Physiotherapy is not one thing, it is a whole-child approach to therapy. It uses the knowledge and skills of therapists to make treatment plans unique to that child. Therapists share these skills with the families and anyone else involved in the child’s care. This helps to make sure that the special advice is in use across all areas of the child’s life. This provides an opportunity for that child to develop and maximize their potential.
Medical language and processes can seem overwhelming. The following sections contain more information on some of the key areas in children's physiotherapy. If you need more information please do not hesitate to contact your child’s physiotherapist.
Clinic assessments help the therapist to review and track your child. This helps to guide and plan the appropriate course of action. There are lots of assessments but here are explanations of some of the more common ones.
Every child with a diagnosis of cerebral palsy aged between 2 and 16 is able to have this assessment. It happens at a 6 monthly review until the age of 6 and yearly thereafter. It looks at movements in your child’s legs and spine. It is an early warning system for known potential joint problems or contractures. These may lead to functional difficulties. The assessment allows appropriate and prompt intervention or referral to other services.
The CPIPS assessment is also an opportunity to see how your child’s condition is affecting their lives in other ways. This helps to support you and your child in maintaining a healthy lifestyle.
Here is a short video on the WWCiH website that demonstrates an assessment.
The review clinic is for children with complex care needs who are at risk of body shape changes. These changes may impact their health, well-being and function. The assessment allows for early detection of changes in muscles and joints. This helps with the timing of intervention and onward referrals for your child.
Reviews are annual but can be more frequent if appropriate.
Your child may attend a Joint Assessment Clinic (JAC) as an initial appointment. These take place in your local Child (Development) Centres. Your child will see a Doctor and members of the wider team. This includes Nursing, Physiotherapy, Occupational Therapy and Speech and Language therapy teams based on the child’s needs. This clinic will help identify which services could help to support you and your child.
North Star assessments is a functional assessment scale for children with Duchenne Muscular Dystrophy.
More information can be found on the Scottish Muscle Network Website.
This is an assessment of your child’s walking and happens at West of Scotland Mobility & Rehabilitation Centre (WestMARC), Queen Elizabeth University Hospital.
Click here to find out more about Glasgow Clinical Gait Analysis Service assessments.
SDR is an operation used to reduce spasticity (muscle stiffness) in a very specific group of children. The surgeons cut the nerve roots which controls the level of stiffness in your child’s legs. If your local team think your child may be suitable for SDR they will arrange for more detailed assessments with the hospital team.
Following one patient’s SDR journey in Scotland:
Physiotherapists use their knowledge and skills to support those around the child to help them to reach their physical potential. Every child’s physiotherapy program is unique to them. This requires a coordinated approach with your child at the centre.
Your child may have a specific goal that requires repetition of an activity to help achieve. Physiotherapists are able to design specific programs to meet your child’s individual needs. They will take into consideration the condition, age and stage of development of your child.
This may include developmental play, balance, strengthening activities. Or a combination of them all depending on your child’s goals and needs.
Your therapist will always support you, your child and people working with your child to fit programs into their daily lives.
Botox® is an injection that targets specific muscles to help relieve muscle stiffness and painful muscle spasms. It blocks the flow of nerve impulses to the muscles around the site of the injection. This will work within a few days and can last up to 6 months.
If your therapist felt Botox® may be appropriate, your child will be referred to specialist physiotherapists. They will do further assessments and develop a plan with you, your child and your local therapist.
Below is a short video on the What? Why? Children in Hospital (WWCiH) website which demonstrates the process of Botulinum Toxin injections at the Royal Hospital for Children, Glasgow.
Your therapist may prescribe specialist equipment to support your child’s health, wellbeing and development.
Falls are common in children who have neurological disorders. A combination of the following can put your child at greater risk:
It is important to try and reduce the chances of your child tripping and falling. Your child is more likely to have a fall in unfamiliar surroundings and when they are concentrating on other things. It is important for them to look in the direction they are walking. This helps them to negotiate obstacles and uneven surfaces. Sudden changes in direction and speed can also lead to trips and falls.
Walking aids can help and making simple changes at home and planning ahead is useful. Removing rugs and toys scattered on the floor reduces the risk of tripping over them.
A physiotherapist will be able to tell you and your child how to identify ways to reduce the chance of trips and falls depending on their needs.
Hydrotherapy is a treatment that uses the proprieties of water for many effects. It can help with reducing tone, improving joint range of movement and strengthening. It involves specific handling, exercises and movements within the water.
Depending on your child’s needs, some of these therapeutic effects can be achieved in standard swimming pools. Others need very specific properties such as heat, which come from being in a hydrotherapy pool.
Lycra garments are tailored for your child’s needs ranging from shorts, bodysuits to socks and arm gauntlets. The aim of the garment is to help with the management of altered muscle tone, improve posture and functional ability.
Research on their effectiveness is variable and so Lycra is not suitable for many children with neurological conditions.
In neurological conditions, there are many reasons that your child may be in pain. Weak and tight muscles can make it more difficult to change position. This can lead to pain and discomfort.
There are different ways to manage pain.
Changing the way in which your child does certain tasks can help to save energy and reduce the amount of stress placed on their body. This may be sitting rather than standing or using different positions to reduce working against gravity.
By looking at your child’s posture and movements over the course of 24 hours, the physiotherapist can assess what may be the cause of your child’s pain. A physiotherapist can advise on positioning and handling depending on your child’s needs.
Rebound therapy uses the bounce, speed and rhythm of a trampoline to have specific effects. This includes reducing muscle tone and encouraging movements and balance. It involves specific handling and activities on the trampoline.
Keeping healthy and taking some precautions can help keep your chest clear. This can minimise the chances of you getting a chest infection. The following advice can help keep your chest healthy:
If you develop any of the following symptoms it is important that you visit your GP.
Follow guidance from your physiotherapist on your respiratory plan if you have one.
Your child’s therapist will work with education to support their needs within school or nursery. This may involve working with the rest of the health team to support educational staff.
This support may include:
Your physiotherapist may give exercises to help strengthen specific muscle groups. This will improve your child’s stability and control around a joint or a movement/function.
In children, strengthening exercises vary from targeted exercise to specific play activities. Your child’s therapist will always explain what they are trying to achieve. They will also explain how often to do the activities.
Stretching maintains the length of muscles and may help to reduce pain. There are many reasons your therapist may suggest stretching activities. Your therapist will always explain the routine and activities which will be based on your child’s individual needs.
Below is a video on why we stretch when you have a neurological condition and another video of one example of stretching (there will be many alternatives).
Please speak to your child’s therapist for further information.