Introduction to Paediatric Physiotherapy: Difference between revisions
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== Introduction == | == Introduction == | ||
Physiotherapists | Physiotherapists / physical therapists work to maintain and improve their patients' or clients' function and movement.<ref>Pagliarulo MA. [https://books.google.com/books?hl=en&lr=&id=5DgEEAAAQBAJ&oi=fnd&pg=PP1&dq=introduction+to+physical+therapy+e+book+scholarly+article&ots=dc4dAl3SOl&sig=PukXc0eiw8IGf0Xplv9b3MMNRI8#v=onepage&q=introduction%20to%20physical%20therapy%20e%20book%20scholarly%20article&f=false Introduction to Physical Therapy-E-Book]. Elsevier Health Sciences; 2021 Jan 12.</ref> Paediatric physiotherapists work with children and their families who experience some disruption in the normal flow of development. Typically physiotherapists will address motor issues, but their patients may also present with other impairments that affect cognition, language and psychosocial issues. Developmentally, children follow a predictable pattern of motor skills attainment, although timelines can vary. Genetic makeup, cultural expectations, caregiver practices, and interactions within the environment all have an impact on how children learn functional skills.<ref>Long T. [https://books.google.com/books?hl=en&lr=&id=jxVbDwAAQBAJ&oi=fnd&pg=PP7&dq=pediatric+PT+scholarly+article&ots=6NCGXrlYQN&sig=2imKlH1H9dC9nFUO0jxGIiLbuAY#v=onepage&q&f=false Handbook of pediatric physical therapy.] Lippincott Williams & Wilkins; 2018 May 17.</ref> | ||
=== Aims of | === Aims of Paediatric Physiotherapy === | ||
When working with children with physical impairments or disabilities, the overall goals of a paediatric physiotherapist are to achieve developmentally appropriate functional skills, decrease the impact of an impairment, impart adaptive strategies, and educate the family and caregiver to ensure carryover.<ref name=":3">Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. [https://publications.aap.org/pediatrics/article/143/4/e20190285/37233/Prescribing-Physical-Occupational-and-Speech Prescribing physical, occupational, and speech therapy services for children with disabilities]. Pediatrics. 2019 Apr 1;143(4).</ref> | |||
Goals during | Goals during paediatric physiotherapy sessions include: | ||
# | # Promote independence | ||
# | # Increase participation | ||
# | # Facilitate motor development and function | ||
# | # Improve strength and endurance | ||
# | # Enhance learning opportunities | ||
# | # Ease challenges associated with daily care giving<ref>Eskay, K. Introduction to Pediatric Course. Plus. 2022</ref> | ||
=== Common Paediatric Impairments === | === Common Paediatric Impairments === | ||
Neurodevelopmental conditions among children | Neurodevelopmental conditions among children are on the rise. These disabilities can be related to congenital or acquired health conditions which result in temporary, permanent or progressive impairments. Depending on the disability, all aspects or certain settings of a child's life can be affected. Some common examples of childhood disabilities include: | ||
* | * [[Cerebral Palsy Introduction|Cerebral palsy]] | ||
* | * [[Spina Bifida|Spina bifida]] | ||
* | * [[Traumatic Brain Injury in Paediatrics|Traumatic brain injury]] | ||
* | * [[Autism Spectrum Disorder|Autism spectrum disorder]] | ||
* | * Intellectual disability | ||
* | * [[Juvenile Rheumatoid Arthritis|Juvenile idiopathic arthritis]]<ref name=":3" /> | ||
=== Where | === Where Do Paediatric Physiotherapists Work? === | ||
Paediatric physiotherapists can work in a diverse group of settings including: | |||
* | * Schools | ||
* | * Outpatient centers | ||
* | * Hospitals | ||
* | * Rehabilitation centers | ||
* | * The child's home | ||
* | * Neonatal intensive care units<ref>Innerbody Research. Available from: https://www.innerbody.com/careers-in-health/how-to-become-a-childrens-physical-therapist.html#:~:text=Pediatric%20physical%20therapists%20work%20in,directly%20in%20the%20child's%20home.</ref><ref name=":3" /> | ||
=== Family Centered Care === | === Family-Centered Care === | ||
Previously, interventions for children were based on structures and body function impairments. | Previously, interventions for children were based on structures and body function impairments. Recently, there has been a shift to focus on the child's participation and activities with their family. In addition, interventions have shifted from what the child cannot do to what the child can do.<ref name=":0">Hielkema T, Toonen RF, Hooijsma SJ, Dirks T, Reinders-Messelink HA, Maathuis CG, Geertzen JH, Hadders-Algra M. [https://www.tandfonline.com/doi/full/10.1080/01942638.2017.1405863 Changes in the content of pediatric physical therapy for infants: a quantitative, observational study. Physical & occupational therapy in pediatrics]. 2018 Oct 20;38(5):457-88.</ref><ref name=":2">Longo E, de Campos AC, Palisano RJ. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531638/ Let's make pediatric physical therapy a true evidence-based field! Can we count on you?.] Brazilian journal of physical therapy. 2019 May;23(3):187.</ref> | ||
