Rehabilitation and Physiotherapy
Rehabilitation is the name given to all diagnostic and therapeutic procedures which aim to develop maximum physical, social and vocational function in a diseased or injured person. The goal of rehabilitation is to gain independence in activities of daily living, school or work and social life. This is possible to the extent of the person’s impairments.

Components of child rehabilitation
Child rehabilitation consists of improving mobility, preventing deformity and educating the parents about the child’s problem.

Goals of rehabilitation

Improve mobility

• Teach the child to use his remaining potential
• Teach the child functional movement
• Gain muscle strength

Prevent deformity

• Decrease spasticity
• Improve joint alignment

Educate the parents

• To set reasonable expectations
• Do the exercises at home

Teach daily living skills

• Have the child participate in daily living activities

Social integration

• Provide community and social support

It also involves helping the child to learn the skills he will need in daily life, school and while playing with friends. Lastly, rehabilitation means decreasing the complications which arise as a result of the child’s neuromuscular impairments. Therapeutic exercises help the child learn how to sit, stand, walk and use his upper extremity for function. The child also learns how to use his remaining potential to compensate for the movements he cannot perform. Decreasing spasticity, gaining muscle strength and improving joint alignment decrease deformity. The education of caregivers involves gently coaching them to set reasonable expectations for their child, and teaching them to follow their child’s exercises at home. Parents should encourage their children to participate in daily living activities by using the functional skills they learned during therapy. Community and social support is another aspect of rehabilitation. There is no method which can decrease the neurological impairment. Explain to the parents not to spend valuable time and hope with alternative treatments. Aim to have the child fulfil his maximum physical, intellectual and psychological capacity and have a happy childhood as close to normal as possible. Focus on the child’s abilities and interests. Try to improve function by working on these. The child can easily improve in the activities he likes doing. This will enable him to have a happy childhood and a job in the future. CP rehabilitation consists of physiotherapy, occupational therapy, bracing, assistive devices, adaptive technology, sports and recreation.

Components of rehabilitation

• Physiotherapy
• Occupational therapy
• Bracing
• Assistive devices
• Adaptive technology
• Sports and recreation
• Environment modification

The main aim of rehabilitation is providing an education for the child, and to help him grow up to be a productive, independent adult. Various therapy procedures exist some of which do not really relate to real world situations. The skills that the child gains during therapy sessions should be useful within the community. Never ignore the child’s education throughout the various therapy procedures. Always aim to send the child to school for an education and prepare him for community integration.

Planning rehabilitation
The child begins to receive physiotherapy when he is a baby. Occupational therapy starts towards age two to teach daily life activities. The toddler uses assistive devices for mobility. Bracing may be necessary as the child begins to walk. Sports and recreation are crucial for the school aged child. Play is
important beginning in infancy throughout adolescence. Have short and long term goals depending on the child’s expected functional outcome. Evaluate the child, specify these short and long term functional goals and set a time limit in which you expect the child to achieve these goals. Review
the plan if the child cannot achieve the expected function in the predetermined time period.

Rehabilitation planning
Example: Independent standing
1- State the necessary time period to achieve this goal i.e. 12 weeks
2- Plan the methods to achieve this goal i.e. Stander, exercises to
improve trunk balance
3- Evaluate the end state.
4- Revise the treatment program or the goals if not successful.