Physiotherapy
Physiotherapy helps children to move and balance and helps to minimise the development of musculoskeletal problems.
Dublin Clients
The Physiotherapy Department provides assessment and ongoing therapy intervention to clients with primary physical disability from the ERHA region (mainly Northside). Babies and young children are prioritized for therapy. Upon receipt of referral, appointments are arranged usually within 3 weeks. Referrals come from the 3 main maternity hospitals, The Children’s University Hospital, Temple St., Our Ladies Hospital for Sick Children,Crumlin and occasionally from local GPs and Area Medial Officers. For clients aged 18+ years, a similar service is provided although the waiting time for this may be up to 3 months. Referrals to this adult service usually come from in-house paediatricians with some clients having joint consultations with a physiotherapist and the adult rehabilitation consultant.
Clients from outside Dublin
There is also a service for clients coming from
outside Dublin. This is a consultatory / review service. These clients
(both children and adults with
congenital physical
disability) are usually referred by their local physiotherapist and/or
paediatrician/consultant for specialist opinion regarding their therapy programmes.
Regular contact
between the local primary treating physiotherapist and the CRC physiotherapist
is essential to ensure that the needs of the client are fully met. Outreach services
have been set up with some health boards enabling a team of experienced
CRC therapists and paediatricians to travel to various locations around Ireland
to consult with local therapy teams and thus minimising travel to Dublin
for families.
Clients attending CRC pre-school and school
Clients attending CRC school receive physiotherapy as appropriate during the school day and a postural management programme is incorporated into the school timetable where practical. Parents are welcome and encouraged to attend physiotherapy sessions and each child has a multidisciplinary programme with joint goals drawn up in consultation with parents and child
Conditions Treated
All of the major conditions resulting in physical disability
are treated in the department e.g. Cerebral Palsy, Muscular Dystrophy,
Brachial Plexus
Injuries,
Spina Bifida and Arthrogryposis . Babies with developmental delay and other
more unusual syndromes with associated primary physical disability also
attend. Cerebral Palsy is the most common condition amongst the client
population.
There are specialized clinics for clients with Muscular Dystrophy, Brachial
Plexus Injuries and Spina Bifida where the full team is present to assess
and make recommendations for each client .
Assessment:
All clients referred to the service undergo formal assessment which can take a few visits to complete. This may be undertaken by a physiotherapist alone or as part of the wider team, depending on client's needs. For Dublin clients, following the assessment, a therapy plan is devised and goals are set and agreed by all—parents, therapists and consultants. Reassessments take place following implementation of the treatment programme. Assessments and outcome measures carried out are those that are appropriate to the age and condition of client and are in line with international best practice.
Therapy Programme:
The therapy programme will be tailor made to help the client's specific
problem and also takes into account the lifestyle of client and family.
Therapy usually
takes place in the physiotherapy department and may be one to one
, group or as part of joint therapy with other disciplines. As no two children
are affected
in the same way the therapy programme is individualized. Frequency
of
therapy depends on a number of factors and this will be discussed
before
embarking
on the programme, Clients will usually be given a home programme
to follow and this will be updated regularly. For babies and young children,
parents
play a vital role in the treatment of their children. Programmes
will
be set jointly with families so that therapy becomes part of everyday
life.
Physiotherapy
sessions in the CRC give parents a chance to learn the treatment
techniques that are appropriate to their child. For most clients therapy
will
continue into adult life. Hence it is important that clients and their
families
learn that by incorporating
their treatment programme into the daily routine this will assist
with their child's development .
The treatment for children with cerebral palsy in CRC is based on the Bobath method, however other recognised treatment regimes are also included if appropriate. Bobath treatment aims to give the child the experience of more normal posture and movement by helping the child to change his abnormal postures so that he can comfortably adapt to the environment and develop a better quality of functional skills.
The physiotherapist works closely with the visiting orthopaedic consultants and attends with all clients at their orthopaedic appointment in CRC. The physiotherapist is part of the team when decisions regarding surgery or botulinum toxin injections are made. Following these interventions an intensive therapy programme usually takes place. Hydrotherapy is used to help regain movement and to strengthen.
Training and development:
Physiotherapy treatment in CRC is continually updated through staff
attendance at national and international courses , so that international
best practice
can be brought to CRC clients.
Many of the staff are Bobath trained having completed the 8 week long Bobath course. Fortnightly in-services within the department ensure that all staff pursue continuous professional development and learn from one another.
Physiotherapists regularly deliver lectures on external courses and intensive training courses are provided by the department to physiotherapists countrywide.