Physiotherapy for Children

Neuro-developmental/Neuromuscular Physiotherapy is a scientifically proven method to help promote increased mobility, strength, postural control, flexibility, coordination, balance/corestabilization, and gross motor skills in a child.Bobath (Neuro-developmental) Therapy emphasises on observation and analysis of the child’s current functional skill performance and the identification of therapy goals. Neuro-developmental therapy (NDT) aims for active participation and practice of relevant functional skills. It also influence muscle tone and improves postural alignment by specific handling techniques.

• Developmental Delay
• Gross Motor Delay
• Torticollis
• Cerebral Palsy
• Deviant
• Genetic Disorders
• Other Neurological Disorders
• Developmental Coordination Disorder
• Hypotonia
• Acquired Brain Injury
• De-conditioning from Prolonged Illness or Hospitalization
• Post Botox and Operative Treatment.

Cerebral palsy and Physiotherapy

Cerebral palsy is a non progressive disease which occurs due to the injury to the developing brain. It can occur due to an insult to the brain during antenatal or postnatal period, when the brain is rapidly growing and forming different connections called synapses.

The causes of the insult could be:

1. Infection
2. Lack of oxygen to the brain
3. Structural malformations
4. Jaundice
5. Genetic /Metabolic causes

As the child grows there are changes in the body due to various factors like growth spurts,   illness, changing levels of activity etc. which makes the disease appear progressive. But the changes are due to the above causes and not due to progression of the disease in the brain.

Principle of physiotherapy

Neuroplasticity or brain plasticity is the ability of the brain to get altered through environmental stimuli. As a part of the brain gets damaged in cerebral palsy, the remaining part of the brain tries to take the function of the damaged brain through its ability of neuroplasticity which is dependent on the outer environmental stimulation. Intensive and task specific exercises helps to modulate and re-establish connections both at the macro and micro level in the brain. This forms the basis of providing physiotherapy as the treatment modality in cerebral palsy.

Role of physiotherapy in Cerebral palsy

Physiotherapy plays an important role in treating children with cerebral palsy. The aim is to make the child mobile, as independent as possible, and prevent the development of contractures.

Certain facts in physiotherapy:

1. Stretching exercises are done to increase range of motion and decrease spasticity.
2. Spasticity causes decrease in mobility of joints hence leading to contractures. Range of motion exercises need to be done regularly to enhance mobility at each joint and prevent contracture.
3. Strengthening exercises are to be done to build the strength of the muscles.
4. Special attention should be paid to posture and balancing.
5. All the activities need to be done in playful setting so that the child’s attention could be directed towards the activities.

Activities should be focussed according to cephalo caudal progression i.e. head control should be followed by sitting exercises and then standing exercises.

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