Infantile rheumatism is different from adult rheumatism not only by virtue of its clinical pictures but also by virtue of the relief positions and incorrect positions of joints adopted. If relief positions in children are identified and corrected in good time, incorrect positions can often be prevented from developing altogether. This requires the skills of therapists specially trained in physiotherapy, occupational therapy, massage and electrotherapy, working in close collaboration with parents under one roof.

 

A special, internationally recognised approach to therapy for treating children with juvenile idiopathic arthritis (JIA) and other rheumatism spectrum illnesses has been developed at our clinic.

• Physiotherapy
• Individual therapy
• Educating parents
• Physiotherapy
• Occupational therapy
• Therapy pool
• Massage/electrotherapy
• Training therapy

As a matter of principle, physiotherapy and occupational therapy are carried out as individual therapy. This is complemented by a certain degree of group therapy. We feel that creating an atmosphere in the treatment rooms appropriate for the age of the child and creating trust in the therapist is a key prerequisite for relaxed and effective treatment. For young children, at least one parent should be present during the treatment. This ensures that the child feels safe, whilst simultaneously allowing the parents to be involved in the treatment.

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It is important for all children that their parents should be able to carry out by themselves the main aspects of the therapy in a home environment.  To this end, we train parents in how to treat their children. This specialised knowledge is complemented by parent information evenings covering physiotherapy and occupational therapy.

You can find the brochure  `Physiotherapy for childhood idiopathic arthritis for parents and young people – made easy' here.

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We work with children and parents in setting the objective for the treatment based on the diagnostic findings in each case.  The therapy is divided into several stages:

• relaxation, pain relief
• stretching contracted structures
• activating the musculature that is pulling the joint out of the relief position
• facilitate functional movement patterns, e.g. walking
• relaxation, pain relief

For each step we use individual elements from various disciplines of physiotherapy, such as:

• Brügger therapy
• Spiral dynamics
• Manual therapy
• Sling therapy
• Osteopathy
• Craniosacral therapy
• Bobath therapy
• Vojta therapy
• Feldenkrais
• Reflexology massages

Here, it is not the individual specialised technique that brings successful results, but the approach to treatment as a whole. For young children we structure the therapy as a game and carry it out in an appropriate environment (soft toy/play corner).

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The improved motility in hands, elbows or shoulder joints achieved during physiotherapy is put to practical use in occupational therapy. By taking part in pottery, silk painting, wicker weaving and other hands-on activities, children learn to use their joints actively but in a way that is gentle on them. At the end, they have created a piece of work of their own.  We can manufacture various support devices to assist with ooccupational therapy. These devices, which include hand splints to support the joints, devices to help in putting on socks or extended brush handles, serve to promote patients' independence.  We place great emphasis on practising everyday hand movements using support devices. For children, the focus is on writing using a hand splint. This can usually be accomplished relatively quickly by practising various forms of painting.

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Our therapy pool is composed of a swimmers' pool and a non-swimmers' pool. A water temperature of 32°C ensures optimal relaxation for the musculature. Because the children are buoyed up by the water, they can move without pain.

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We can use various massage techniques to ease tense muscles. We use electrotherapy chiefly for pain relief. We have adapted both treatment methods to the specific needs of children and adolescents with JIA.

• traditional massage
• connective tissue massage
• lymph drainage
• reflexology massages
• high-voltage therapy
• interference current therapy
• TENS therapy
• ultrasound therapy
• hot air therapy

We follow up the massage, electrotherapy and therapy pool with physiotherapy and ooccupational therapy to maximise on the relaxing effect.

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Support from Bayerischer Rundfunk's 'Magic Moments' donation campaign enabled us to build a training therapy room. All equipment was chosen especially to meet the requirements of young people with joint inflammation and chronic pain. Training therapy has since become a major element of our therapeutic approach.  Measures administered by a physiotherapist to increase movement form the basis of the treatment. In complement to this, the equipment can be used to train individual muscle groups in a targeted manner and work movements can be initiated.  As with training in a fitness studio, qualified instruction from our physiotherapists on how to carry out the exercises correctly is the prerequisite for success. Incorrect equipment settings and movements outside the correct range of motion can have adverse effects on joints and can even damage them.  Since young people are especially fond of training with equipment, we can draw up an individual training programme with them that they can follow in their local qualified fitness studio, whether by themselves or with friends.

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Header Physiotherapy

Marianne Spamer

Tel.: 08821 – 701 248

Fax: 08821 – 73916

 spamer.marianne(at)rummelsberger.net

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