Perspective

A physiotherapist is a university-trained health care expert who can treat diseases or injuries that impact your ability to move and perform daily tasks. Physiotherapists that specialize in dealing with children from birth to adolescence are known as paediatric physiotherapists.

In health and social care settings, approaches to practice based on partnership and shared decision-making with patients are now widely recommended, but these recommendations have received less attention in children's services, as well as the decision-making experiences of non-medical practitioners and their patients or clients. In the context of community-based physiotherapy services for children with cerebral palsy, this study looked at children's, parents', and practitioners' perspectives on collaborative decision-making. Eleven children with cerebral palsy and their parents were interviewed in semi-structured interviews in an inner city region of northern England. With the help of ten physiotherapists, two focus groups were held. The constant comparative approach was used to analyse the data. When asked specifically about decision-making, parents, children, and practitioners all stated that they had little or no input, and that each side saw the other as the decision-maker. However, when asked about their experiences in more detail, each party stated that they had some input into decision-making. The accounts of practitioners centred on their responsibilities for deciding on resource allocation and, as a result, the usefulness and intensity of treatments. These practitioner-led judgments, according to parents, were sometimes at odds with their child's objectives. Parents and children appeared to have the most say in whether or not interventions were acceptable and how they were implemented. The involvement of children was less than that of their parents.

While parents had the legal authority to limit unwelcome interventions, children were generally limited to negotiating how interventions were carried out. According to these stories, each party's engagement varied depending on the topic at hand, and decision-making appeared to be more unilateral than shared. Greater clarity regarding the domains that are suited for a shared decision-making approach and the roles of different parties, as well as a better knowledge of its flaws and benefits, would seem to be a positive step in advocating shared decision-making. Physiotherapists that specialize in mobility for newborns, children, and adolescents are known as paediatric physiotherapists. It is a therapeutic field of physiotherapy that focuses on improving a child's movement abilities through approaches such as movement training, strengthening, exercise, stretching, intense therapy programmes, adapted equipment, motor learning and play, and education.

From an anatomical, physiological, and psychological standpoint, physiotherapy for children differs significantly from physiotherapy for adults. At Therapies for Kids, we think that in order to effectively treat children, all of these factors must be considered. Our Paediatric Physiotherapists are highly trained experts who use the most up-to-date evaluation tools and techniques to create high-quality programmes to help your kid achieve his or her goals. We believe we can help with any difficulty, big or small!

Our physiotherapists have a combined 80 years of experience in helping children stay motivated and optimistic about their physiotherapy, which they have found to be an important factor in their growth. Therapies for Kids is dedicated to providing longterm beneficial outcomes through early intervention programmes and post-surgical intervention assistance.

How can physiotherapy help your child?

Children with neurological and developmental disabilities, as well as sensory impairments linked to hearing and vision, can benefit from early intervention from a paediatric physiotherapist. Children with biomechanical, postural, and sporting injuries can benefit from physiotherapy. Some children may have a variety of problems that a Paediatric Physiotherapist can help with a musculoskeletal (MSK) issue affects one out of every eight paediatric primary care visits. Patients with these conditions are routinely referred to paediatric orthopaedic surgeons, but up to 50% of referrals are for normal variations. This leads to long wait times and prevents access to urgent surgical cases. Advanced practise physiotherapists (APP) have been successfully used in adult MSK care to manage nonsurgical candidates, with demonstrable benefits to both patients and services. In paediatric orthopaedics, there is a void in the literature about APP.

Paediatric orthopaedic services are underfunded, with significant wait times as a result. Normal variations account for around half of all referrals, and they don't necessitate specialized care. Inappropriate referrals have been linked to poor musculoskeletal examination skills and low diagnostic confidence among primary care providers. Independent management and discharge rates of 95 percent have been observed at APP clinics for normal variations, as well as a significant reduction in patient wait times.

In MSK health services, patient journeys involved many touch points and some duplication. Patients praised the APP's interpersonal and professional qualities, and overall, their experiences with the APP service were favourable, with speedier admission into the medical system. Some patients had preconceived notions about what the APP could provide them because they had already seen a physiotherapist. Initial fears were allayed after the APP appointment, as the APP was wellversed in MSK issues. Because of the availability of tests and 'specialists,' as well as the doctor's close vicinity, hospitals have remained the favored venue for MSK appointments.

In paediatric orthopaedics, there is limited data to support the APP. More research into diagnostic agreement, patient/ stakeholder satisfaction, patient outcomes, and economic evaluation is required. The field of paediatric orthopaedics is facing a crisis in terms of how to efficiently manage the influx of referrals. Innovative multidisciplinary solutions are needed so that physicians are not the exclusive providers of all services. In paediatric orthopaedics, the APP could be a component of the solution.