paediatric physiotherapy

Paediatric physiotherapists are specialists in the assessment, identification, diagnosis, and treatment of disorders of movement and physiological issues. They help children to achieve their optimal physical development. They have specialist knowledge in the movement, development and conditions that are likely to affect the baby and growing child and treat from 1-day-old babies to adolescents.

PAEDIATRIC CONDITIONS

SPINA BIFIDA

It happens when a baby's spinal cord fails to develop normally while it is still in the mother's womb.

Causes
-family background or genetics
-less nutrients (folic acid)
-external variables
-environmental causes

Symptoms
Having skin issues on the back
Depression in the back region
Fat deposits on the body
The back has more hair
Having trouble focusing and learning
Problems with bowel habits
Bone and muscle deformities
Difficulties with memory
Associated conditions

Physiotherapy Management
-Improving the general mobility by exercises
-Positioning of the child along with handling is taught to caretakers
-Aids helpful in walking are prescribed(walkers)
-Aids the youngster in carrying out daily activities
-Relaxation exercises
-Stretching exercises
-Strengthening exercises for weak muscles
Your physiotherapist will advise you to hold the new born child carefully following surgery, aids the youngster in standing and moving about on their own. Orthoses are prescribed.

CEREBRAL PALSY

Introduction

Cerebral Palsy (CP) the mobility and posture disorder, which develops during infancy or early childhood as a result of brain injury. The brain damage is irreversible and cannot be repaired, but the earlier intervention is begun, the more progress can be made. Any non-progressive CNS lesion that happens within the first two (or even five) years of life is referred to as CP.

Cerebral Palsy is a group of permanent, but not unchanging, disorders of movement and/or posture and of motor function, which are due to a non-progressive interference, lesion, or abnormality of the developing/immature brain.

TYPES
 Spastic Cerebral Palsy.
 Dyskinetic Cerebral Palsy (athetoid, choreoathetoid, and dystonic cerebral palsies)
 Ataxic Cerebral Palsy.
 Mixed Cerebral Palsy

CAUSES
 Congenital
 Genetic
 Inflammatory
 Infectious
 Anoxic
 Traumatic
 Metabolic
 Injury to the developing brain may be prenatal, natal or postnatal.

PHYSIOTHERAPY MANAGEMENT
Aims
 Improve mobility
 Prevent deformity
 Educate the parents
 Teach daily living skills
 Social integration
Treatments
 Active and passive movements
 Weightbearing
 Positioning
 Electrical stimulation
 Cryotherapy
 Hydrotherapy
 Neuro facilitation techniques
 Mobility aids

DOWN'S SYNDROME

It is a birth condition occurring due to abnormality in the chromosome. It is hereditary which can affect a child's ability to develop normally. It may have an impact on both the mind and the body. It is a chronic illness. Early access to the correct treatment can have a significant impact on a person's ability to lead a fulfilling life.

Causes
-Genetic causes
-Advanced maternal age

Symptoms
 Thinking and understanding issues
 Growth problems seen
 Associated heart problems
 Organ abnormalities
 They will learn more slowly than normal kids.
 Face characteristics will change-teeth abnormalities, small nose, flat face, big tongue, ridges on skin etc.
 Vision and hearing will be compromised
 Muscular weakness

Physiotherapy management
-They will experience difficulties walking, standing, and sitting. Physiotherapy can assist the youngster in bettering their standing, sitting, and walking movements through exercises
-A physiotherapist will instruct the child in exercises while they play or engage in enjoyable activities to lift their spirits.
-Balance improving exercises
-Muscle strength increasing exercises
-Activities of daily living are trained
-Posture improving exercises are given

FLAT FEET

Failure of development of the arch of the foot causes it to touch the ground completely.

CAUSES
 Tightening of muscle over back of the lower leg.
 Loosening of Achilles tendon present around back of lower portion of lower leg.
 Strength of abdominal muscle will be poor.

SYMPTOMS
 Heel is tilted laterally.
 Normal pattern of walking is changed.
 Moving of the foot in different directions is limited.
 Pain on touch from foot to knee.
 Unable to do the physical activities .

