Breathe Magic: overcoming loss of motor skills among children and young people with hemiplegia

Key Messages

Children with hemiplegia suffer from a loss of motor skills, making everyday activities difficult.

Traditional intensive hand therapies can be repetitive for children and other more invasive therapies can be expensive and have mixed results.

The British ‘Breathe Magic Intensive Therapy Programme’ seeks to improve the bimanual (two handed) motor skill performance of children and young people with hemiplegia by integrating therapy into magic tricks.

The initiative showcases the potential for using arts and culture in health promotion.

The Issue

Hemiplegia results in weakness or restriction of movement to one entire side of the body. It is caused by injury to the parts of the brain that control body movement. Consequently, people with hemiplegia suffer from a loss of motor skills, making everyday activities such as dressing and eating difficult. For children and young people, the lack of independence can cause isolation, low self-esteem and poor self-confidence.

Cultural Contexts

Hemiplegia cannot be cured, but with intensive therapy, children and young people suffering from it can increase their participation and motor skills. However, the traditional hand therapies offered to children with hemiplegia are often repetitive and can be hard to engage children with, leaving little incentive to practise intensively. Consequently, such therapies often do not have the desired impact of increasing upper limb activity.

The ‘Breathe Magic Intensive Therapy Programme’ improves the levels of motor activity in children and young people with hemiplegia by making bimanual intensive therapy fun and engaging. The programme offers children 1-to-1 intensive therapy over a 10-day group camp, followed by bi-monthly therapy over the following 6 months. This equates to a total of 78 hours of therapy.

During the camp, the children are taught close up bimanual magic tricks and practise activities of daily living. The motivation of becoming a magician gives the children the incentive to repeatedly practice important movements, which results in participants showing statistically significant improvements in hand function and spontaneous upper limb use in bimanual daily activities. In addition, the programme has led to improvements in psychological well-being, self-confidence, self-esteem and parent-child relationships.

Policy Implications

The case of Breathe Magic Intensive Therapy Programme showcases the potential for profiling arts and culture in health interventions. Research has shown that arts activities like music engagement, painting, dancing and writing can have significant positive effects on both physical and mental health. As such, a number of projects all over the world have taken the approach of offering people suffering from both physical and mental health problems access to dancing classes, book clubs and ceramics classes – often with great success.

Links for Further Reading

  1. Breathe Magic:
  2. Green, D., Schertz, M., Gordon, A. M., Moore, A., Schejter Margalit, T., Farquharson, Y., Ben Bashat, D., Weinstein, M., Lin, J.P. & Fattal-Valevski, A. (2013). A multi-site study of functional outcomes following a themed approach to hand–arm bimanual intensive therapy for children with hemiplegia. Developmental Medicine & Child Neurology, 55(6), 527–533.
  3. All-Party Parliamentary Group (2017). Creative Health: The Arts for Health and Wellbeing, All-Party Parliamentary Group on Arts, Health and Wellbeing Inquiry Report. July 2017, Second Edition.
  4. Stuckey, H. & Nobel, J. (2010). The Connection Between Art, Healing, and Public Health: A Review of Current Literature. American Journal of Public Health, 100(2):254-263.
  5. Crone, D., O’Connell, E., James, D.V.B., Tyson, P. and Clarke-Stone, F. (2011). Art Lift, Gloucestershire: Evaluation Report: Executive Summary. University of Gloucestershire, U.K.
  6. Strokestra: