Paediatric Physiotherapy

Paediatric Orthopaedic Physiotherapy

What is Paediatric Orthopaedic Physiotherapy

Paediatric physiotherapy is the delivery of physiotherapy services to children and youth, from birth to 18  years of age. Our paediatric physiotherapy services include a comprehensive assessment of a child’s gross motor function and posture, including strength, posture, gait, flexibility, balance, coordination, and sensory processing. Subsequent treatment can include manual therapy, hands-on facilitation, education, referrals to other specialists, and/or prescription of a home exercise program.

Infants, toddlers and young children who require physiotherapy intervention may not fully grasp the purpose or function of therapy services; as such, our paediatric physiotherapy sessions incorporate functional play and exciting motivators while creating a fun atmosphere to help accomplish therapy goals.

For youth and adolescents who have suffered an injury, we help them to understand their injury in a way that is easy for them to grasp and help them to feel valued throughout their rehabilitation process.

Who Can Benefit From Paediatric Orthopedic Physiotherapy?

Our Registered Physiotherapists can assess and treat your child for:

• Flat head syndrome (Torticollis/Plagiocephaly)
• Musculoskeletal injuries
• Delays in gross motor skills
• Developmental Coordination Disorder
• Musculoskeletal support for patients with Down Syndrome, Cerebral Palsy, Muscular Dystrophy, and other neuromuscular conditions
• Acquired brain injuries including concussions
• Low tone (Hypotonia)
• Orthopaedic conditions
• Weight challenges
• Athlete injuries and development

What Kind Of Physiotherapy Treatment Will My Child Have?

Our physiotherapists use a hands-on approach to treat neurological and orthopedic conditions. Our approach to treatment programs is active movement and play-based therapy to improve function and mobility. We also use a number of other modalities (shockwave therapy, ultrasound, acupuncture, functional electrical stimulation) as well as treatment techniques such as taping, soft tissue release and exercise to optimize functional recovery.

Infant Motor Milestone Physiotherapy Assessment

When it comes to infant motor milestones, it can be difficult to know where your baby lies in the varying ranges of “normal.” If you have concerns about how your child is developing, they may benefit from a physiotherapy infant motor milestone assessment to determine if there is any active intervention or exercises you would benefit from performing at home to get them back on track. 

What Are Motor Milestones?

There are specific age-ranges where we expect to see the acquisition of certain skills in infants. The skills associated with physical movements are known as motor milestones. Some common examples of these are: reaching hands to grasp feet, rolling over, sitting independently, pulling to stand, and walking.

What Is Motor Milestone Delay?

Each skill that is expected of an infant has a typical range associated with when we expect them to acquire and master that skill. These time ranges are quite variable, but when an infant moves outside of these expected timelines, it may indicate a motor milestone delay. Delays can happen for a variety of reasons, including but not limited to:

• A lack of opportunity: for example, your baby may not pull themself up to stand if all of their toys/ exciting objects are on the ground
• A lack of space: children need room to explore and move to acquire skills, so if they are spending most of their time contained in small spaces, they may struggle to progress in their motor milestones
• Weakness or low tone: some children have more weakness in their core muscles typically defined as hypotonia or low tone. These children have more difficulty holding their bodies upright and may need facilitation to improve their core strength to develop their motor milestones
• Other conditions or developmental disorders: children with developmental disabilities often lay outside of the “typical: ranges of motor milestone development and acquisition, and need an individualized approach to achieving their gross motor gains

What Does An Infant Physiotherapy Motor Milestone Assessment Look Like?

At your first assessment, our physiotherapists will take time to learn about you and your child to get a better idea of what may be causing a motor milestone delay. We will ask questions about pregnancy, birth, and day-to-day life with your child including sleeping, feeding, and what skills they have and have not acquired.

Our physiotherapists will then perform a physical assessment including but not limited to looking at range of motion, strength, functional movements, sensory integration, and play skills. We will often use specific outcome measures such as the Alberta Infant Motor Scale (AIMS) for milestones and craniometers to measure head shape if there are concerns of a flat spot (known as plagiocephaly). 

The physiotherapist will then see what movements they can facilitate or help your child achieve with a bit of hands-on cueing and support. These exercises are performed in a play-based setting with toys and specialized paediatric equipment used to facilitate the acquisition of new skills.

