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Thursday, June 9, 2011

An Inside Look at Physical Therapy from the Folks at KidsCare Therapy

KidsCare Therapy is back, for our third and final month to tell you about another great therapy service for children. Thus far we’ve covered occupational and speech therapy, and during the month of June we are going to tell you all about the third discipline we treat –physical therapy. As with the other disciplines, we will start out this month by giving you a general overview of a pediatric physical therapist’s scope of treatment in this post, and then follow it up in a couple of weeks with specific diagnosis, potential warning signs and some treatments. After this month we hope that you will all be well versed as to how to identify a child that may be in need of speech, occupational or physical therapy, as well as how you can help to ensure you keep a child in your life healthy, and on target!

By definition physical therapy is a branch of rehabilitation that uses specifically designed exercises to help patients regain or improve their physical abilities.  Physical therapists work with many types of patients from infants all the way through adulthood to assist with that which limits a patients ability to move and perform functional activities as well as they would like in their daily lives. This differs from occupational therapy (which we learned about in April) because physical therapy deals more with large body movements versus the fine use of the hands. Physical therapy is helping mobility and strength, while occupational therapy assists more with the fine motor skills involved with performing each task. While both of these play into one main goal, which is to help ensure a child develops into a fully functioning adult, with all of their motor skills intact– each of these disciplines have different ways of obtaining this goal. A physical therapist would describe “success” as being able to facilitate improvement of functional skills and independence, but also strength, coordination and balance for increased mobility.

When most people think of physical therapy they tend to think of a therapist who helps sports injuries in athletes, adults after surgery, or those who have been in accidents. Most people don’t think about children needing physical therapy as well, but a pediatric physical therapist can treat a wide range of disabilities or delays to help ensure a child continues to thrive. By giving a child the opportunity to continue to grow physically at an early age, it can alleviate problems that may develop later in life, and can facilitate growth, as well as help to development cognitive, speech and fine motor skills.

While pediatric physical therapists do work with children who have broken bones or have been in accidents such as car accidents, falls, or had traumatic injuries, most generally they work with kids to treat delays - whether a child is premature or just having problems developing their balance, range of motion, coordination, strength, body awareness, motor planning, or functional mobility at the same rate as their peers. A pediatric physical therapist can also help bring a child to a more appropriate level in his or her play skills. Often times a child will not be playing not because they don’t want to interact (what child doesn’t want to have fun?) but instead because their body is physically limiting them.

As with occupational therapy, physical therapy is also ideal for the home setting with children. Essentially they are learning how to play and use their mobility skills around the toys and activities that they will be doing on a daily basis at home and in the community. In this familiar environment a child is more likely to grow at a faster rate, and it helps the ability to continue to facilitate therapy with the parents after the therapist has left the home!
Please read below to learn how a child was able to overcome great obstacles with the help of home pediatric physical therapy.

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Joshua is a shining example of how physical therapy can make an impact on the activities of daily life for children with developmental delays.

When the therapist from KidsCare Therapy met him, she was struck by his boisterous yet affectionate personality.  Joshua, a three-year-old boy with Down syndrome, was referred to physical therapy for gross motor delays.  As with most children with Down syndrome, he exhibited low muscle tone, joint hypermobility, decreased strength and decreased endurance, poor balance and lack of coordination.  At his initial evaluation, Joshua was unable to remain standing erect for more than a minute, fell frequently, could not independently ascend the steps outside his apartment, and was unable to kick or catch a ball.

In order to provide Joshua with improved stability, we worked with an orthotist to obtain SureStep orthotics.  This company’s orthotics are designed to provide children with low muscle tone more stability through the hindfoot, but flexibility in the forefoot, to allow running and jumping.  Joshua has shown significant improvement in gait, balance, and coordination since receiving his orthotics.

Other important components of his therapy have been therapeutic exercise and home exercises for strengthening.  His family has played an integral role in working with Joshua on developmentally appropriate activities for strengthening.  He has shown gains in strength and core stability through Swiss ball training, sit ups, climbing activities, and the use of a weighted vest.  The combination of strength training and equipment ordered through therapy has enabled Joshua to make significant gains in his gross motor skills.  He is now able to climb the stairs with stand-by assist, jump off the ground with both feet, kick and catch a ball, run, and play without frequent falls.  Joshua’s clear progress has been observed empirically through improvements of standardized testing.  His physical therapist states, “I have enjoyed being able to play a role in helping him achieve greater independence and mobility.”
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Be sure to be on the lookout for KidsCare Therapy’s final post where we will cover specific symptoms you can look for in a child to see if they may need physical therapy services, as well as ways that you can help to ensure a child in your life develops their physical skills at a normal pace. 

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