Definition & Overview

Paediatric physical therapy, also known as physiotherapy or simply PT, is a medical specialty that specializes in helping kids and teens overcome movement problems. These problems are most often caused by illnesses, injuries, or congenital disabilities, but can also be due to other reasons. Paediatric PT is the paediatric version of a similar field of treatment used to achieve the same purpose among adult patients. The goals of paediatric physical therapy include:

  • Detecting potential problems at an early stage
  • Relieving pain and inflammation
  • Helping kids and teens return to their normal activities
  • Making the affected body parts regain strength
  • Restoring patients’ range of motion
  • Restoring the original function of the affected body parts
  • Teaching patients and their families on how to prevent recurrences
  • Improving patients’ overall quality of life

These goals are achieved by a combination of treatments that are expected to bring gradual but notable improvement to the condition of the patient.

Who Should Undergo & Expected Results

Generally, patients who experience pain and whose normal mobility or function of different body parts is limited are in need of physical therapy. The treatment can be short-term or continuous, depending on the problem that is being treated. If it is a minor injury, a few sessions of PT can help a patient achieve complete recovery, whereas problems caused by a disease or major debilitating injury may need long-term treatment and management.

Paediatric physical therapy is similar to physical therapy with the only difference being the age of the patient; paediatric PT is designed specifically to cater to the needs of:

  • Infants
  • Children
  • Adolescents

There are several classes of conditions that physical therapy for children focuses on. These are congenital, developmental, neuromuscular, orthopaedic, skeletal, and acquired diseases. More specifically, those who should undergo paediatric physical therapy are kids and teens who suffer from or are affected by any disabling condition related to or caused by:

  • Birth defects
  • Cancer-related conditions
  • Cerebral palsy
  • Chronic health problems, such as arthritis
  • Chronic or recurrent pain affecting the back or neck
  • Delays in physical development
  • Genetic problems
  • Head injury
  • Heart disease
  • Injury, most commonly due to sports activities, which may include sprains, strains, fractures, or broken bones
  • Limb deficiency
  • Lung problem
  • Muscle disease
  • Orthopaedic disability or injury
  • Trauma

Treatment usually begins by establishing a management or treatment plan. To do so, the physical therapist may need to request for several imaging tests such as X-ray, CT scan, and MRI to make an accurate diagnosis. A thorough physical assessment and a review of the patient's medical history will also be carried out.

With the help of paediatric physical therapy, children suffering from the above conditions are expected to be able to live and move in a normal manner. At every visit, the physical therapist will track the progress by measuring the patient’s strength and flexibility, identifying existing problems that need further treatment, and analyzing the patient’s overall condition (i.e. how he moves, walks, or runs). Expected benefits or improvements should encompass a patient’s:

  • Gross motor skills, such as walking, jumping, kicking, and climbing the stairs, among others
  • Fine motor skills, which are smaller actions, such as picking an object up with the fingers or wiggling the toes
  • Balance and coordination
  • Strength and endurance
  • Sensory processing
  • Cognition
  • Developmental milestones, especially in the case of infants and toddlers with developmental delays

How Does the Procedure Work?

Physical therapists specializing in paediatrics combine the following techniques to achieve treatment goals:

  • Activities that test balance and coordination
  • Adaptive play
  • Developmental activities
  • Electrical stimulation
  • Exercise
  • Heat therapy
  • Massage
  • Ultrasound scans
  • Water therapy (aquatic activities)

Exercise makes up a major part of paediatric physical therapy. Patients are asked to undergo the following types of exercises as a part of the treatment:

  • Core exercises
  • Flexibility exercises
  • Strength training
  • Stretching

Unlike in adult physical therapy, the paediatric side is faced with additional challenges when it comes to creating a treatment plan. This is because treatment techniques and activities should be tailored or modified so that they would become interesting to children who typically have short attention span. It is important to make the young patients feel like they are simply engaging in play, but at the same time, the activities should adhere to the treatment goals and address specific problems. Thus, instead of routine exercises, paediatric physical therapy may involve getting the child to crawl through a tunnel, walk on a beam, ride a scooter, swing, catch objects, throw objects, and so on.

These are then supported by programmes designed to teach patients how to avoid injuries and keep themselves safe despite their conditions. The physical therapist is also responsible for recommending whether the patient needs more treatment or can already go back to his normal activities.

PT programs are conducted in various settings, including private PT clinics, out-patient clinics, health and wellness clinics, nursing facilities, schools, rehabilitation hospitals, and sports training facilities.

Physical therapy programmes are also sometimes combined with occupational therapy, which incorporates sensory integration techniques into the treatment program.

Possible Risks and Complications

Since paediatric physical therapy involves physical movement, it is normal for patients to experience some mild soreness or discomfort, especially after doing some exercises. These, however, are minimized since the patients are relatively young. If the effects of therapy seem to be bothering the patient, the parents should talk to the therapist.

To avoid complications and reduce risks, it is important to choose the right physical therapist. It is important to note that therapists also have their own specializations or have received individual training. Thus, it is best to choose a PT with an expertise in treating the specific type of health condition involved. For example, parents should look for orthopaedic physical therapists or sports PTs if the problems are orthopaedic or sports-related, respectively.

References:

  • Long AR, Rouster-Stevens KA. The role of exercise therapy in the management of juvenile idiopathic arthritis. Curr Opin Rheumatol. 2010 Mar;22(2):213-7.

  • Ruperto N, Lovell DJ, Quartier P, et al; Paediatric Rheumatology International Trials Organization and the Pediatric Rheumatology Collaborative Study Group. Long-term safety and efficacy of abatacept in children with juvenile idiopathic arthritis. Arthritis Rheum. 2010 Jun;62(6):1792-802.

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