Your physiotherapist will always accompany this assessment with education on their findings, recommendations for any equipment deemed appropriate, and an individualized home exercise program including pictures, videos, and detailed instructions through an online application.

Subsequent treatments will involve re-assessments of outcome measures and hands-on therapy to continue to work toward your goals and getting your child back on ‘track’ for optimizing gross motor development.

Summary

Paediatric physiotherapists can perform detailed, individualized motor milestone assessments aimed at helping ensure that your child has the tools and education they need to acquire age-appropriate skills. If you have any concerns about how your child is progressing in their development, an infant milestone assessment is a good place to start to ensure you leave with tangible education and tools to help your child thrive.

See what ALPHA families are saying about infant motor milestone assessments:

“Recently I went [to ALPHA] because I was worried about my 11 month old. She wasn’t hitting her motor milestones and I was starting to freak out a little. I saw Kali and she was amazing! She reassured me about my baby girl’s development, was very patient with assessing her, and came up with some movements we could incorporate into our daily play. Within 2 days, my daughter was hitting the milestones she was missing before seeing Kali at Alpha. Highly recommend going here – whether for an adult or paediatric assessment!”

Paediatric Pelvic Floor Physiotherapy

What Is Pelvic Floor Dysfunction?

Pelvic floor dysfunction refers to a wide range of symptoms that can occur when the pelvic muscles are weak due a change in resting tone. Muscle tone can be lengthened resulting in low tone or shortened resulting in higher tension. Sometimes the muscle tone is normal but the purposeful contraction or relaxation of the pelvic floor muscles is not coordinated. As a result, your child may experience several pelvic conditions including:

• Enuresis or bed wetting
• Constipation
• Overactive bladder (frequent need to urinate)
• Underactive bladder (inability to empty bladder completely)
• Urge incontinence (strong, sudden urge to urinate that is difficult to control resulting in leaks)
• Postponement (avoiding using the washroom when needed resulting in leaks)
• Dysfunctional voiding (squeezing or pain when voiding)
• Stress or giggle incontinence (urine leakage when jumping, sneezing, playing, laughing, and other physical activity
• Chronic low back or pelvic pain

What Is The Pelvic Floor?

The pelvic floor is made up of a group of muscles that attach from your pubic bone in the front to your tailbone in the back. They also run side to side from your two sit bones (ischial tuberosities). These muscles create a bowl of muscles that contract and relax.  This helps achieve the following:

• Hold up and support the organs within the pelvic cavity such as the bladder, uterus, and rectum
• Control the opening of the urethra and rectum thereby maintaining the ability to prevent leakage of urine and/or feces.
• Have proper functioning of the pelvic floor muscles to support the stability of the hips and low back

What Is Paediatric Pelvic Floor Physiotherapy?

Paediatric pelvic floor physical therapy aims to support and optimize your child’s bladder and bowel habits through the following methods:

• Guided home exercises that aim to strengthen your child’s core and pelvic floor muscles
• Biofeedback training which strengthens your child’s ability to understand and coordinate pelvic floor muscle contraction and relaxation
• Educating your child to understand what is happening with their body, the anatomy and function of the pelvic floor muscles, and provide strategies at home and in school to help support optimal pelvic floor function
• Pelvic floor physical therapy takes a child-centric approach to treatment to ensure they always feel safe, comfortable, respected, and an active participant in their rehabilitation program

What Is Paediatric Pelvic Floor Physiotherapy?

Paediatric pelvic floor physical therapy aims to support and optimize your child’s bladder and bowel habits through the following methods:

• Guided home exercises that aim to strengthen your child’s core and pelvic floor muscles
• Biofeedback training which strengthens your child’s ability to understand and coordinate pelvic floor muscle contraction and relaxation
• Educating your child to understand what is happening with their body, the anatomy and function of the pelvic floor muscles, and provide strategies at home and in school to help support optimal pelvic floor function

Pelvic floor physical therapy takes a child-centric approach to treatment to ensure they always feel safe, comfortable, respected, and an active participant in their rehabilitation program

Who Can Benefit From Paediatric Pelvic Floor Physiotherapy?

Incontinence and the above conditions, during the day or night, is a common paediatric condition and affects up to 1 in 7 school-age children. For many children and their families, these conditions are difficult to manage on their own as incontinence is often not within conscious control and as such, requires additional intervention to improve. Just like when other muscles of the body are not working as they should, physiotherapy can help your child!

