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.

01/27/2026

This study was aimed at understanding the physical fitness, postural stability and motor skills of children born preterm (between 24 and 35 weeks) when they reached 8 years old.
Clinical take aways:
*Premature children had lower levels of physical fitness
*Premature children displayed decreased balance, flexibility and jumping ability
*Development of muscle imbalance secondary to long periods in supine results in extensor muscle activation over flexor muscle activation which can lead to permanent changes in the muscle structure in premature children
*Preterm children do not catch up with their peers over time
What I’m still thinking about:
When we impact central muscle activation balance we change alignment, impacting respiratory diaphragm recruitment which impacts very many systems.
https://pubmed.ncbi.nlm.nih.gov/41476303/

01/22/2026

This article (link in bio.) directly reflects my clinical experience—children with daytime urinary incontinence frequently present with sensory processing differences. The children I see for pelvic health concerns often have interconnected differences in sensory processing, motor control, and emotional regulation. Viewing children through an isolated pelvic floor function lens is not adequate. And viewing them solely through a behavioural lens does them a disservice.
It’s time for a different approach—one that prioritizes understanding the whole child first, and then applies that understanding to their bladder and bowel function.
This is exactly why and I developed our Paediatric Pelvic Health course. It's child-centred, systems-based and trauma informed. If you’re a paediatric therapist interested in pelvic health, or a pelvic health therapist seeking to understand the whole child, this course is for you.
Join us for Paediatric Pelvic Health: Dynamic Core for Kids Edition. Day 1 (Virtual) on March 7 or you can combine it with Day 2 (In-person) in Guelph Ontario for a comprehensive learning experience. Thanks to for hosting! https://bit.ly/49rd63i

01/19/2026

A short follow up to the last article on respiratory diaphragm function in children with CP. A 2021 study noted that in a group of 53 children with spastic CP, a manual diaphragmatic stretching release 3 x per week for 6 weeks, the study group displayed improved diaphragm mobility and improved chest wall expansion at the xiphoid and umbilical levels. Unfortunately there was no change in the pulmonary function testing. It would be so interesting to repeat this study using the US assessment noted in the study I discussed in the last post.
https://pubmed.ncbi.nlm.nih.gov/34029936/
🤔

01/15/2026

I'm a big fan of the respiratory diaphragm (RD)! Here's a 2025 study that examined the RD in children with CP. The authors used US assessment in 10 children with spastic CP in order to minimize the impact of motor and cognitive capacity as often happens with some standard lung function testing.
Clinical takeaways:
Children with CP displayed:
*Less excursion of the RD
*A decreased inspiratory slope (which implies less intensity of neural drive to the RD or decreased power/strength of RD contraction)
*Increased lower respiratory tract infections, which were positively associated with decreased excursion and inspiratory slope.
https://pubmed.ncbi.nlm.nih.gov/41458372/
The RD is a key contributor to postural control, continence, constipation and emotional regulation (and more). Assessment and treatment to optimize RD function is an excellent place to start when designing a management plan.

01/14/2026

I am so happy to see this free, full text article. Looking at outcomes for orthpaedic surgery in children with neuro-sensory-motor complexity should be multi-faceted. This study performed a scoping lit review, gathered 7 experienced healthcare pros (the authors acknowledge is a small panel) and came to consensus regarding recommended outcome measures.
Clinical takeaways:
*The panel agreed on measures to address pain/discomfort/fatigue, lower limb structure, motor function, daily life activities, gait-related activities, physical activity, independence and quality of life.
*The set of core recommended outcome measures were: Edinburgh Visual Gait Scale, Gross Motor Function Measure, Gait Outcome Assessment List, Gillette Functional Assessment Questionnaire, Patient-Reported Outcome Measure Instrument System (pain interference, and fatigue), and Cerebral Palsy Quality of Life for Children questionnaire.
All these measures are readily available online.
https://onlinelibrary.wiley.com/doi/10.1111/dmcn.70133
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01/13/2026

