Physiotherapy at Dynamics targets the following population: infants, children and adolescents with a variety of developmental, neuromuscular, orthopaedic, congenital and acquired disorders. Treatment is aimed at improving independent mobility, strength, flexibility, balance, coordination, endurance, gross and fine motor skills, cognition and motor planning.
Following conditions will be treated:
- Congenital disorders including Cerebral Palsy (CP)
- Developmental disorders including Ataxia and Dyspraxia
- Inherited diseases like Muscular Dystrophies
- Head Injuries
- Disease of the Spinal Cord
- Peripheral Nerve Injuries
- Spinal Cord Injury
- Post-Op Orthopedic and Neuro Surgery
- Congenital Deformities like Club Foot/CTEV
- Athletic Injuries
- Gait related difficulties
Benefits of physiotherapy treatment include normalising muscle tone, increasing range of movement and improving muscle strength as well as balance and coordination. Physiotherapy treatment improves quality of life by enabling the child to reach developmental milestones (e.g. rolling, crawling and walking) and maximising their potential with daily tasks.
Assessment & Treatment Management
In order to optimise the child’s function and mobility, a comprehensive evidence based treatment plan is devised to suit individual child’s requirement. An initial assessment of the child is made based on tests adminstration and current mobility status. Based on this assessment an individualised treatment plan is formulated and treatment is started. Paediatric physiotherapy treatment may include a combination of hands-on techniques and exercises. Advice and support is also provided for parents and teachers to provide the best possible care. The short term and long term goals are reassessed and modified, if required, periodically based on the progress achieved.
The treatment in neurological involvement is based on one or a combination of methods such as the Bobath, neuromuscular facilitation (PNF), Carr and Shepherd, Rood’s approach, Conductive Education and the Brunnstrom approach to initiate normal patterns of movement in a child and improve their motor ability.
For children with orthopaedic conditions various combinations of stretching and strengthening techniques are used to normalise joint stability and muscle function.
Physiotherapeutic Management for some common neurological conditions:
Children with cerebral palsy and developmental delays are treated by a combination of various approaches. Neurological physiotherapy is based around the principle that the brain is dynamic and able to adapt to change. Physiotherapy treatment will hence focus on:
- Exercises to increase muscle strength and control so that the child is able to shift their body weight and balance better.
- Muscle stretching to lengthen muscles, increasing range of movement and preventing muscles and joints from becoming stiff.
- Activities to improve head and trunk control. For example, supporting the child in sitting to develop weight shifting, rotation, coordination and balance. Mirror imaging is often used to increase their awareness of where their limbs are in space (prioprioception).
- Core strengthening is addressed by ensuring optimal postural alignment in all positions and creating strength and awareness of the muscle activation needed to achieve and maintain that alignment.
- Exercises to increase mobility and their success of learning to walk based around everyday activities. Physiotherapy may involve exercise for the hand to improve writing and grasping objects.
- Advice about supportive devices such as using a wheelchair, orthotic devices or other adaptive equipment if necessary.
Spasticity issues commonly seen in children with CP and head injury are managed by:
- Use of ice to decrease spasm frequency and pain.
- Stretching muscles through range to relieve stiffness in the joints and surrounding tissue.
- Exercises to increase muscle strength and functional performance. This may include regular standing and weight bearing on upper and lower limbs depending on the involvement.
- Activities to improve range of movement.
- Promoting normal movement patterns.
- Advice on orthotics/splinting for hands and feet.
- Correcting and varying joint position during activities.