Physiotherapy and Children

The importance of physical activity and posture in disease prevention and health promotion is well documented. As physiotherapists we are experts in this area and part of our role is to promote wellness, mobility and independence. There is a growing epidemic of diseases related to lifestyle which can be prevented as well as treated with exercise and health behaviour changes.Some of this can be associated with a more sedentary lifestyle due to technology used by young people and adults.

A study found that the time spent using computers by 8-18 years olds doubled between 1999 and 2004. It has been stated there is a direct link between the use of a computer and musculoskeletal symptoms resulting from poor ergonomics and posture. Some statistics show 60% of children and adolescents express discomfort when using modern technology. Within the NHS and private sectors physiotherapists and nutritionists in particular are working together to educate and help the community, and one area where we can make an impact is in schools where positive behaviour changes can result in an improved overall well being presently and in the future. The root of adulthood unhealthy behaviours and physical inactivity reportedly may lay in childhood and adolescence health behaviours, therefore there is growing interest into the efficacy of tackling these behaviours at a young age. The European Region for the World Federation for Physical Therapy recommends promotion of physical activity and exercise as an essential requirement for achieving and maintaining fitness as part of a healthier lifestyle, and one of the most effective ways is through schools.The Chartered Society of Physiotherapy set about a campaign called ‘Move for Healthy Kids’ which combines physiotherapists and dietitians/nutritionists presenting special assemblies at schools in order to prevent the occurrence of lifestyle related disease. This means that the children, parents and teachers have expert advice brought directly to them. There has been research that has found positive effects in reducing postural and physical inactivity related symptoms in young people with the use of education and powerpoint presentations. For example, a study found that providing a presentation involving problem solving and participation from school children resulted in improvements in computer related posture and discomfort. Another found that educating 9-11 year olds in back care principles reduced the prevalence of neck and back pain in the short term and at a one year follow up. At this age pain and discomfort can just be put down to growing pains alone therefore young people do not necessarily get referred to a health professional but this can result in a chronic form of pain or impairment leading into adulthood which then becomes more difficult to treat. Changing this perception early can positively effect quality of life significantly. We also need to provide education for those who are already active in order to help prevent acute or overuse injuries which then in turn can lead to inactivity.

The benefits of a healthy and active lifestyle are well documented through research. Studies have shown that 9-15 year olds who were inactive were three times more likely to develop cardiovascular disease in adulthood, therefore even diseases associated with adulthood can be targeted even before adolescence. General benefits of physical activity include the prevention and treatment of musculoskeletal impairments, mild to moderate depression, Type 2 diabetes, obesity and several forms of cancer. Particularly in children and adolescents it can help to improve self-esteem, reduce anxiety and depression and improve motor skills, improved parental relationships, decreased anger, decreased psychological stress, reduced drug use, lower levels of mental health problems and increased quality of life.

Typical poor postures in young people include winging scapula, increased thoracic spine kyphosis and increased lumbar spine lordosis. This can result in headache and neck/back pain. Those who were less active were more likely to have these postural problems. Using laptops and desk top computers for more than five minutes has been assessed in research. It has been found that the use of a laptop increases the activation of the cervical erector spinae muscle and upper trapezius in 4-17 year olds. This level of overactivation has been shown in adult studies to increase the development of musculoskeletal disorders therefore this study shows the risk in children and adolescents also exists. Other studies have shown that young people with complaints of neck pain or palpable muscle tension were at risk of neck pain in later life.

Helping adolescents make choices in regards to their health and well being can positively impact their life long development and facilitate a successful transition into the next stage of development. If adolescents begin to decrease their level of physical activity it will continue to decrease into adulthood.

Exercising during adolescence has shown positive effects on cognitive function at the peak of neural plasticity that lasts even when exercising has stopped demonstrating that exercising during adolescence produces more persistent effects than exercising in adulthood in non spatial forms of learning, memory and anxiety. This neuroplastic effect during adolescence can have lasting functional consequences.


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