Atypical development of a child can directly impact the entire family. | Atypical development of a child can directly impact the entire family. Caregivers and family members may develop feelings of vulnerability and guilt or feel unable to care for their child.<ref name=":1">Cunha RF, Costa KB, Morais RL. [https://www.scielo.br/j/fm/a/GPhjPqrxyHcpCqP6K5zcfSG/ Family-centered care on a physiotherapy course]. Fisioterapia em Movimento. 2022 Mar 25;35.</ref> This new model of care shifts the decision from the clinician to the caregivers as they are considered the experts in their child's needs and abilities.<ref name=":0" /> <ref>Hornby G, Lafaele R. [https://link.springer.com/article/10.1186/s12913-019-4394-5 Barriers to parental involvement in education: An explanatory mode]l. Educational review. 2011 Feb 1;63(1):37-52.</ref> <ref>Kokorelias KM, Gignac MA, Naglie G, Cameron JI. [https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4394-5 Towards a universal model of family centered care: a scoping review]. BMC health services research. 2019 Dec;19(1):1-1.</ref><ref name=":2" /> Acknowledging the family's interest and values is, therefore, critical. This process provides opportunities for the families to feel empowered and increase their self-confidence as they face daily challenges.<ref name=":1" /> | ||
=== Team === | === Team === | ||
In most | In most paediatric settings, the physiotherapist will work collaboratively as a team member. Each team is different, depending on the needs and wants of the family and the child. In general, the team will include the child, parent/caregiver and other specialised medical personnel such as speech-language pathologists / therapists, occupational therapists, psychologists, social workers, teacher and physicians. | ||
There are three types of team | There are three types of team that a paediatric physiotherapist may work within: | ||
# Multidisciplinary: | # Multidisciplinary: professionals work independently providing separate evaluations, goals and interventions specific to their discipline; there is generally less communication between team members | ||
# Interdisciplinary: | # Interdisciplinary: team members interact with each other in relation to the evaluation and development of an intervention plan; interventions are typically provided by the individual provider but occasionally co-treatments occur; there is more communication amongst team members | ||
# Transdisciplinary: team members provide joint evaluations and collaborate on goal development | # Transdisciplinary: team members provide joint evaluations and collaborate on goal development and carrying out interventions; one provider is the primary provider who works with family on a regular basis - they implement the intervention plan and consult with other providers; the primary provider is based on the highest need of the family | ||
<nowiki>**</nowiki> Despite which team approach is used, coordination, communication and documentation are all | <nowiki>**</nowiki> Despite which team approach is used, coordination, communication and documentation between team members are all essential .<ref>APTA Pediatrics: Facts Sheets and Resources: Available from: https://pediatricapta.org/includes/fact-sheets/pdfs/12%20Ped%20PT%20as%20Practioner%20of%20Choice.pdf. 2012.</ref> | ||
== Resources == | == Resources == | ||
Revision as of 01:56, 23 August 2022
Original Editor - Robin Tacchetti Top Contributors - Robin Tacchetti, Jess Bell, Kim Jackson and Naomi O'Reilly
Introduction[edit | edit source]
Physiotherapists / physical therapists work to maintain and improve their patients' or clients' function and movement.[1] Paediatric physiotherapists work with children and their families who experience some disruption in the normal flow of development. Typically physiotherapists will address motor issues, but their patients may also present with other impairments that affect cognition, language and psychosocial issues. Developmentally, children follow a predictable pattern of motor skills attainment, although timelines can vary. Genetic makeup, cultural expectations, caregiver practices, and interactions within the environment all have an impact on how children learn functional skills.[2]
Aims of Paediatric Physiotherapy[edit | edit source]
When working with children with physical impairments or disabilities, the overall goals of a paediatric physiotherapist are to achieve developmentally appropriate functional skills, decrease the impact of an impairment, impart adaptive strategies, and educate the family and caregiver to ensure carryover.[3]
Goals during paediatric physiotherapy sessions include:
- Promote independence
- Increase participation
- Facilitate motor development and function
- Improve strength and endurance
- Enhance learning opportunities
- Ease challenges associated with daily care giving[4]
Common Paediatric Impairments[edit | edit source]
