Paediatric Rehabilitation

Hypotonia refers to the progressive loss of muscle tone over time. While some infants (birth to 1 year) are born with hypotonia, others develop this condition as a symptom of other conditions, such as cerebral palsy. Paediatric hypotonia involves a spectrum of conditions, including problems with balance, posture, coordinated movements, swallowing, and speech in children. These symptoms are managed using pharmacotherapy, balance and gait training using assistive devices, orthosis (an external apparatus that provides support and protection for joints or parts of the body), sensory integration programmes of proprioception (ability to sense movement, action, and location), visual (eyesight), vestibular (sense of balance and orientation), auditory (sense of hearing), and kinaesthetic (sense of movement) training, and speech and swallowing training.

Autism spectrum disorders are neurological and developmental conditions that impact the ability of a patient to perceive and socialise with others. The term ‘spectrum’ in ‘autism spectrum disorders’ refers to the wide range of symptoms they exhibit and the variations in their severity. These disorders are characterised by difficulty with communication and participating in social interactions. Other characteristics include atypical activities and behaviours, such as difficulty in transitioning from one activity to another, heightened focus on details, and unusual reactions to sensations. While some patients with autism can live independently, others have severe disabilities and require lifelong care and support. A combination of genetic and environmental factors has been reported to cause autism.

Our autism spectrum disorder-specific rehabilitation programme offers goal-directed treatment for children with special needs through a multi-sensory integration programme and training on activities associated with daily life, cognitive retraining, and pharmacological management for children with attention deficit disorder and attention deficit hyperactivity disorder.

Myelomeningocele, also known as open spina bifida, is a debilitating neural tube defect caused at birth. In this condition, the foetus’s spine and spinal canal do not close before birth, resulting in the incomplete formation of spinal bones. Children with neural tube defects usually face problems in ambulation/walking, maintaining posture, and continence in the bowel and bladder, and sensory impairment. In our programme, these patients are managed using age-appropriate ambulatory training with/without orthosis, assistive devices, sensory education, bowel and bladder rehabilitation, and training in activities associated with daily life.

Muscular dystrophy is a group of genetic conditions associated with progressive muscle weakness and muscle mass loss. Mutations in important genes encoding proteins that are essential for the formation of healthy muscles result in the abnormal/insufficient production of these proteins, ultimately causing muscle degeneration. There are many types of muscular dystrophy, each of which is caused by a specific genetic mutation. The symptoms consistent with muscular dystrophy include scoliosis (abnormal curvature of the spine or the back), balance issues, restricted joint movement, muscle spasms, respiratory difficulty, and cardiomyopathy (heart muscle disease). Thus far, no cure has been identified for muscular dystrophy. However, medications and therapy assist patients with symptom management and may slow the course of the disease.

Our programme for children with muscular dystrophies includes the evaluation and assessment of motor impairment and dependence that are managed by orthosis, assistive devices, activities of daily living training, energy conservation and pacing techniques, and prevention and management of complications.

With advancing medical science in the field of preterm neonates, our team provides screening for a wide range of any possible developmental issues for very young children. If flagged during screening, we provide early intervention strategies for children less than 6 months of age to prevent or reduce the risk of disability in later life.

Obstetric brachial plexus injury (OBPI) occurs during delivery due to complications such as a breech position or difficult maternal birth canal causing injury to the nerves supplying one of the arms of the child.

If left untreated, this condition can lead to significant impairment, affecting arm development and function.

Our specialised care provides support from early infancy for children affected by OBPI.

This prevents excessive disability and maintains near normal arm usage through life.

Goals of therapy

• Help children function to the greatest level of their ability
• Help children achieve independence in school and home activities
• Provide emotional training and support to children and their family members