How we help children to move and play to the best of their ability
We are all familiar with how physio’s help adults, but many people don’t really know how paediatric physio’s help babies and children. Following on from our previous article ‘What is Paediatric Physiotherapy’ this article describes a day in the life of the physio’s in our clinic. This will allow you to see the types of conditions we work with, and how we help these children to move and play to the best of their ability.
This is what happened at Move and Play Paediatric Therapy on Tuesday 3rd July 2018:
Anna had a busy day, as it was the school holidays and she had a two children booked in for a block of therapy. Block therapy (also known as ‘intensive therapy’) is a way of delivering a higher dose of therapy over a short period of time so that children can work intensely towards achieving specific goals.
In the morning, Anna:
- Helped a 6 year old boy with quadriplegic cerebral palsy to build strength and control so that he can learn to stand up by himself. This will allow him to be able to stand for transfers between his power wheelchair and a toilet chair, and also to stand to have his shorts or trousers changed. Anna used a combination of Theratogs (supportive suit that helps to better align the body and facilitate proper muscle activation), stretches, exercises and movement practice. This little man had 2 sessions today – one in the morning and one in the afternoon.
- Worked with a 2 year old girl with muscular dystrophy to work towards being able to side step around furniture and to develop the skills for stepping for when her walker arrives. Anna helped this little girl practice standing up from sitting, standing up tall with support at her knees, and taking her body weight over either leg.
- Helped a 6 year old girl with dyskinetic cerebral palsy to learn to better control her head and trunk when she is sitting, and did some exercises to stretch and strengthen her trunk to try and prevent this little girl from developing a scoliosis. Importantly, this little girl’s session also incorporated techniques to help her to learn to use her body and her voice to ask for ‘more’, or to provide a ‘yes’ or ‘no’ response, allowing her to have more ability to make choices for herself.
After her late morning break, Anna then:
- Helped 2 little girls with Down Syndrome to progress their motor development. The first little girl was working on her ability to sit and to play with her hands in sitting. The second little girl was working on improving her walking, learning to negotiate obstacles without falling over, and to step up onto a step.
Finally, after lunch Anna had her second session with the 6 year old boy with quadriplegic cerebral palsy, building on the morning’s session by progressing his strength and skills.
Rachael had a mix of children to on the 3rd July, and a combination of clinic visits and a home visit.
In the morning, Rachael:
- Helped a 6 year old boy with autism who wants to improve his core strength and endurance so that he can more easily participate in rugby training and games. His session consisted of a series of exercises to strengthen his core muscles (his abdominals, his back muscles and the muscles around his pelvis), but also to learn to keep this part of his body stable, which will improve his balance and power.
- Joined with Emily to put a fibreglass cast on the leg of an 8 year old girl with hemiplegic cerebral palsy (cerebral palsy affecting one side of her body). This cast aimed to stretch out this girl’s calf and foot so that she can get her foot flatter on the ground when she is walking and to help her tolerate her AFO (leg splint) better.
After her lunch break, Rachael then:
- Reviewed a 6 year old boy with mild hemiplegic cerebral palsy to check his ankle and foot. Rachael assessed this boy’s walking, running, jumping, hopping, and balancing, and also checked the range of movement available in his ankle, foot and calf muscle. Children with cerebral palsy require regular reviews of their musculoskeletal system because they are at risk of developing contractures (shortened muscles) as they grow.
- Worked with Emily again to put plaster casts on the legs of a 9 year old boy with autism who walks on his toes. Toe walking is a common presentation for children with autism, but it can also be present in children without autism. The plaster casts help to stretch out the tight calf muscles, and also allows the child to practice walking for a week using a heel-toe pattern so that they can, over time, learn to walk using a more typical pattern (See our article on toe-walking here)
- Had an initial appointment with a 6 year old boy with learning difficulties, difficulty concentrating and clumsiness. Rachael assessed this boy’s walking; his higher level motor skills such as running, jumping and hopping; his ball skills; his coordination; his motor planning; and his core stability. From this assessment, Rachael has now developed a plan for treatment which will help to address the underlying issues contributing to his clumsiness and difficulty concentrating.
After a quick break, Rachael then travelled to the home of an almost 9 year old girl with a genetic condition causing global developmental delays, where Rachael worked with the Mum to help the little girl to practice walking with better alignment of her legs, as well as her balance and coordination.
Emily does not see as many clients as she is only available for a couple of hours per week, but on this day Emily:
- Did a telehealth consultation with a 1 year old girl with Down Syndrome and her Mum who live in Rockhampton. During this telehealth consultation Emily was able to watch over a computer screen to see how this little girl is developing and how she is moving, and then taught the Mum strategies and exercises to help her daughter to learn to sit better and to move between sitting and crawling. Delivering physiotherapy this way via telehealth saves this family a 4 hour drive to attend their physio appointment!
- Completed an initial assessment with an 11 year old girl who has badly sprained her ankle and is starting to return to walking without a Moon Boot. Emily assessed her ankle stability, her joint movement and muscle length, and then assessed her walking and balancing on that leg. Emily provided some basic rehabilitation exercises for the girl to commence, and provided some compressive stocking to help keep the swelling down as the girl gradually gets back into walking.
- Did a longer assessment for a 9 year old boy with a rare congential condition that causes short stature and respiratory issues. This assessment was to determine his needs for the next 12 months as he is about to have an NDIS plan review. Emily discussed with the boy and his parents what their goals are for the next 12 months, and what supports they felt were necessary to achieve them. After the end of the appointment, Emily then wrote the report for the NDIS (which ended up being 5 pages long!)
In between the client appointments, our physio’s also:
- Tutored and mentored the final year physio student we had on placement at the clinic
- Made phone calls to equipment suppliers about some equipment fittings that were coming up later in the month
- Discussed specific shared clients with the Occupational Therapist and Speech Pathologist to make sure we are all on the same page and all working together towards the clients goals
- Responded to emails from clients, other health professionals, equipment suppliers, and the NDIS and it’s community partners
- Completed all our appointment notes to ensure we have a record of everyone’s progress and plans for future progress
- Worked on completing reports required by the NDIS – applications for equipment or assistive technology, and reports for plan reviews
What a day! We hope this gives you a clearer idea of how we work with children and families, and the type of work that we do to help children of all abilities to achieve their best.
Does your child need to see a physiotherapist? At Move and Play Paediatric Therapy, we help children with a variety of movement difficulties and different abilities to move and play at their best. We would love to chat about your child’s needs and find out how we can help.
Please contact us on (07) 4942 9343 or comment below and we will be in touch.