Physical therapy

Physiotherapy is a healthcare profession that uses physical exercise to develop, maintain and restore movement and function throughout life wherever movement and motor function are impaired. Paediatric physiotherapy has its own particularities: the therapist must understand how motor function normally develops at each age. Modern physiotherapy and modern Bobath therapy for children with neurological movement disorders share the same theoretical basis, the theory of neuroplasticity, and the core principles of Bobath are used successfully in physiotherapy for these children.

Before sessions begin the physiotherapist assesses the child: level of mental and motor development, posture in different positions, joint range of motion, muscle tone at rest and during movement, motor milestones (head control, rolling, sitting, standing up, walking), the influence of tonic reflex activity on posture and movement, and any orthopaedic problems such as contractures and deformities, using tests and standardised scales as appropriate. The therapist then sets the goals of therapy together with the parents, taking the child's individual state into account, and works continuously with the rest of the rehabilitation team.

Good contact between therapist and child matters: sessions must take place in a supportive atmosphere and must never cause pain, because pain and stress produce negative neuroendocrine changes in the child's body. Some parents and even some medical staff believe effective physiotherapy can go on despite a child's tears and protest. The specialists at our centre are firmly against this approach; the harm of stress to a child's development is scientifically proven, and it can cause not only psychological trauma but also microtrauma to tendons and muscles.

Preventing orthopaedic complications is one of the physiotherapist's most important tasks. Exercises must be accessible to the child and made harder gradually; when movements are too difficult, children with delayed motor development show more pathological reflexes and worse muscle tone. Exercises are done at a pace the child can follow, with the child as active as possible. Motivation matters, so sessions are run as play, which is how children learn, and skills that are relevant to the child are then carried over into everyday life.