General principles of physiotherapy

Physiotherapy begins in early infancy and continues throughout adolescence. The primary purpose is to facilitate normal neuromotor development. With the help of correct positioning, appropriate stimulation and intensive exercise the therapist tries to gain head control, postural stability and good mobility in the child. This is possible only to the extent of the child’s neurological capacity. Even with vigorous physiotherapy many children remain functionally impaired in varying degrees. There are different methods of therapy for children with neurological impairments. Even though they differ in the techniques they use, basic principles remain the same. The problems of neuromotor development are difficulty flexing and extending the body against gravity, difficulty sitting and functional ambulation.

Basic problems in the neuromotor development of children with CP

• Difficulty with flexing and extending the body against gravity
• Sitting
• Functional ambulation

For functional ambulation a child needs motivation to move and explore the world around him.

For functional ambulation a child needs

• Motivation to move
• Enough muscle strength and control
• Able to shift his body weight (balance)
• Awareness of body position and movement (deep sensation)
• Sufficient visual and vestibular system
• No deformities interfering with joint function

He must have enough muscle strength and control. He must be able to shift his body weight and have an awareness of body position in space at rest and during movement. Visual and vestibular systems must be sufficient. There must not be any deformities interfering with joint function. In physiotherapy sessions the therapist works with the child in supine and prone  positions to improve head and trunk control. She supports the child in the sitting position to develop weight shifting and unilateral balance, ability to rotate the body and the ability to respond to sudden changes in position. The rehabilitation team strives for longterm, functional mobility in a variety of environments so that the child will integrate into the community and social life in a healthy way.