CHILD PHYSIOTHERAPY PAEDIATRIC

 

Paediatric physiotherapy

 

Paediatric Physiotherapy is the assessment and treatment of children with developmental, neurological and growth related conditions. It takes into consideration the unique needs, anatomy and biomechanics of children from birth until full growth and development has occurred. The goal of paediatric physiotherapy is to facilitate participation, development and independence in life taking into consideration the unique, ever-changing needs of the growing baby, child and adolescent.

 

Paediatric physiotherapy is best suited for those with:

• Gross motor delay
• Autism Spectrum Disorder
• Cerebral Palsy
• Developmental Coordination Disorder
• Down Syndrome
• Spina Bifida
• Acquired Brain Injury
• Hypotonia
• Muscular Dystrophy or other neuromuscular challenges
• Torticollis/Plagiocephaly
• Other genetic disorders
• Weight challenges

 

Developmental milestones

 

Developmental milestones are behaviours or physical skills seen in infants and children as they grow and develop. Rolling over, crawling, walking, and talking are all considered milestones. The milestones are different for each age range. Closely watching a "checklist" or calendar of developmental milestones may trouble parents if their child is not developing normally. At the same time, milestones can help to identify a child who needs a more detailed check-up.

 

Normal baby development falls under two categories. The first is gross motor development which includes lying down, rolling, sitting, standing and walking. The second is fine motor development which includes things like grasp and release. The developmental milestones are outlined below.

 

0-3 months

 

• Limbs remain relatively straight
• Kicks feet when on back
• Brings hands and fingers to mouth
• Able to support head in mid line in supported sitting

 

3 – 6 months

 

• Brings feet to mouth when lying on back
• Begins reaching
• Able to lie on propped on elbows and follow moving toy
• Sits with support
• Begins to roll from tummy to side or back to side

 

9 – 12 months

• Begins to crawl
• Can sit unaided
• Pulls to stand
• Cruises along furniture
• Walking with one hand held

 

12 – 18 months

 

• Walks independently
• Walks up one step with support
• Runs
• Kicks a ball

 

Older than 2 years of age

 

• Jumping
• Walks on balance beam
• Can pick objects off floor
• Can walk up and down stairs without assistance

 

 

When to see a physiotherapist

Child should be referred to a physiotherapist when they have problems with gross and fine motor skills (such as doing up buttons), posture and balance problems (such as frequently tripping or falling), neurological problems (such as stiffness or floppiness), or continence problems (such as constipation or bed-wetting).

 

 

Modes of therapy available

There are many different modes of therapy available to help children reach their developmental milestones. Hydrotherapy is useful as the water buoyancy helps the muscles to do activities that are difficult to do on land. Neurodevelopmental Therapy (NDT) can help overcome neurological impairments and develop motor skills. Core strengthening, Swiss ball therapy and taping help children to perform a wide range of musculoskeletal activities by increasing their coordination and muscle strength. 

Children’s Physiotherapy

Little Steps Paediatric Physiotherapy at the Rehab Hub

Ali and Érin of Little Steps Physiotherapy each have over ten years’ experience in paediatric physiotherapy working across a variety of NHS settings. For many years they have also offered private paediatric physiotherapy, supporting children and their families in their own homes across Bedfordshire, Hertfordshire and Cambridgeshire.

They now run a paediatric physiotherapy clinic from the Rehab Hub in Biggleswade for babies, toddlers, teens and in-betweens. Their mission is to help every child feel confident with movement so that step by step they reach their individual physical potential.

Ali and Érin have expert assessment, handling, and treatment skills for a variety of childhood conditions including:

• Cerebral Palsy 
• Developmental delay
• Developmental coordination disorder
• Musculoskeletal concerns 
• Orthopaedic problems 
• Biomechanical and postural pain 
• Cystic Fibrosis and respiratory conditions 
• Neuromuscular conditions 
• Talipes 
• Torticollis 
• Post-surgical rehabilitation 
• Oncology 

Geriatric Physiotherapy

•  19/09/2020
 
• Admin

Questions

WHAT IS GERIATRIC PHYSIOTHERAPY?

