Rebuilding Grasp — Functional Juggling and Hand Rehabilitation in Florence, Italy¶

SELF APS
Disabled Day Centre – Trezzo sull'Adda, Italy
Written by Lapo Botteri
Delivered by Circo Tascabile at the C.T.E. center in Cinque Vie, Florence

Target¶

This project focused on adults with severe motor disabilities, particularly individuals with impaired hand gripping ability. The participants—six residents of the C.T.E. center in Cinque Vie, Florence—were all wheelchair users, each presenting complex physical challenges but maintaining medium-to-high cognitive functioning. The initiative was developed in close collaboration with the facility’s physiotherapists, with the goal of supporting rehabilitation efforts through playful, curiosity-driven activities that promote neuro-motor adaptation.

Beginning Situation¶

My name is Lapo Botteri, and I hold a degree in Physical Education with additional certification as a sports teacher. I first encountered Functional Juggling in 2016 through a workshop with Craig Quat. The experience shifted my professional trajectory. Within weeks, I approached a local therapy center and began integrating the methodology into my practice. I’ve remained with the same organization ever since, now working 13 hours per week and developing long-term, individualized programs.

The C.T.E. center serves individuals with complex mobility limitations, many of whom face additional challenges such as spasticity, limited range of motion, or coordination impairments. While physiotherapists focus on biomechanical rehabilitation, my role—through Functional Juggling—has been to engage neuromotor programming at the intersection of play, precision, and movement intelligence.

Goals¶

Each participant had a personalized set of goals, defined in collaboration with the center’s staff. The primary objective was to support upper limb rehabilitation through sensory-motor exploration. Secondary aims included:

Enhancing grip strength and manual dexterity
Encouraging ambidextrous coordination
Improving attention span and cognitive-emotional engagement

Setting and Tools¶

Working Space
Sessions were held in the center’s small gym, a quiet, adaptable space well suited for sensory-focused activities. Each participant engaged in a 15-minute one-on-one session, once per week, from October to May.

Working Tools
Materials were selected according to each participant’s abilities and goals. These included:

Juggle Board
Juggling rings
Stress balls
Finger puppets
Rain sticks
Animal squeakers
Flashcups
Household objects (cutlery, brushes, bottles)
Sensory props tailored to specific grip types

Process¶

The program unfolded weekly across eight months. Each session followed a structured flow, with content adapted to each individual’s physical and emotional needs.

Preparatory Phase
We began with verbal check-ins and tactile activation. Questions like “How are you today?” were paired with gentle hand and arm massages to increase body awareness and reduce tension.

Analytical Phase
We explored fine motor skills and targeted movement patterns such as finger isolation, wrist rotation, and bilateral integration. The goal was to refine precision and self-awareness in movement.

Global Phase
Refined elements were combined into integrated tasks, such as controlling ball movement on the Juggle Board or exchanging juggling rings rhythmically. These tasks emphasized functional flow, coordination, and movement confidence.

Organization Process¶

Two interdisciplinary teams provided essential input throughout the program:

Educators
They offered background on each user’s daily behavior, emotional profile, and learning preferences, helping to adjust session pacing and tone.

Physiotherapists
They ensured technical safety, advising on posture, muscular limitations, and safe movement ranges. Their guidance allowed for creative exploration within a safe biomechanical frame.

While we encountered no major obstacles, we did observe unexpectedly high levels of engagement and improvement, surpassing initial expectations.

Output¶

Though no formal metrics were used, feedback was collected from across the team:

Physiotherapists
Reported no measurable biomechanical changes, but recognized that the work complemented their sessions meaningfully.

Educators
Observed notable improvements in attention, behavioral regulation, and hand coordination. Participants began using both hands more naturally and showed progress in handling tools like pens, cups, and utensils.

Music Therapist
Saw enhanced control and intention while participants used musical instruments, particularly when striking mallets on xylophones.

Speech Therapist
Noted improved focus and greater ease in operating manual communication devices.

Conclusions and Reflections¶

Two central questions emerged:

First: Why did the physiotherapists observe less change than other team members? Their clinical lens is crucial, yet it may overlook the subtle functional gains made through embodied play.

Second: How can we better document this type of change? In future projects, we hope to implement baseline assessments and post-session comparisons, using tools like video analysis or motion sensors, to more clearly track outcomes.

Functional Juggling may not yield instant results. But it creates space for small miracles—like holding a spoon, gripping a pencil, or striking a mallet with renewed purpose and joy.

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