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We are pleased to announce that here at The Physio Hub we are now running a hydrotherapy service!

What is Hydrotherapy?

‘Hydrotherapy’ also known as ‘Aquatic Therapy’ involves therapy with the use of water/hydrotherapy pool as a treatment intervention.

Hydrotherapy is defined as:

” A physiotherapy program utilising the properties of water, designed by a suitably qualified Physiotherapist. The program should be specific for an indivdual to maximise function, which can be physical, physiological, or psychological. Treatments should be carried out by appropriately trained personnel, ideally in a purpose built, and suitably heated Aquatic Physiotherapy Pool“

(ATACP 2014)

Hydrotherapy pools are heated to a constant temperature of between 34 and 35 degrees to allow maximum physiological benefits. Hydrotherapy reduces the load on the joints and can be used to increase joint range of movement, stability and muscle strength in a warm environment. Hydrotherapy can also be effective in improving general mobility, balance and core stability.

So what are the benefits?

There are a number of benefits which can be both physical and psychological.

Therapeutic effects of exercise in the water:

• Pain Relief
• Maintenance or an increase in joint range of movement
• Increase in muscle strength
• Re-education of movement patterns
• Improvements in circulation
• Encouragement of functional activities
• Maintenance and improvements of balance
• Maintenance and improvments of co-ordination

Can my child access hydrotherapy and land based therapy?

Yes, hydrotherapy can be used in conjunction to land based therapies. The water provides an environment to allow specific movements which are often difficult to gain in a land based session.

Does my child need to be able to swim?

No, your child doesn’t need to be able to swim to access the hydrotherapy pool. Your child will be supervised by a therapist at all times. The sessions are ran on a 1:1 basis, dependent on client need.

How long will the sessions be?

Hydrotherapy sessions usually last between 25-30 minutes (this is time in the water) but this is dependent on a childs individual needs.

What assessments will take place?

The hydrotherapy sessions will take place 8 weeks of x1 session per week. We will run the sessions in 8 week blocks. An initial land based assessment will take place prior to sessions in the pool. Details of relevant medical information will be assessed, as most importantly we need to assess if the hydrotherapy pool is appropriate for your child. On completion of a block course of hydrotherapy, a dry land review will take place to review outcome measures and goals set on initial assessment.

“Hydrotherapy is fun and gives children freedom of movement only experienced in warm water”

We currently have time slots available!

Please contact clinic to speak to a member of our team on: 01429 872722.

Our sessions are currently taking place at the Pioneering Care Centre in Newton Aycliffe. The centre has great facilities with wheelchair access and changing facilities. The hydrotherapy pool has seated hoist access and also a ceiling track hoist to enter the pool.

If you require any futher information regarding this service or would like to speak to a therapist regarding hydrotherapy for your child, then please do not hesitate to contact clinic. 

Hypermobility is a term commonly used. Hypermobility is the term used to describe the ability to move joints beyond the normal range of movement.

‘I think my child is Double-jointed, they are very bendy’

So what does it actually mean?

Joints are connected and supported by structures called ligaments. In children that are hypermobile these ligaments are more ‘stretchy’.

Don’t Panic!

Hypermobility is relatively common. In fact it is just a normal variation of how our bodies are put together. Joint hypermobility is often of no medical consequence most children don’t even have any symptoms. Some children use hypermobility as an advantage. For example dancers, musicians and athletes.

Because the joints are more lax, hypermobile children can be prone to injury affecting these joints.These injuries may cause immediate pain and sometimes also lead to longer-term pain.Other problems with hypermobility include:

• Joint Pain
• Fatigue
• Reduced Muscle Length
• Reduced Muscle Strength
• Reduced Joint Stability
• Recurrent soft tissue injuries
• Joint Contractures

At the Physio Hub with specific tailored exercise programmes we aim to:

• Reduce Pain
• Increase Muscle Length
• Increase Muscle Strength
• Increase Joint Stability
• Increase Proprioception
• Increase Co-ordination

A tailored therapy programme can improve function, independence and performance of individuals affected by hypermobility.

Do not hesitate to get in touch. 01429 872722

Reports of back pain in children is relatively common. Back pain or back ache can be caused by a number things. It is important however to assess the root cause of this problem. One thing it could be related to, is a possible scoliosis. Scoliosis in children is relatively common.Scoliosis occurs in approximately 3 out of every 100 people. For the majority of children, it’s not much of a problem.

Does your child have?

• Uneven shoulders
• Have one hip more raised than the other
• Do they lean to one side
• Do their ribs look asymmetrical

Scoliosis: What does it mean?

Scoliosis is an abnormal curve of the spine, it can be described as a ‘C’ or ‘S’ shape. Usually a scoliosis is diagnosed in early childhood or early adolescence.

What causes Scoliosis?

There are two types of Scoliosis:

Idiopathic: Which is the most common type of scoliosis. It means that there is no underlying cause.