Neurodevelopmental conditions among children are on the rise. These disabilities can be related to congenital or acquired health conditions which result in temporary, permanent or progressive impairments. Depending on the disability, all aspects or certain settings of a child's life can be affected. Some common examples of childhood disabilities include:
- Cerebral palsy
- Spina bifida
- Traumatic brain injury
- Autism spectrum disorder
- Intellectual disability
- Juvenile idiopathic arthritis[3]
Where Do Paediatric Physiotherapists Work?[edit | edit source]
Paediatric physiotherapists can work in a diverse group of settings including:
- Schools
- Outpatient centers
- Hospitals
- Rehabilitation centers
- The child's home
- Neonatal intensive care units[5][3]
Family-Centered Care[edit | edit source]
Previously, interventions for children were based on structures and body function impairments. Recently, there has been a shift to focus on the child's participation and activities with their family. In addition, interventions have shifted from what the child cannot do to what the child can do.[6][7]
Atypical development of a child can directly impact the entire family. Caregivers and family members may develop feelings of vulnerability and guilt or feel unable to care for their child.[8] This new model of care shifts the decision from the clinician to the caregivers as they are considered the experts in their child's needs and abilities.[6] [9] [10][7] Acknowledging the family's interest and values is, therefore, critical. This process provides opportunities for the families to feel empowered and increase their self-confidence as they face daily challenges.[8]
Team[edit | edit source]
In most paediatric settings, the physiotherapist will work collaboratively as a team member. Each team is different, depending on the needs and wants of the family and the child. In general, the team will include the child, parent/caregiver and other specialised medical personnel such as speech-language pathologists / therapists, occupational therapists, psychologists, social workers, teacher and physicians.
There are three types of team that a paediatric physiotherapist may work within:
- Multidisciplinary: professionals work independently providing separate evaluations, goals and interventions specific to their discipline; there is generally less communication between team members
- Interdisciplinary: team members interact with each other in relation to the evaluation and development of an intervention plan; interventions are typically provided by the individual provider but occasionally co-treatments occur; there is more communication amongst team members
- Transdisciplinary: team members provide joint evaluations and collaborate on goal development and carrying out interventions; one provider is the primary provider who works with family on a regular basis - they implement the intervention plan and consult with other providers; the primary provider is based on the highest need of the family
** Despite which team approach is used, coordination, communication and documentation between team members are all essential .[11]
Resources[edit | edit source]
References[edit | edit source]
- ↑ Pagliarulo MA. Introduction to Physical Therapy-E-Book. Elsevier Health Sciences; 2021 Jan 12.
- ↑ Long T. Handbook of pediatric physical therapy. Lippincott Williams & Wilkins; 2018 May 17.
- ↑ 3.0 3.1 3.2 Houtrow A, Murphy N, Kuo DZ, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH. Prescribing physical, occupational, and speech therapy services for children with disabilities. Pediatrics. 2019 Apr 1;143(4).
- ↑ Eskay, K. Introduction to Pediatric Course. Plus. 2022
- ↑ Innerbody Research. Available from: https://www.innerbody.com/careers-in-health/how-to-become-a-childrens-physical-therapist.html#:~:text=Pediatric%20physical%20therapists%20work%20in,directly%20in%20the%20child's%20home.
- ↑ 6.0 6.1 Hielkema T, Toonen RF, Hooijsma SJ, Dirks T, Reinders-Messelink HA, Maathuis CG, Geertzen JH, Hadders-Algra M. Changes in the content of pediatric physical therapy for infants: a quantitative, observational study. Physical & occupational therapy in pediatrics. 2018 Oct 20;38(5):457-88.
- ↑ 7.0 7.1 Longo E, de Campos AC, Palisano RJ. Let's make pediatric physical therapy a true evidence-based field! Can we count on you?. Brazilian journal of physical therapy. 2019 May;23(3):187.
- ↑ 8.0 8.1 Cunha RF, Costa KB, Morais RL. Family-centered care on a physiotherapy course. Fisioterapia em Movimento. 2022 Mar 25;35.
- ↑ Hornby G, Lafaele R. Barriers to parental involvement in education: An explanatory model. Educational review. 2011 Feb 1;63(1):37-52.
- ↑ Kokorelias KM, Gignac MA, Naglie G, Cameron JI. Towards a universal model of family centered care: a scoping review. BMC health services research. 2019 Dec;19(1):1-1.
- ↑ APTA Pediatrics: Facts Sheets and Resources: Available from: https://pediatricapta.org/includes/fact-sheets/pdfs/12%20Ped%20PT%20as%20Practioner%20of%20Choice.pdf. 2012.