Geriatric Physical Therapy covers a wide area of problems concerning the elderly. There are many conditions that affect people as they grow older and include but are not limited to the following: arthritis, osteoporosis, cancer, Alzheimer’s disease, hip and joint replacement, balance disorders incontinence, etc. Geriatric physical therapists specialize in providing therapy for such conditions and ailments. Physiotherapists play a key role in enabling older people to use a number of the body’s systems fully to enhance mobility and independence. Physiotherapists can make a difference by helping older people to be comfortable and pain-free. The types of problems faced in geriatric physiotherapy are grouped into three different categories.

One category is the problems that happen because the patient simply does not use their limbs or does not exercise. These problems can be addressed by reconditioning through range-of-motion exercises and other exercises.

Another category geriatric physiotherapy deals with is cardiovascular disease, like heart disease and stroke. The physiotherapy professional has an array of tools at her disposal to work with these conditions. Exercise, aqua therapy, electrical stimulation, and more can be used.

The third category is skeletal problems. Geriatric physiotherapy helps people who have these disorders, such as osteoporosis and osteoarthritis. These problems require special attention as osteoporosis makes patients frailer, and osteoarthritis is very painful.

HOW DOES IT WORK?

The procedure is performed with the help of a suitable professional, the physiotherapist. The physiotherapist will teach and apply global exercises and active techniques to the elderly so that the patient gains mastery of new movements of his/her body and develop physical and mental balance. Currently, geriatric physiotherapy can be applied in three different ways: through hydrotherapy, mechanotherapy, and kinesiotherapy (biomechanical movements). The elderly are treated much like anybody else in the sense that there is an initial treatment phase that will be medical or surgical, after which you will often be referred to a physiotherapist who will conduct their own assessment to establish how they intend to treat you. Their rehabilitation plan will vary hugely, depending on, for example, the condition itself, the patient and their mindset, their home and family situation, as well as previous family history. For patients suffering from mobility issues, dementia, or with a history of falls, a physiotherapist is important in evaluating the home setting. 

The goal of your therapist here is not to impose what they think is right on you, but rather to make adjustments that you are comfortable and happy with to allow you as much independence and safety as possible. While rehabilitating mobility, a physio will use traditional tools such as strengthening exercises and hydrotherapy in the context of geriatric care. For example, as falls are a major issue in the elderly, emphasis is placed on balance and postural improvements to minimize the risk of further falls, each of which carries a risk of critical injury. Hydrotherapy is also an important tool in the rehabilitation of the elderly as underwater exercises remove unwanted stress from joints that are very prone to damage

WHAT ARE THE CONDITIONS TREATED BY GERIATRIC PHYSIOTHERAPY?

Geriatric conditions usually include musculoskeletal problems, mental illness, incontinence, impaired senses, balance problems, chronic pain, and sleep deprivation. Physiotherapy treatments have been successful in resolving or managing each of these ailments. Here’s what physiotherapy has to offer to the field of geriatrics. What are the conditions treated by Geriatric Physiotherapists?

Joint Pain
Joints connect bones within your body, bear weight and provide support during movements. Usually, joint pain is caused by injuries, inflammation of the lining of the joint, hemarthrosis, arthritis, STDs, and gout. If the joint pain is left untreated for a longer time, it can restrict mobility and lead to weakness or instability to perform normal activities. Geriatric physiotherapy is the best treatment to help reduce joint pain and improve the stability of the joints.

Generalized Weakness
Generalized weakness is one of the most common issues that almost every individual faces post a certain age. One of the attributes of this is degenerative changes that come with age resulting in poor muscle tone, stiff joints, etc. This is further worsened by the presence of other chronic conditions such as neurological issues, endocrine problems, and musculoskeletal issues. Some of the common causes of generalized weakness are flu, thyroid disease, anemia, depression, lack of sleep, undiagnosed diabetes, congestive heart failure, and medication side effects. Geriatric physiotherapy helps in bringing back physical strength and stability, thereby improving patients’ quality of life.

Postural Instability
Postural instability is a condition of inability to maintain an upright position. In other words, it is the imbalance and loss of righting reflexes that are required to maintain an upright position. Geriatric physiotherapy such as balance exercises can improve postural instability and help patients resume back to their normal state.