Congenital/Neuromuscular: Which iscaused or related to a neurological condition.

Scoliosis affects both boys and girls equally. However, in girls they are x8 times more likely to require surgical or bracing interventions.

Diagnosis:

Early diagnosis is key and treatment helps to prevent any further progression.In around 90% of cases, no surgical or bracing intervention treatment is required because the spine corrects itself as the child grows.It is important however that strength and mobility is maintained within the spine during this process.

How can we help?

Here at the Physio Hub we aim to address the key issues:

• Find the Root Cause
• Assess the effect of Gravity
• Maintain Flexibility
• Increase Strength

As previously mentioned, many children with a scoliosis don’t have any symptoms. If there any other symptoms that your child presents with related to back pain, it is important to rule out any other causes.

If you have any queries regarding scoliosis or any concerns regarding your child’s back in general,then please don’t hesitate to contact us.

Does your child struggle to keep up with his peers or appear awkward in the way he moves when playing? Here at The Physio Hub we see many children who struggle with every day activities such as riding a bike, writing and P.E. Often professionals may use the term Dyspraxic.

What is Dyspraxia and what does it mean for my child?

Dyspraxia – now formally named Developmental Co-ordination Disorder (DCD), is a common but significant difficulty that affects a child’s movement skills. Problems include difficulty with being able to organise, plan and carry out an activity, children can appear awkward and clumsy and will often be reluctant to participate in activities that are unfamiliar to them.

What causes DCD?

There is no known cause for Developmental Co-ordination Disorder but it can have a significant effect on occupational performance such as writing, P.E and play skill which impacts greatly on self esteem and social participation.

Signs and Symptoms:

• Late Milestones
• Difficulty hopping, skipping, jumping, catching and riding a bike
• Poor hand writing and self care skills
• Hesitant to learn new tasks
• Anxious and distracted
• Poor organisation
• Reduced spatial awareness
• Reduced postural stability

Identifying DCD

Developmental Co-ordination Disorder can be identified by recognising that the child’s ability to acquire or carry out a co-ordinated motor skill is substantially below that expected for their age and skill opportunity and that it cannot be explained by any other neurological disorder or medical condition.

DCD might initially be identified through a child’s difficulty with hand writing which leads to further investigation or assessment into motor skills. A childs learning ability is not affected by Developmental Co-ordination Disorder, but the ability to place ideas and thoughts on paper can be if hand writing is a problem. Social participation and self esteem can also be reduced because poor movement skills decrease the likelihood of being involved in the same activities as their peers.

How can we help?

Children do not grow out Developmental Co-ordination disorder, it continues into adulthood if left undetected. Occupational Therapy at The Physio Hub offers both formal and informal assessment of your child’s movement skills including:

• Body awareness
• Motor Planning
• Postural control and stability
• Visual Perception
• Visual Motor Integration
• Handwriting

Treatment programmes and intervention will focus on play activities that have been specifically analysed to incorporate both fine and gross movements to work on your child’s specific motor skills problems.

We cover a wide area across the North East of England, treating children from, Hartlepool, Stockton on Tees, Durham and further afield.

If you have any queries then please don’t hesitate to contact us.

Selective dorsal rhizotomy (SDR) is an operation used to improve / remove spasticity (muscle stiffness) in children with cerebral palsy.

Cerebral palsy occurs when a child sustains a brain injury early in life. It most commonly occurs at birth. Although the brain injury remains static throughout the child’s life, the difficulties associated with the condition can cause changes as the child is growing. In a child with cerebral palsy the damage to the brain tends to be in the area that controls muscle tone and movement of the arms and legs. There are several different types of cerebral palsy. SDR is a procedure which is increasingly being used to treat children with spastic cerebral palsy.

Spasticity refers to increased tone in a muscle. Normally, muscles have enough tone to maintain posture or movement against the force of gravity, while at the same time providing flexibility and speed of movement in order for us to move. In children with cerebral palsy the way in which the sensory nerve fibres work is abnormal, resulting in spasticity.

The basis of selective dorsal rhizotomy (SDR) involves dividing and cutting some of the sensory fibres in the spine to reduce spasticity, by decreasing the sensory stimulation whilst preserving voluntary movement.

What does it involve?
Selective Dorsal Rhizotomy (SDR) is a surgical procedure that involves making an incision in the lower back, to allow access to the end of the spinal cord and sensory nerve roots. It is performed under a general anaesthetic and the nerve roots that contribute to spasticity are divided. The reduction in spasticity is permanent.

Did you know?
SDR is most commonly used for children with diplegia (spasticity of 2 limbs).
Diplegia accounts for 25-30% of children born with cerebral palsy.
The technique was first developed in early 1900’s but is now much more advanced.

