In preterm neonates, optimal breast feeding is limited due to several reasons e.g., illnesses, gut immaturity and inadequate suck, swallow and breathing coordination due to poor oromotor skills .Many research studies shows that sensorimotor interventions are used to improve oral feeding in preterm babies.

One of the research shows that current technique used widely in Brazil is the non-nutritive sucking in gloved finger or orthodontic pacifier. Other countries recorded the technique of non-nutritive sucking in pacifiers followed by oral sensorimotor stimulation as the most current approaching.

Two methods which are commonly used in NICU for preterm infants are OMS (oromotor stimulation) and nonnutritive sucking (NNS) which increases the probability of more preterm babies being breastfed at discharge.

2 major benefits of oromotor stimulation (OMS) program (peri- and intra-oral stimulation, with or without nonnutritive sucking) applied to preterm infants during gavage feeding are:
a) Improved sucking abilities of a preterm infant.
b) Reduces transition period from gavage to full oral feeding.

But recently, MNRI (Masgutova Neurosensorimotor Reflex Integration) therapy is taking one step ahead. MNRI technique helps in INTEGRATING ORAL- FACIAL REFLEXES. These exercises helps in activation of sucking reflex pattern by stimulating all muscles which take part in sucking motor skills. MNRI Therapist uses finger tips and applies specific pressure on several points for 5-7 times in a day which activates sucking reflex and improves rhythmic sucking.

NICU IS ALL ABOUT SAVING AND CHANGING LIVES……..

For more information please check MNRI official website or contact us at +91-9886330012

Tummy time is a period in which you make your little one (Baby) to lie down on his/her tummy.

Why is it so important for babies?

Babies develop postural STRENGTH And ENDURANCE in CEPHALOCAUDAL manner. This means the head develops first and then the trunk, pelvis and lower extremities. Tummy Time always help your baby to achieve his/her Developmental Mile Stone.

When should we start Tummy Time for babies?

We can start tummy time from the day 1.

Regular Benefits of Tummy Time:

• It reduces tummy re-flux and gas and always promotes optimal bowel movements.
• It helps in maintaining body posture as well as head shape and chances of getting positional torticollis also reduces.
• It helps in motor skill development and improves sensory skills along with visual development.

For any further information please contact us on +91-9886330012 or info@pediatricphysiotherapy.in

There are 2 components of HYPERTONIA:

1. Neurogenic : Overactive Muscle Contraction
2. Biomechanical: Stiffening and shortening of the muscle and soft tissue.

If above components are left untreated, it might lead to abnormal limb posture, soft tissue shortening and biomechanical changes in the contracted muscles.

Various therapies like myofascial release, Pediatric IASTM, Pediatric Dry Needling, Aquatic therapy can reduce tone immediately for a while.

Passive stretches, splinting and positioning are all essential to prevent further deterioration of body alignment.

Facilitation of active control of limbs and strengthening exercises to the trunk and limb muscles are essential in promoting Functional Movement in Children with CP.

But sometimes Physiotherapy alone is not sufficient to overcome HYPERTONICITY or its biomechanical component, especially in moderate to severe Spasticity.

At this stage Medical Treatment and other Surgical Treatment should be considered as soon as possible.

Among many medical and surgical treatment, Botulinum toxin injection is commonly used. Its effect remains for 3 to 6 months depending upon dosage.

After administration of Botulinum Toxin, intensive therapy is provided to get better motor control. Functional gain can be observed even after the effect wears off.

Early Botulinum Toxin intervention followed by casting at the level of gastro – soleus spastic muscles had shown major improvement in prevention of medial foot arch prolapse and foot deformity when children are learning weight bearing and independent walking .

When a spastic child is able to walk, with or without aids, 3-D Gait Analysing is very good for assessing movement pattern and for deciding which muscle groups need botulinum toxin injection at a single or multiple levels.

After Botulinum toxin intervention, intensive physiotherapy is must, followed by proper orthosis to provide optimal effect on muscle strength and length.

For more info you can contact us @  +91-9886330012

There are 2 types of strokes:

•  Ischemic Stroke
•  Hemorrhagic Stroke

There are two age categories for pediatric stroke:

a) Perinatal, which refers to the last 18 weeks of gestation through the first 30 days after birth. Other terms for this age period include fetal, prenatal, in utero for the period before birth. Neonatal and newborn for birth through one month of age.
b) Childhood, ages 1 month to 18 years

Some Common signs and symptoms:

a) Hemiparesis (weakness on one side of the body), or hemiplegia (paralysis on one side of the body).
b) One-sided neglect (unilateral neglect), which causes the stroke survivor to ignore or forget their weaker side and usually occurs when someone has a right brain stroke.
c) Aphasia (difficulty with speech and language), or dysphagia (trouble swallowing).
d) Decreased field of vision and trouble with visual perception.
e) Loss of emotional control and changes in mood.
f) Cognitive changes or problems with memory, judgment and problem-solving.
g) Behavior changes or personality changes, improper language or actions.

If you see any of these signs contact your doctor for EARLY INTERVENTION PROGRAM.

For info you can contact us @ +91-9886330012

Flat Feet is also known as Pes Planus (Medical term) or Fallen Arches. This condition is such that the foot has low or no arches and press almost completely against the ground.

Many children with joint hyper mobility or low muscle tone or ankle joint instability can have problem with flat feet.

Children with flat feet often stand with the feet turned outwards and this cause additional abnormal force to translate towards foot causing further flattening of medial arch.

Poor foot architecture can stress medial collateral ligaments of knee and can lead to knock knee and if that continues in children then it can lead to medial rotation of femur. Furthermore deformation can also cause scoliosis in children.

