the ball is thrown; Hanging from a swinging bar and lifting legs to knock over objects; or Rolling or crawling up and down inclines.