I’ve heard it isn’t available in the UK?
The surgery is not routinely commissioned by the NHS but is currently under review.
At present SDR is available in the UK. However, it is only commissioned in 5 hospitals:

– Alder Hey Children’s NHS Foundation Trust
– Great Ormond Street Hospitals NHS Foundation Trust
– Leeds Teaching Hospitals NHS Trust
– Nottingham University Hospitals NHS Trust
– University Hospitals Bristol NHS Foundation Trust

Each hospital where SDR is available, gather data and results from each SDR case within the UK. With these results hopefully SDR will continue to be commissioned in trusts within the UK. At present it is not a definite that SDR will continue to be commissioned.

SDR: United States of America
You may have heard of SDR surgery being carried out in America. A well-known neurosurgeon involved with the SDR procedure is Dr.Parks, who is based at St.Louis Children’s Hospital.

Is my child suitable?
A strict criteria is required for suitable candidates due to the intense nature of physiotherapy required post SDR. The UK criteria is much stricter than in America.

Children between 3 and 12 years of age with typical spastic diplegia.
Gross Motor Function Classification System (GMFCS) level II or III.
Children who demonstrate adequate muscle strength in the legs and trunk.

It is recommended that there needs to be at least three months from the last botulinum toxin injection and at least six months from orthopaedic surgery before considering SDR.

It is important to remember that not all children with Cerebral Palsy are suitable for SDR surgery. SDR is a definitive procedure and cannot be reversed.

How can The Physio Hub Help?

The SDR guidelines state intense Physiotherapy is required post SDR. Private funding is normally explored for children who undergo SDR. After discharge the aim of a physiotherapy programme is to continue to develop strength in the child’s lower limbs, trunk and pelvis increase range of movement in the legs and to develop and improve walking. The ongoing local physiotherapy, needs to be discussed and agreed preoperatively. Regular postoperative physiotherapy is essential to obtain the best results after SDR.

Here at The Physio Hub we are specialised paediatric physiotherapists who will help your child every step of the way through the SDR process. The Physio Hub offers physiotherapy to children in the Hartlepool, Stockton and Middlesbrough area. We also cover a broader area within the North East region. We currently have clients who have undergone the SDR who are at present going through the rehabilitation process with us.

The team use up to date evidence based practice and research to ensure the best possible treatment and interventions.
We also work closely with local NHS services following your child’s SDR to ensure joint goal setting.
We can also provide Pre-op physiotherapy for your child. It is recommended that before SDR takes place, a programme of physiotherapy is advised to ensure optimum muscle strength.

IMOGEN’S STORY

Imogen is one of our little superstars here at The Physio Hub. Imogen is now 1 year post-SDR surgery. Pre-surgery Imogen was mobile with her K-Walker and was unable to stand independently. A year of hard work and determination and she is now mobile with x 2 walking sticks. She is also practising her walking, unaided and is continuing to improve everyday.

Well Done Imogen! Keep up your super hard work!

If you require any further information then please don’t hesitate to get in touch.

Following several enquiries from parents requesting information on how private therapy works along side that provided by the NHS we thought you may be interested on the guidance given from the DOH (Department of Health) CSP ( Chartered Society of Physiotherapists) and BAOT (British Association of Occupational Therapists) on how this works. Here at The Physio Hub we strive to work alongside NHS therapists to provide the best care for children and their families.

In 2009 the DOH published guidance for NHS patients who pay for additional private care. Key points included:
you’re still entitled to NHS care free of charge if you choose to pay for additional private services
your position on a waiting list should not be affected when choosing to pay for private services

The CSP states:
Patients who choose to be treated privately are entitled to NHS services on exactly the same basis of clinical need as any other patient and should not have NHS treatment withdrawn or refused because they also have private care. Patients have a right to choose where they seek treatment, and in some cases this can result in patients seeking and receiving concurrent treatment in both the NHS and private sectors.

As with any other patient who moves between NHS and private status, patients who pay for private physiotherapy care should not be put at any advantage or disadvantage in relation to the NHS care they receive. They are entitled to NHS services on exactly the same basis of clinical need as any other patient.

BAOT quote:
If you and another practitioner are involved in the treatment of the same service user, you
should work co-operatively, liaising with each other and agreeing areas of responsibility. This should be communicated to the service user and all relevant parties

– Are you in the process of transitioning between a Statement of Educational Needs and an Educational Health Care Plan (EHC)?
– Do you require further independent advice regarding your child’s therapy needs?
– Have you been told that you can not gather an independent opinion because it will not be accepted by the local authority?

Section 6 quotes that: Where the local authority secures an EHC needs assessment for a child or young person, it must seek the following advice and information, on the needs of the child or young person, and what provision may be required to meet such needs and the outcomes that are intended to be achieved by the child or young person receiving that provision.

A) Advice and information from the child’s parent

B) Educational advice and information

D) Psychological advice from an educational psychologist

E) Advice and information in relation to social care

F) Any other advice the local authority feels is appropriate

G)Advice and information in relation to transition into adult services for children in year 9 and above

If you require any further advice please do not hesitate to contact the clinic: 01429 872722