Paediatric pelvic floor physiotherapy usually works best for children over the age of 5 but depending on the attitude and ability of your child, we may be able to treat younger patients.

If you are unsure if paediatric pelvic floor physiotherapy is right for you, we do offer a complimentary 15 minute session with our paediatric pelvic physiotherapist to determine if we can help.

What Happens During The Assessment?

Assessing your child thoroughly often involves gathering information and measures over the course of the first 2-3 appointments.

The beginning of the assessment focuses on getting to know your child better and to understand the symptoms they experience as well as learning more about their developmental milestones, school and home life, hobbies, and activities of interest. We try to encourage your child to be involved in this part of the assessment as much as they are comfortable doing so. Following this introduction, your physiotherapist will ask more specific questions related to your child’s bladder, bowel, pelvic pain, dietary/hydration habits, and behaviours.

During the assessment, you and your child will be provided with education on how the bowel and/or bladder works, and how it communicates with the pelvic floor muscles. We will discuss how this relationship can be disrupted and how paediatric pelvic floor physiotherapy can help.

If the physical therapist believes that biofeedback training is an appropriate tool for your child’s rehabilitation program, they will be introduced to the biofeedback training system. Biofeedback consists of a handheld computer with a screen. The screen provides a visual display of pelvic floor muscle contraction and relaxation capacity.

On the first assessment, this computer system is usually trialed on a larger muscle (such as the forearm) to help your child feel more comfortable with the concept. When the biofeedback is used for the pelvic floor muscles, small circular stickers are placed on the external skin near the anus. This helps the computer effectively measure the conductivity of these muscles.

The biofeedback system never uses any internal vaginal or rectal assessing methods. Surface electrode stickers remain external. Most children very much enjoy this part of treatment as the biofeedback system also includes fun games to keep them engaged and motivated.

The external physical assessment portion includes assessing your child’s movement patterns including but not limited to standing, walking, jumping, and balance. Your child’s range of motion and strength through their extremities will also be assessed. No internal examination or palpation (vaginal and/or rectal palpation of the pelvic floor muscles) will be performed for children.

The goal of the assessment is that you and your child have a better understanding of how the pelvic floor muscles work and to build a relationship with the physiotherapist so your child feels comfortable and even excited about starting treatment. Ultimately, we believe in a collaborative relationship between the physiotherapist, child, and family to best support the success of paediatric pelvic physiotherapy rehabilitation for your child.

What If I Have More Questions About Paediatric Pelvic Physiotherapy?

Please email us at info@alphahealthservices.ca and we will direct your email to our paediatric pelvic floor physiotherapist, Leeanna Maher. We are also happy to book a complimentary 15min phone consultation with Leeanna so she can help you answer any pre-assessment questions and determine if paediatric pelvic floor physiotherapy is right for your child.

Paediatric Concussion Rehabilitation

What Is A Concussion?

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. The sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. Injury to the neck, including soft tissue and muscle injury, as well as symptoms related to the vestibular system, are also common with concussions.

Our Concussion Rehabilitation Program at ALPHA Health Services

ALPHA’s concussion program was developed by Dr. Charlotte Anderson, PhD, Dr. Jim Niu, and Dr. Alex Francello. The program combines clinical research, a multidisciplinary medical approach to care, and years of experience working with patients suffering with acute or chronic symptoms post-concussion. The concussion program at ALPHA is recognized across Canada, and is proudly affiliated with the Orthopedic Rehabilitation Institute.

We understand that concussions can cause challenges with concentration so we take care to help youth and adolescents who have suffered a concussion to help them understand their injury in a way that is easy and simple for them to grasp and help them to feel valued throughout their rehabilitation process.

Frequently Asked Questions

2024 Infant/Kids Physiotherapy Rates:

Infant/Kids Orthopedic Physiotherapy Rates:

• 60min Initial Physiotherapy Assessment, $150
• 45min Follow-up Treatment, $120

Infant/Kids Pelvic Physiotherapy Rates:

• 60min Initial Pelvic Physiotherapy Assessment, $170
• 45min Pelvic Follow-up Treatment, $150

Infant/Kids Concussion Rehabilitation Rates:

• 60min Initial Concussion Physiotherapy Assessment, $190
• 30min Concussion Follow-up Treatment, $115
• 45min Concussion Follow-up Treatment, $130

** Physiotherapy is covered by most extended health care benefit plans.