Treatments For Flat Feet:

Flat feet only need to be treated if you have an associated problem, such as pain, over pronation or an underlying health condition.
Non-surgical treatments are often recommended first, although surgery may be needed in some cases.

Professionals who can help you to overcome this issue:

• Pediatric orthopedic
• Pediatric physiotherapist
• Podiatrist

Core Strengthening is essential for the progression of other developmental skills.

Here are the few core strengthening exercises to help you get started:

• Bridging :Have your child lay on his back with his knees bent and feet flat on the floor.  Have them push hard through their heels to raise their bottom up off the floor.  Be sure that they are keeping their head and shoulders on the ground (see photo above).  Can they hold it?

•  Superman Pose :

Have your little one fly like the superhero and strengthen his back!  Have him lay on his stomach on the floor and try to lift his arms up off of the floor so that his upper chest comes up too.

• Plank :

This one is an obvious (and overall) core strengthener.  Have your child lay on his stomach on the floor with his hands flat on the floor at shoulder level and toes on the floor.   On the count of 3, have him push up on his hands to straighten his arms and lift his whole body all the way to his toes off of the floor (above).

• Wheelbarrow Walking :

Again, have your child lay on his stomach on the floor. While you hold his knees (easier) or ankles (bit more of a challenge), have him walk his hands forward 10 steps and backward 10 steps.  Can he walk forward to a ball and and put it in a basket with one hand?  How long can he hold this position without pulling their legs away?

If a child with cerebral palsy cultivates an active lifestyle with a proper nutritional diet, they are destined for a healthier path.

A plan of care can be designed according to each individual child and his needs and they can take help from professionals who provide following therapy/treatment:

Acupuncture
Aquatic Therapy
Behavioral Therapy
Chiropractic Intervention
Conductive Education
Cranial Sacral Therapy
Hippotherapy
Intensive Suit Therapy
Massage Therapy
Movement Lessons
Music Therapy
Neuromuscular Electrical Stimulation
Nutrition and Diet Plan Counseling
Occupational Therapy
Physical Therapy and Physiotherapy
Play Therapy
Recreation Therapy
Respiratory Therapy
Sensory Integration Therapy
Social Therapy
Speech and Language Therapy
Taping Technique
Vocational Counseling

Surgical Intervention:     a)Selective Dorsal Rhizotomy
b)Selective Percutaneous Myofascial Lengthening

Hence with a combined healthy dosage of exercise, different therapies, nutrition and surgical intervention we can thwart the advancement of disease and further disability. So that these children with cerebral palsy can live well into adulthood.

For further information mail us at : info@pediatricphysiotherapy.in

Some allowance for growth is built into the brace from day one. You will notice a small space between the end of the brace and toes. When your child’s toes extend over that area it’s time for a new one. Occasionally growth will be in the form of a wider foot rather than length. In this case, you would notice a significant amount of redness and indentation in the foot from the sides and top of the brace if this occurs.

Will my child have to wear these the rest of his life?

Obviously your child’s diagnosis and the specifics of his/her condition are critical to answering this question. The best person to answer this type of question would be your child’s physician. They would have the information needed to answer completely.

When my child is breaking in their braces, does it count if he is sitting and not active at that time?

For the initial break in period activity is not a factor. However once your child becomes active it’s important to check every hour to ensure blisters are not developing.
 What will my foot orthotics do for me?

– Your physician will prescribe a foot orthotic for you based on your diagnosis. Depending upon your condition, one of several styles of foot orthotics can be provided for you.
– If the foot orthotics are called “functional,” that means they are intended to control or limit unwanted motion in the foot or ankle and improve alignment of the skeletal structures of the foot.
– An “accommodative” foot orthotic is designed to redistribute weight throughout the foot to reduce pressure areas. It will also provide excellent cushioning and shock absorption.

For more info contact us @+91-9886330012

Physiotherapy is the rehabilitation of physical impairments by training and strengthening a patient’s large muscles – those in the arms, legs, and abdomen. The goal of physical therapy is to maximize functional control of the body, or increase gross motor function.

Latest Therapy which has been more advanced and result oriented therapy for these kids are Suit Therapy and Spider & Monkey Cage Therapy.

http://www.omicsgroup.org/journals/effect-of-cage-therapy-using-advanced-spider-suit-compared-to-traditionalphysical-therapy-on-gross-motor-function-in-children-with-2376-0281-1000193.php?aid=68798

A Physiotherapist is an important treatment partner for any child born prematurely. Physiotherapy should begin from the day 1, if baby health status allows it.

4 most important things where physiotherapist will guide parents of premature baby are:

• Education on holding, carrying, and playing with the baby. Your physiotherapist will make suggestions for positioning, holding, and carrying your baby. Your therapist will provide ideas for positioning the baby on the back for sleep, and on the stomach for play when the baby is awake.

• Fostering developmental skills. Some babies born prematurely have developmental problems. Your physiotherapist will help your child learn to master motor skills, such as holding up the head, sitting up, crawling, pulling to standing, and walking. Physiotherapists can help parents support their child’s development by providing hands-on training for movement, feeding, and play. Your therapist also may suggest changes at home to encourage movement development, communication, hearing, vision, and play skills.

• Increasing strength. Some babies born prematurely may have decreased muscle strength or tone associated with the prematurity. Your physiotherapist will teach you exercises and play activities to maintain or increase your baby’s strength. Your therapist will identify games and fun tasks that promote strengthening.

• Orofacial neuromotor stimulation. Some babies born prematurely will have difficulty in sucking milk. Your physiotherapist will stimulate orofacial neuromotor structures so that sucking reflex for your baby should improve, which will help in sucking milk.

Research has shown that EARLY INTERVENTION THERAPY maximize infant’s growth and maturation.