Children’s physiotherapy, or paediatric physiotherapy, is a specialised area of physiotherapy targeted at the unique needs of babies, children and young adults. Paediatric physiotherapists undergo significant further training to allow them to manage the physical, mental and educational needs of children.
Children may have developmental, neurological, respiratory or musculoskeletal difficulties and paediatric physiotherapists are well equipped to assess and treat a wide range of conditions in partnership with the child and their parents. These conditions can be the result of illness, disability or injury and may include:
- Acute soft tissue injuries such as muscle strains, ligament sprains and joint injuries
- Fractures and leg-lengthening procedures
- Congenital conditions such as talipes equinovarus (CTEV) where the feet are abnormally positioned
- Developmental conditions such as cerebral palsy (CP) and Down’s syndrome
- Difficulties coordinating movement
- Breathing problems such as asthma and cystic fibrosis (CF)
- Physical and learning disabilities
- Developmental delays in the achievement of head control, sitting balance, crawling and walking skills
Why Physiotherapy For Children?
Paediatric physiotherapy studies have demonstrated that physiotherapy can restore movement and body function, help affected children reach full potential, achieve age-appropriate development and enjoy a good quality of life.
Children are not just small adults but have specific physical, developmental, mental and emotional needs that must be considered for the best outcome.
However, there is evidence this branch of physiotherapy is also effective at encouraging physical fitness and promoting wellbeing in children without movement or functional issues. For example, healthy children and teenagers on physiotherapy programmes have been shown to have a lower risk of developing problems with posture and their consequences, such as low back pain.
What Do Children’s Physiotherapists Do?
Children’s physiotherapists specialise in assessing and treating children from birth to 19 years old who have respiratory, developmental, musculoskeletal, neurological or other conditions. They work closely with parents, GPs, teachers and school nurses to assess the individual needs of the child. This involves looking at:
- The performance of movements, balance and coordination
- Developmental milestones such as crawling, sitting unaided and walking
- Musculoskeletal problems such as development dysplasia of the hip (DDH or clicky hips), hypermobility and Osgood-Schlatter’s Syndrome
- Respiratory function and management of infections
- Gait problems due to in-toeing, flat feet, toe walking or falls
- The ability to carry out activities of daily living
The assessment aims to gather as much information as possible to help the physiotherapist identify areas that need improvement, and determine how this can be achieved. This information is used to develop a carefully crafted plan of treatment and exercise activities most effective for that particular child.
Attention is also given to ensure that all activities are safe, as well as stimulating and fun, to sustain engagement and motivation throughout the programme.
Where Can Children Have Physiotherapy?
Paediatric physiotherapists work with children privately, or through the NHS, in many different settings. These may include the child’s home, nursery or school. However, some children may have needs that require their physiotherapy to be carried out in a clinic or hospital.
Which Activities Are Provided For Children?
As with adults, physiotherapy with children involves the use of a wide variety of different activities, ranging from isolated exercises to negotiating obstacles while walking to ball exercises, climbing, swimming and more.
These activities, which are all tailored to the child’s specific needs and therapy goals, fall into five main categories:
- Movement and exercise, such as muscle strengthening, stretching and neurological movement techniques such as Bobath
- Respiratory care, including chest clearance and fitness training
- Manual therapy, where the therapist uses their hands to improve joint and muscle movements
- Splinting and orthotics
- Hydrotherapy, in which physiotherapy exercises are performed in water
The Importance Of Toys
Toys are frequently used during activities with very young children as a way to stimulate play and curiosity, but also to achieve specific health targets.
Research has shown that encouraging toddlers with delayed development to reach and grasp for toys is an effective way to improve balance and mobility during seated everyday tasks like eating and bathing. The added benefit of parents being trained by the physiotherapist means this kind of activity can be carried out in the home environment.
Physiotherapy For Babies
Paediatric physiotherapists do a significant amount of work with very young babies.
Children with cystic fibrosis (CF) need help to clear mucus from the lungs to prevent and manage respiratory infections. Parents need to be taught respiratory techniques for long-term management of this condition.
Neurological or developmental problems may present with abnormal postures and movement. Parents are taught to stretch out tight structures, encourage normal movements and discourage abnormal postures and movement patterns.
Babies with clicky hips or talipes may be in a harness or serial plaster of Paris casts respectively. Physiotherapists manage these conditions routinely under the supervision of an orthopaedic consultant and review babies regularly to ensure a good result.
How Can I Find A Children’s Physiotherapist?
To find a pediatric physiotherapist near you, simply enter a place or postcode in the Local Physio search bar and select ‘treatment for children’ from the specialities drop down. All therapists featured on Local Physio are fully qualified and registered with the Health and Care Professions Council (HCPC).
Calvo-Munoz I, et al. Preventive physiotherapy interventions for back care in children and adolescent: a meta-analysis. BMC Musculoskeletal Disorders, 2012; 13:152, http://www.biomedcentral.com/content/pdf/1471-2474-13-152.pdf
The Association of Paediatric Chartered Physiotherapists, Physiotherapy for children, December 2013, http://apcp.csp.org.uk
NHS Choices, Physiotherapy – How it Works, 2012, http://www.nhs.uk/Conditions/Physiotherapy/Pages/How-does-it-work.aspx
NHS Scotland, Child Health Services, What are Physiotherapists, 2005, http://www.scotland.gov.uk/Resource/Doc/69582/0017136.pdf
Early Childhood Teacher Association (ECTA), Australia, Physiotherapy with Children, http://www.ecta.org.au/_dbase_upl/08_07_AugVideolinq_Slides.ppt
Valvano J, et al. Activity-focused motor interventions for infants and young children with neurological conditions. Infants & Young Children, 2006; 19(4):292-307 https://depts.washington.edu/isei/iyc/valvano_19.4.pdf