I'm excited to be presenting a new hybrid paediatric pelvic health course grounded in a trauma-informed model with my friend and teacher partner .
Due to unforeseen circumstances the date for Day One (virtual) has changed. Day One now takes place online on SATURDAY MARCH 7, 2026.
This course weaves together discussions of central control, neural networks, sensory processing, motor control, and continence systems—across both neurotypical and neurodiverse populations—to deepen our understanding of a truly global approach to care.
We’ll introduce relevant, practical strategies that complement therapists’ existing skill sets, along with tangible tools clinicians can share with families. We’ll also explore outcome measures, parent intake, and assessment through a paediatric pelvic health lens.
This course was intentionally designed to build bridges—supporting paediatric clinicians seeking deeper insight into pelvic health, and pelvic health clinicians looking to expand their understanding of paediatric populations. Early bird pricing available now!! To register or for more information https://bit.ly/4aWDRxQ

01/09/2026

Welcome to 2026! This is a super interesting article studying inspiratory muscle training (at 50% max inspiratory pressure) combined with sitting on unstable surface in individuals post-stroke. In the study group the surface was progressed each week to a more unstable surface (15 min x 3 per day x 4 weeks).
Clinical takeaways:
*Inspiratory muscle training improved diaphragmatic thickness, respiratory function, Trunk Impairment Scale and Times Up and Go measures
*Inspiratory muscle training combined with sitting on unstable surface improved the same measures with 50% greater benefit
https://pubmed.ncbi.nlm.nih.gov/41423385/

01/06/2026

Awesome news! Creating Connections: Intro to NDT and DC4K in St. John’s, NL is filling quickly ✨ I began my NDT journey in St John's with my 8-week course, and I’m honoured to return with a dynamic systems approach to postural control—supporting gross motor, fine motor, and respiration/phonation in children with motor and sensory differences. Join us for this exciting, hands-on learning experience. https://bit.ly/4qjW4tB

01/01/2026

Happy 2026 to you all! ❤🎉

12/30/2025

Cheers to 2025!! Our brains use dynamic systems to organize postural control and our clinical lens needs to reflect that. When we integrate sensory processing + motor control + emotional arousal in our clinical reasoning, we see the “why” behind movement and we can shape interventions that truly support functional change. This is the difference.

12/20/2025

Today is my son's birthday ❤ and it has also become the day I traditionally sign off for a holiday pause. Thank you all for being part of my research and reflection journey this year. May your holiday season sparkle!

12/17/2025

I've been thinking a lot more about sleep since taking a short sleep course in November (thanks .ca !). Here's a 2025 article that studied high risk for obstructive sleep apnea in children (OSA) with CP.
Clinical takeaways:
*Prevalence of high risk for OSA was significantly higher in the GMFCS V group.
*Higher frequency of tonsil hypertrophy, hospitalizations, antibiotic use, reflux, drooling and epilepsy found in GMFCS V group
*Prevalence of high risk OSA in GMFCS I-IV was still higher than in TD control group
*Tonsil hypertrophy was significantly correlated with high risk for OSA
https://pubmed.ncbi.nlm.nih.gov/40789332/

Address

Saint Catharines, ON
L2T2S4

Telephone

+19053801627

Website

http://www.heartspacept.com/

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Our Story

HeartSpace provides Physical Therapy clinic services to babies, children and adolescents with motor and sensory challenges at our Kids Therapy Circle location. Shelley Mannell PT has over 30 years experience in pediatric Physical Therapy. She began teaching as a clinical faculty member in the School of Rehabilitation at McMaster University. Shelley developed HeartSpace Yoga and Meditation for children in her clinic and more recently co-created Dynamic Core for Kids, an approach to treating core stability in children with challenges; this approach is used by therapists all over the world. In addition to her clinical work, Shelley teaches continuing education courses for pediatric therapists internationally. HeartSpace PT includes associate Michelle Duncanson PT who provides home-based services in Niagara.