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As per Census 2011, India has about 78,64,636 Differently abled children below the age of 19 years. They need specialized training & rehabilitation plan to live an independent life.

Importance of Physiotherapy for Parents of children with special needs

Physio therapy builds on a child’s strengths & abilities and focuses on improving their functional skills. Therapy sessions may include: testing to learn child’s needs, regular treatment to work on mobility skills, Special Techniques which help promote overall Development in the child, strengthening or stretching exercises and teaching the family those exercises that can be done at home. The need for therapy changes for each child over time. Children sometimes acquire new skills quickly and sometimes need help of family & therapists to learn skills that may develop slowly. The earlier you start therapy (within the first weeks of life), the better the developmental outcome for the child.

Early intervention with an appropriate therapy program is very important factor that can bring better results. An early intervention service is one that begins before three years of age (as early as day one following birth) and is designed to improve the development of a child with risk factors for developmental delay or disability. These services can include special instruction; Medical care; physical, occupational, or speech therapy; health services; family training and counselling; or assistive technology services. The strategy is to take advantage of cerebral plasticity.

Children with physical disabilities can often spend their entire day in the same positions that can affect their health even more adversely. From higher risks for illnesses and effects of a sedentary life, disabled children can benefit from physiotherapy. It is very important for health and mobility of disabled children and helping them reach their potential. A coordinated program that uses the knowledge and training of a physiotherapist can help children develop motor skill and life skills.

It Helps to Promote normal growth and Overall Health in the Body

It maximises Physical, Mental & emotional growth and health and other positive outcomes for infants in the NICU. Giving developmental support and teaching handling skills to the mother as well as cluster care, Diurnal lighting, muted sounds and promoting good posture in the NICU environment augments developmental outcomes and help the risk infant achieve normal growth and development.

Physiotherapy is one of the most important ways to help promote better overall health in disabled children. Sadly, disabled children often have multiple medical issues that affect their health beyond their physical disability such as higher risks for colds, infections, viruses, etc. By utilizing physiotherapy to manipulate the body to function better, it can instil a better sense of health & well-being.

Physio therapists, families, teachers and physicians must work together to jointly determine goals and provide most appropriate child specific therapy program. Each of these people are essential members of the rehabilitation team. Therapy may not necessarily change the outcome or course of disability; though, new therapies are constantly being developed. Goal is to help each child be as independent as possible and assist the family in achieving a greater understanding of child’s disability and adapting to the life changes that their unique situation may require.

It Keeps Them Fit

When the body isn’t mobile and in action, the sedentary lifestyle can affect weight and overall health of a disabled child. Therefore, it is important to make full use of the body even when child has physical limitations. With physiotherapist’s help, a child will be able to stretch their body and strengthen muscles that are rarely used. This helps them manage their weight, overall health and gives them better mobility and control of their body.

It helps to Relax the Body and Reduce Pain

Physiotherapy not only helps to keep the body fit and trim, it also helps to release tension, pain and stress that can often build up in a mobility challenged child. Far from being a luxury, it is actually one of the most effective ways for disabled children to properly manage their pain from problems like spasms and spasticity that are otherwise hard to manage. It works to manipulate the body into a better state of health and it could be a very helpful way to relaxing the body and relieving stress as well.

Few Guidelines for Parents for Handling their Children

Carrying Positions for a Floppy Child

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Carrying Position for a Child (Extensor Pattern)

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Carrying Positions for a Child (Flexor)

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Helping a Child to move from lying to sitting up

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Braces & Mobility Aids

During the course of treatment many special needs kids need splints or braces to help them become independent in walking and other activities of daily living. In the medical community, splints and braces are called “orthotics”. Orthotics are aids strapped on to a child’s body to assist weak muscles, to position or immobilize a certain part of the body or to correct and prevent deformities. Orthotics for the hands are usually called splints while those attached to the legs are called braces or callipers.

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A child who cannot move in normal ways is in great danger of developing muscle contractures. A contracture is the permanent shortening of a muscle, tendon or joint structure which prevents the normal range of motion. Contractures lead to deformities which over time become “fixed”. Fibrous tissue is laid down in the muscle and if a long time passes after that happens, the muscle can only be lengthened by surgery. But, if caught early, contractures can sometimes be stretched out using plaster casting and stretching exercises. To prevent contractures, splints and braces are applied to support the weak muscles.

Some children have muscles that are very strong on one side of a joint and very weak on the other side. For example the muscles that bend the knee may be strong while the muscles that straighten the knee joint may be weak. This muscle imbalance can also cause contractures so it is often necessary to apply braces to prevent deformity.

Braces & splints should only be used if they help the child move better and become more independent. Too much bracing may weaken muscles. Also, braces that are too heavy for weak muscles may make it more difficult for the child to walk and will discourage him from even trying. So the best approach is to use as little and light bracing as possible to meet the goal of helping the child move more easily.

Hand splints are often applied to hold the wrist and hand bones in the proper alignment so that the hand can be used more comfortably. Often, hand splints are given to protect the bones and soft tissue from further damage following an injury. The hand is held in a safe and well supported position while the healing is progressing.

Each child must be carefully assessed to determine what type of bracing will help increase his ability to use his body properly. A brace that works very well for one child may not help another child. This assessment can be done by an Orthotist, or an Occupational or Physio Therapist.

 

Dr. Meeta Saxena, PhD.

Senior Consultant and HOD, KG Patel Children Hospital, Baroda, since 1987 where she oversees the OPD as well as NICU and PICU. Runs her own Physiotherapy clinic since 1991. Resource person for Handicap International since 2006 and invited for training of Physiotherapists at Kabul (Afghanistan), Srinagar and Rajkot etc. She does regular teaching and training in Physiotherapy for senior students.

She conducts workshops on Sensory Integration, Cerebral Palsy and Developmental Disorders. She has conducted a number of training and counselling workshops in the industries and educational institutes for ergonomic workspaces and fitness.

Has presented 12 research papers at national conferences of which two have won best paper award. Current area of research is in fitness for adolescents and Children.

 

Recipient of “THE CP NAIR Oration award” by the Indian Association of Physiotherapists in 2006. 

Awarded for meritorious services for “Outstanding contribution to the physiotherapy profession” by Dr. Brian Mulligan at the CMP International Conference in 2014 at Mumbai.

 






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