Paediatric physiotherapy in Amersham & Chorleywood
This encompasses a number of disorders that interrupt or affect a child’s development. Most specific developmental disorders can be accommodated and overcome with early intervention
- Development delay may affect a child's fine and gross motor skills, speech and language, and/or personal and social skills. A child diagnosed with a global delay will have delays in all areas of their development.
- Developmental Co-ordination disorder (DCD) is a term covering many difficulties including, dyspraxia, co-ordination and clumsiness. Dyspraxia is described as having two main elements: difficulty with planning a sequence of coordinated movements and difficulty with executing a plan. It is associated with problems of perception, language and thought.
- Sensory Integration is where the child has difficulty processing information from their sensory system (sound, touch, vision) and is often an issue for children with DCD.
This covers many diagnoses which affect the bones and muscles can also be described as musculoskeletal.
- Torticollis (wry neck) causes limited range of movement at the neck in babies is due to a tightness of the sternocleidomastoid muscle in the neck this condition can affect their development.
- Plagiocephaly is a term used for flattening or distortion of the developing skull in babies (can be associate with torticollis).
- Positional talipes (club foot) a common condition in newborn babies, where the foot or feet have tight ligaments and tendons leading to an altered resting position of the foot. The foot remains flexible and therefore responds well to physio.
- Trauma is any injury caused by falls, sporting injuries, or other icidents. Includes such things as sprains, strains and healing post fractures.
- Osgood-Schlatters is characterised by pain on the bony prominence just under the knee cap. Most commonly related to growth spurts in sporty teenagers. Important to have a good stretching and strengthening programme. May also respond to acupuncture
- Chondromalacia Patella is a common cause of anterior knee pain. It is the softening and breakdown of the cartilage that lines the underside of the knee cap (patella) and can cause a grinding/grating feeling as the knee moves.
- Sever’s disease (calcaneal apophysitis), is due to overuse and repetitive microtrauma of growth plates of the calcaneus (where the Achilles tendon attaches to the heel). It is the most common cause of heel pain in the growing athlete.
- Brachial plexus injuries (Erb’s Palsy) can cause symptoms such as altered sensation and lack of muscle power in the arm. This is due to the group of nerves that conduct messages from the spinal cord to the shoulder, elbow, forearm and hand being injured as a result of shoulder trauma (often associated with childbirth), inflammation or tumours.
- Perthes disease (legg-calve perthes disease) where growth/loss of bone mass leads to some degree of collapse of the hip joint and to deformity of the ball of the femur and the surface of the hip socket. Symptoms include hip pain as well as pain referred into the knee and is usually associated with reduced range of movement and altered walking pattern.
- Developmental dysplasia of the hip (DDH) is an umbrella term for a variety of conditions in which the ball and socket of the hip do not develop properly and can cause pain, altered muscle control and difficulties with day to day activities.
- Postural Back pain there are many causes of back pain, including muscle spasm, lack of adequate core stability and poor posture. Some children can develop a curvature of the spine (scoliosis and associated with neurological impairments such as CP) which can lead to altered biomechanics, muscle imbalance and pain.
- Flat feet (pes planus) flat feet in children can be structural or associated with muscle weakness/joint instability. Can be described as when the whole of the foot makes contact with the floor and there is lack of an adequate in step during standing.
describes auto-immune diseases affecting joints, muscles and skin.
- Juvenile Idiopathic Arthritis (JIA) Children under the age of 16 can develop arthritis in one or multiple joints. Children may complain of persistent joint swelling, pain and loss of range of movement, fever/rash. A full medical work up is necessary to ensure definite diagnosis, however physiotherapy alongside appropriate medication is paramount in controlling disease progression and avoiding long term joint damage.
- Juvenile Dermatomyositis (JDM) there is a distinctive heliotrope (purple/mauve in colour) rash affecting the eyelids and swelling of face, hands (gottrones papules) and knees can be common. Along with this, there is characteristic muscle inflammation causing weakness and pain. It is a disease that primarily affects muscle and skin, but can also have features of joint involvement (as in JIA).
- Joint hypermobility Syndrome is a condition that features joints being able to move beyond their normal range and is scored using the ‘Beighton scale’ with a score of 4 out of 9 (joints) being considered hypermobile. Its recognition within the paediatric population has increased over the years and the common musculoskeletal complaints associated with this can be pain, muscle weakness, fatigue.
- Chronic pain syndromes covers a multitude of pain behaviours, including pain amplification, complex regional pain and neuropathic pain. It is complex in nature and influenced by physical and psychological factors. Due to this, children usually require a multidisciplinary management utilising physiotherapy, occupational therapy and psychology services.
Conditions where the complex brain and nervous system process is be disrupted and can lead to motor and sensory difficulties. Physiotherapy can be utilised to help teach or re teach the brain movement patterns.
- Cerebral palsy damage to the brain/nervous system occurs before, during or soon after birth. The term encompasses a group of non-progressive disorders that primarily affects a child’s motor development.
- Spina Bifida is a congenital disorder caused by the incomplete development of the spinal cord. Some of the bones overlaying the spinal cord are not fully formed and remain open, which can affect the function of that nerve and the body part it supplies.
Respiratory conditions/chest physiotherapy
Covers issues which may arise due to existing pathology affecting the child’s air way and lungs.
- Cystic fibrosis the lungs over produce thick sticky mucus due to a genetic condition. Physiotherapy (manual techniques, active cycle of breathing and/or autogenic drainage) alongside medication is required to prevent infections and help to keep the lung fields as clear as possible.