Physiotherapy
We are a team of Physiotherapists and Therapy Assistants who work with children in the Bradford area aged from 0-16 years. Your child can be referred into our service either by their GP or hospital Consultant.
We assess and treat children with a range of conditions including:
- Upper limb, lower limb, back or neck pain
- Talipes
- Torticollis
- Obstetric brachial plexus palsy (OBPP)
- Walking difficulties
- Foot problems
- Rheumatology conditions including Children’s arthritis and Joint hypermobility syndrome
- Post-operative difficulties/rehabilitation
- General musculoskeletal rehabilitation following an injury or hospital stay
What to expect from your first Physiotherapy appointment within the Children’s Musculoskeletal (MSK) and Rheumatology Service
On your child’s first visit your Physiotherapist will carry out an assessment of your child’s main difficulties. This will involve an initial discussion followed by a physical examination. From here we can jointly discuss how we can help and together develop a plan.
We have access to a hydrotherapy pool so that your child can receive some physiotherapy in water (if this is appropriate) and we also have access to a gym environment.
We work closely with other health professionals such as orthotists, consultants, GPs, health visitors, Clinical Nurse Specialists, CAMHS and Occupational Therapists.
We greatly encourage movement and activity as part of the rehabilitative process and your child’s treatment is likely to involve exercises and physical activity (both specific and general) that we would expect your child to engage with in order to allow their condition to improve.
Neurology
Neurological physiotherapists are experienced at assessing and treating babies and children with different neurological conditions. They provide treatment for neurological and developmental problems. Neurological conditions arise from damage to the central nervous system (brain and spinal cord) and /or peripheral nervous system. This can lead to difficulties with movement, muscle tone, strength, sensation and balance. Developmental problems can cause delays in the achievement of milestones.
Neurological paediatric conditions commonly treated by paediatric physiotherapists include:
- Congenital disorders including Cerebral Palsy
- Developmental disorders
- Spina Bifida
- Head Injuries
- Disease of the spinal cord
- Cancers of the brain or spinal cord
- Inherited muscle disorders like muscular dystrophy and Spinal Muscular Atrophy
Benefits of physiotherapy treatment include increasing range of movement, improving muscle strength and balance and coordination. Physiotherapy treatment will improve quality of life by enabling your child to reach developmental milestones within the limits of their condition (e.g. rolling, crawling and walking) and maximising their potential with daily tasks. Along with Occupational Therapy colleagues they will assess your child for specialist postural management equipment as required.
Your child may be invited to a ‘Measuring clinic’. This is also known as a ‘CPIPs’ clinic. This is a comprehensive assessment to measure the Range Of Movement at hips, knees and ankles. The assessment was originally formulated for children with Cerebral Palsy but is so good we use it for all children with altered muscle tone in their legs. It is a National initiative and more information on the assessment can be found here: CPIP Information for Parents
Neonatal Therapy Service
What is a Neonatal Therapist?
The Neonatal Therapy Service is made up of Physiotherapists and Occupational Therapists, based on the neonatal unit at the BRI.
A Neonatal Therapist aims to support the development of babies who may be at risk of having movement or developmental difficulties due to:
- Prematurity (born less than 30 weeks)
- Low birth weight (born less than 1.5kg)
- Problems before, during or after birth
- Problems or conditions affecting joints or muscles
- Other problems that may affect how they move
Many babies develop well despite being born early or being ill in their early life. We have a Physiotherapy led developmental follow-up programme to monitor your baby’s progress once they have gone home. Physiotherapists will offer suggestions for appropriate developmental play activities, and make sure your baby gets the earliest possible help if they need it.
Therapy on the Neonatal Unit
The therapy team will see your baby as part of the daily ward round or weekly developmental ward round.
After an assessment the Therapist will be able to explain to you how your baby’s movements and skills are developing. If your baby would benefit from support with their development the Therapist will advise you and the nursing staff on ways you can support and encourage their movement, sensory experience and other skills and support you and your baby’s mental health. This may include ways to position, handle and carry your baby, adapt care routines, read behavioural cues, developmental play ideas, and stretches. This advice is not usually a list of exercises but ways to support your baby’s development through the day and night.
