Pediatric Physiotherapy

Pediatric physiotherapy refers to physiotherapy that is provided by specially trained physiotherapists to infants, toddlers, children and teenagers ranging from 0 to 18 years.

Children are completely different from adults; not only are their personalities and mannerisms different from adults, but their anatomy and physiology differs as well. Because of these differences, pediatric physiotherapists develop individualized treatment plans that focus on movement and early development to optimize function, improve performance, and improve quality of life for children up to the age of 18 years. 

There are a wide variety of conditions that pediatric physiotherapists treat, including: gross motor development delays, torticollis, cerebral palsy, cystic fibrosis, post-concussion syndrome, hip dysplasia, and hypotonia general orthopedic conditions and sports injuries, and even chronic pain.

For the purpose of this article, we’ll focus on the role of pediatric physiotherapy for the treatment of motor development delays, and torticollis.

Motor Development Delays 
Gross motor development follows a predictable pattern in children that reflects the functional maturation of the central nervous system. This is why developmental surveillance is recommended at preventative care visits for all children 9, 18, 30 and 48 months of age. Gross motor delays are quite common in the pediatric population and vary in their severity and outcome. While some children with gross motor delays meet milestones at a later age, other children have a permanent motor disability, such as cerebral palsy. Others may have a developmental coordination disorder. 

In cases where motor delays are progressive or pronounced, a neuromuscular disorder is more likely to be found. For children with motor development delays, early intervention with physical therapy is associated with improved outcomes and should be initiated as soon as a developmental delay is observed.

Torticollis 
Congenital muscular torticollis is a postural deformity that is noticed shortly after birth. It is characterized by the head being tilted to one side and rotated to the opposite side, as the result of shortening of the sternocleidomastoid muscle on one side. In some cases, congenital muscular torticollis is seen with other musculoskeletal or neurological conditions. 

Infants with congenital muscular torticollis should be brought to a physiotherapist to deal with the muscular imbalances. A physiotherapist can provide a variety of treatment interventions for these patients including passive range of motion of the neck, active range of motion of the neck and trunk, and manual therapy of the neck to enable symmetrical movement of the neck. They also make recommendations on environmental changes and educate caregivers on the condition. 

If you notice a developmental issue with your child, they may benefit from physiotherapy, which will involve an individualized treatment plan that is tailored specifically to their condition. As the child’s parent or guardian, you play an important role in ensuring the effectiveness of treatment for their condition. You will work with the physical therapist to set goals and review the needs of your child, as well as help to track their progress as they work through their treatment plan. In some cases, when your child is young, it may be necessary to help them at home with their home exercise program. 

Having your child undergo a comprehensive evaluation by a physiotherapist at North Hill Physiotherapy is one of the best ways to gain an understanding of how you can improve your child’s development. After the assessment, our physiotherapists will create a program that is specific to your child’s needs, and set them on the right path toward optimal functioning and an enhanced quality of life. 

References
1. Campos A, Amaria K, Campbell F, McGrath P. Clinical Impact and Evidence Base for Physiotherapy in Treating Childhood Chronic Pain. Physiotherapy Canada. 2011;63(1):21-33. doi:10.3138/ptc.2009-59p.2. Noritz G, Murphy N. Motor Delays: Early Identification and Evaluation. Pediatrics. 2013;131(6):e2016-e2027. doi:10.1542/peds.2013-1056.3. Kaplan S, Coulter C, Fetters L. Physical Therapy Management of Congenital Muscular Torticollis. Pediatric Physical Therapy. 2013;25(4):348-394. doi:10.1097/pep.0b013e3182a778d2.