PHYSIOTHERAPY
 Stretching exercises in the leg and foot.
 Abdominal and hip muscles stretching and strengthening exercises.
 Balance training.

HYPER MOBILITY SYNDROME

The circumstance of musculoskeletal symptoms in hypermobile healthy persons. Generalized common hypermobility with or without disturbance/ subluxation. The joints of the body may suffer larger range of movement than normal.

Symptoms
o Primary symptom is inordinate laxity of multiple joints.
o Acute or Traumatic sprain like intermittent ankle sprains.
o Meniscus gashes.
o Joint insecurity – Acute or intermittent disruptions or subluxations of the shoulder, patella.
o Joint pain( traumatic arthritis)
o Bruising
o Fractures
o spine curve
o Muscle pain
o Fatigue for long duration.
o whim-whams contraction diseases.
o Joint swelling
o Clumsiness.
o Failures in tendon, ligament, bone, skin and cartilage.

Causes
o Peak at 15 years of age in girls.
o Hormonal changes that happen in puberty especially in girls.
o further common in children than grown-ups and girls than boys.

Physiotherapy Treatment
o Education of Hypermobility Syndrome.
o exertion revision.
o Strengthening exercise.
o Strengthening exercise for affected joint.
o Osteopathic manipulative treatment.
o Active rallying exercise.
o Proprioception common position sense exercises – collaboration and balance exercises.
o Control neutral common position – Postural muscle training.
o Retrain dynamic control – muscle training.
o Movement control – muscle training.

MUSCULAR DYSTROPHY

Muscular dystrophy is a group of inheritable conditions. It is non-communicable and progressive generalized complaint of the muscle. In muscular dystrophy, there will be progressive muscle weakness and loss of muscle mass. utmost forms of muscular dystrophy begin in younger age.

Symptoms
o Frequent falls
o Difficulty rising from a lying or sitting position
o Difficulty in running or jumping
o Abnormal walking pattern
o Walking on toes
o Large leg muscles
o Muscle pain and stiffness
o Learning disabilities
o Delayed growth
o Lose capability to do effects like walk, sit upright, breathe fluently and move their arms and hands.
o The child assumes the hand- and- knee position and also climbs to a stage by walking his hands precipitously up his lower leg, knees and thighs (Gowers ’ sign)

Cause
o It's purely inheritable.
o Abnormal genes lead to muscle loss

Physiotherapy treatment
o Range of stir exercises
o Stretching exercises
o Low impact workouts
o probative bracing
o Wheel president operation
o Breathing exercises

WHO NEEDS PAEDIATRIC PHYSIOTHERAPY ?

Children (infants up until the age of 19 years) in the areas of orthopedics, congenital malformations, neurology, neuropsychiatry, breathing and prematurity require Paediatric Physiotherapy. This includes developmental delay, neuromotor and/ or neuromotor problems.

Paediatric physiotherapists possess specialized knowledge and training related to growth and development, syndromes as well as diagnoses within the paediatric filed.

A paediatric physiotherapist is able to assess, identify, diagnose and treat physiological impairments within the paediatric population.

Peadiatric physiotherapy treatment is based on a number of hands-on techniques, exercises and interventions with the goal of addressing functional impairments including muscle tone, strength, coordination, balance and posture, mobility and achieving an optimal range of motion.

Treatment is always performed with the ICF model in mind so that activity limitations and participation are addressed. To this end paediatric physiotherapists treat as part of a team, with the child and family as central components.

WHAT ARE THE BENEFITS OF PAEDIATRIC PHYSIOTHERAPY ?

Improves posture and integrates reflexes of child
Makes movement easier by training more typical patterns of movements.
Improves gross motor skills.
Improves functional mobility.
Improves muscle balance and muscle strength.
Improves balance and coordination.
Improves range of motion.
Improves muscle tone.
Improved gait/gait training.
Addresses respiratory difficulties.
Assists in addressing learning difficulties.
While it must be noted that the benefits of physiotherapy are many, there is little high level sustaining evidence for this.

Bethany Navajeevan Physiotherapy Clinic
& Rehabilitation Centre

'Learn to Heal' with Care & Compassion