Developmental Care
In our Neonatal Unit we endeavour to practice family-centred developmental care for all babies and you as parents/primary carers are key to this. Developmental care encompasses a range of interventions that aim to reduce stress on babies, conserve their energy and promote growth. Our aim is to optimise and promote neurological development by mimicking the conditions of the womb as best as we can. These interventions include environmental adaptations such as use of cot covers, dimming lights and reducing noise to protect your baby’s developing eyes and ears, developmentally supportive positioning and positive touch programmes (comfort holding, kangaroo care/skin to skin). Developmental Care also aims to encourage and support you as parents to empower you to play an active role in your baby’s care. Being with your baby as much as possible, is key to building your confidence but also has huge benefits to your baby. Your Therapist will be happy to support you with all these aspects of developmental care.
Respiratory
We provide an assessment and treatment service for children and young people (CYP) with complex health needs who have respiratory complications. We train families and carers in on-going chest physiotherapy techniques and offer rapid response to those under our service in their own homes. The aim of this service is to identify a deterioration and reduce hospital admissions.
We work closely with the local Children’s Community Nursing and Palliative Care Teams, alongside the regional Neuro-Muscular and Long-Term Ventilation teams to provide joined up care.
Parents and Carers
If your child/young person is already known to our service and you feel they may have a chest infection, please contact the Children’s Community Nursing Team on 01274 365051 (7 days a week, 8am-6pm) and speak to one of the nursing team. They will take a detailed history of your concerns and offer advice.
If the physiotherapist is available, they will then call you back and arrange an assessment if indicated.
The physiotherapist or nurse may ask you to collect a sputum sample and drop this off at St Luke’s Hospital, this is useful to obtain prior to starting any antibiotics.
If you already have a physiotherapy plan, please follow this, increasing home physio sessions as able and escalate as needed.
Referral Criteria
Age 0-18 years old, registered with a Bradford GP.
Children can only be referred via their Child Development Centre Paediatrician. They must have a diagnosis of complex health needs and/or respiratory compromise, for example recurrent chest infections where modifiable factors have not made an improvement.
Treatment Available
Treatment will be based on an individual assessment, it may include:
- positioning
- manual techniques such as percussions and vibrations
- use of medication for secretions management
- specialist equipment to aid with secretion clearance
Co-ordination
Children develop movement and co-ordination at different rates.
If you are concerned about your child’s movement and co-ordination you could ask their school to assess them using FUNMOVES. FUNMOVES is a research project being undertaken by Born In Bradford which our team of Occupational Therapists and Physiotherapists are involved with.
Often children struggle with some activities through lack practice or opportunity to repeat the activity. The following resources will help you work with your child on the activities they may struggle with.
For more information on FUNMOVES visit their website.
Resources
Our colleagues in Sheffield have developed these resources which are particularly helpful for advice on daily living skills such as dressing, bathing, cleaning teeth and using cutlery.
Specialist Equipment
Your child’s therapist has recommended a piece of specialist equipment for your child. The following information will hopefully provide you with more information on why the equipment is important for your child’s health and wellbeing and answer any questions you may have. If something isn’t covered in the information, then please discuss this with your therapist.
Standing frames
Why stand?
Standing frames
Safety & Maintenance
Sleep systems
What is it?
Sleeping is the longest time your child will spend in one place during a 24 hour period. The average person will spend around 3,340 hours in bed per year. Children with neurological conditions can often spend much more time than this. It is, therefore, necessary to ensure your child is supported in bed to prevent bad postures and body shape changes. All sleep systems are designed with comfort in mind. Their aim is to provide a supportive position to protect your child’s body shape. Sleep systems can be used while spending time in bed awake or asleep. They can support your child to lie on their back or on their sides. They are adjustable to accommodate positional changes if required throughout the night.