Balance Impairment
Balance impairment in the elderly is the loss of normal functioning of muscles and bones. It is most commonly caused due to arthritis and orthostatic hypotension. Other factors causing balance impairment include numbness in feet and legs, eye problems, blood circulation problems, and intake of multiple medicines. Geriatric physiotherapy treatment includes balance exercises to help improve the functions of muscles & bones.

WHO WILL BENEFIT?

Geriatric physical therapy is a proven means for older adults to improve mobility and balance, build strength, boost confidence in their physical abilities, and nonetheless, remain active over years. However, some of the work of geriatric physiotherapy is not aimed at returning patients to their earlier states of health. The most important goals are to be able to function at their best abilities. Doing everyday tasks and living an unconfined life are valuable assets. At the same time, geriatric physiotherapy can have a profound effect on a person’s ability to enjoy physical activities. Golf is an activity that many seniors enjoy. It can be a very hazardous sport for the elderly if they are not in a condition to play. It does have many health benefits, too.

Geriatric physiotherapy can focus on physical training to get an older adult in shape to play sports like golf. This strengthens them in many ways. The fact that it allows them to play golf will make them even healthier, both physically and psychologically. Since depression is a growing problem among the elderly, any help they can get in this area is needed. Another role of geriatric physiotherapy is to help with rehabilitation after knee or hip replacement surgeries. People who have these operations are likely to walk differently. It affects their ability to do daily chores and their quality of life.

NEURO PHYSIOTHERAPY & REHABILILATION

 

Neurological Physiotherapy is a specialist area of physiotherapy focused on the treatment of individuals with neurological conditions. Neurological disorders affect the functioning of the brain, spinal cord, and nerves. Stroke, Multiple Sclerosis (MS), Spinal Cord Injury and Parkinson’s are common neurological conditions [1]. It also includes conditions of the peripheral nervous system such as Guillain Barre Syndrome. Neurological conditions can have a devastating impact on the lives of the sufferers, along with family and friends. Disturbances in the travelling of messages between the brain and the body can result in the loss of movement, sensation, coordination, and balance. Other aspects of bodily function, such as perception, speech, memory, cognition, and behaviour may also be affected. Therefore, it is important that neurological physiotherapists work in close partnership with other members of the multidisciplinary team including speech and language therapists, occupational therapist, dieticians, nurses, and doctors. Effective communication between patient, family members, and the multidisciplinary team is critical to positive healthcare outcomes following a neurological disorder [2].

The Role of a Neurological Physiotherapist

Neurological physiotherapists are experienced and trained to treat neurological conditions with the aim to provide interventions which assist an individual to regain or maintain their maximum movement and functional independence. This is achieved by aiding in the development of new pathways through repetition and exercise.

Treatment Interventions

A number of treatment approaches are used, often incorporating a selection of the following as appropriate [2]

• Stretching
• Strengthening
• Balance re-education
• Gait re-education
• Joint mobilization
• Electrical stimulation
• Postural exercise
• Spasticity management
• Advice/Education on lifestyle, fatigue management, and exercise
  
  
  
  
  
  

ORTHOPAEDIC PHYSIOTHERAPY

 Orthopaedic Physiotherapy primarily focus on orthopedics and treatment conditions affecting the musculoskeletal system, which are composed of joints, muscles, bones, ligaments, and tendons.It diagnoses, manage, and cure the disorders of the musculoskeletal system and recuperate patients after the orthopaedic surgery. Any condition that causes pain or limited functional mobility as a result of an injury to bony or soft tissue structures in your body may benefit from the skilled services of orthopedic physical therapy.

Orthopedic injuries and conditions may include:

• Fractures
• Muscle strains
• Ligament sprains
• Post-operative conditions
• Tendonitis
• Bursitis

Sever pains are associated with an injury that occurs to the bones, joints, ligaments, or muscles, and makes mobility difficult hindering daily task functions. With a experienced

qualified Orthopaedic Physiotherapist, success rate for healing becomes much higher as they provide a tailor made treatment programs with exercises that can be done at home to help increase strength and range of motion, getting you on the road to a successful recovery.

Following are some of the exercise programs that are used in Orthopaedic Physiotherapy
Strengthening exercises

• Stretching and flexibility exercises
• Exercises to improve range of motion
• Balance exercises
• Functional mobility exercises
• Endurance exercises
• Plyometric and jumping-type exercises