Lying postural care
Rough guide to lying
Walking frames
Benefits of walking
Wheelchairs and buggies
Bradford Local Offer
The therapists at Children’s Therapy at St Luke’s hospital don’t assess for wheelchairs or buggies however after discussions with the child’s parent/carer may make a referral to Wheelchair Services for assessment. More information on Bradford’s Wheelchair services can be found on Bradford’s Local Offer:
Specialist seating
Why an Occupational Therapist considers introducing specialist seating for a child with postural difficulties?
- To promote their social inclusion (eye contact, interaction)
- To ensure postural stability
- To decrease tiredness and maximise function
- Improve breathing and digestion
- A stable base to promote upper body function which will then enable participation in table top tasks and activities
- Comfort and security
- Participation in activities of daily living
What does specialist seating look like?
There are many types of chairs available and are all made to support different needs. After a thorough assessment has been completed, your Occupational Therapist will decide which chair meets the need of the child and the environment it will be used in.
Hydrotherapy
What is hydrotherapy?
Hydrotherapy is movement and exercise in water. Your child’s physiotherapist has referred your child to hydrotherapy for a 4 week block of treatment. You will learn exercises to help improve mobility, strength and reduce pain that you can then do at your own local swimming pool with your child.
Where is the pool?
St Luke’s Hospital
Horton Wing
Area 2
(If you are unsure please ask at the Children’s Development Centre in Area 4)
Physiotherapy Office: 01274 365612
When are the sessions?
Sessions take place on a Wednesday. Your child will have a session each Wednesday for 4 consecutive weeks. Each session lasts between 20-30 minutes depending on the child.
Please note if your child is late, they will lose out on time in the pool.
What time do we need to arrive?
Please arrive at least 15 minutes before your child’s session starts to allow time to change into your swimwear and shower.
Who will be in the pool?
Your child will need to have a parent/guardian with them in the pool.
A physiotherapist will be in the water with you at all times. You may not enter the pool without a physiotherapist.
There will be other children exercising in the pool at the same time as you and you child. Unfortunately, we are unable to offer single sex sessions.
Does it matter if my child or I cannot swim?
No, the physiotherapist will plan their exercises and movement to ensure that you and your child can do them safely.
How do we get into the pool?
Our pool has stairs access but we also have a hoist set up if needed.
Small children can be passed into the pool with help from hydrotherapy staff. It is not safe to carry children up/down the stairs therefore this is not allowed.
What do I need to bring?
Please bring towels and suitable swimwear for both you and your child.
If your child wears nappies you will need to bring swim nappies – we are unable to provide swim nappies.
You may not eat in/around the pool.
You should bring water to drink following your session.
What should we wear?
- For hygiene and safety reasons you must not travel in your swimwear.
- We have changing cubicles where you can change.
- Wear a clean suitable swimsuit/trunks made of elastane, polyester or nylon, this can be a Burkini.
- You may wear a closefitting/light weight t-shirt with no collar and leggings or shorts. You may not wear denim. For hygiene and safety reasons flowing/floaty clothes are not allowed.
- For hygiene reasons you may not keep your previous underwear on in the water.
- You must tie long hair up. You may wear a swim cap to cover your head.
How do I prepare for my child’s sessions?
For safety reasons you and your child need to eat within 3 hours before your session. However, please finish eating at least 30 minutes before to digest properly. Please ask the hydrotherapy staff for further information if needed.
The physiotherapist will have discussed and completed contraindications forms for using the pool for both you and your child.
What should I do if we cannot attend an appointment?
Please inform the hydrotherapy/physiotherapy staff in advance if you are unable to attend your appointment. Physiotherapy Office: 01274 365612
If your child misses 2 hydrotherapy sessions without informing us they will be discharged as sessions are limited and other children are waiting for treatment.
Unfortunately, we cannot provide extra sessions if any are missed.
Will it be fun?
We hope so! Most children love our pool and have lots of fun splashing!
