What happens during JIA physiotherapy assessment and exercises?


Hi Susan, my name is Jenny. I’m one of the physiotherapists. Thank you for coming along today, to show children who have juvenile arthritis, what to expect when they come for a physiotherapy appointment. What is juvenile arthritis? Juvenile arthritis, which we often call JIA, is a condition which affects your joints and causes inflammation in your joints. So your joints are sort of the moveable bits of your body, like your knees, your wrists, your shoulders. And JIA can cause them to become swollen, sometimes they are a bit sore and they can get stiff. What can help? With juvenile arthritis, it can be a combination of them taking some medicine, but also having some physiotherapy. So physiotherapy gives children certain exercises to do, they might need exercises to stretch out their joints or strengthen up their muscles. How do you know which exercises to do? When you come for your first physiotherapy appointment, we’ll carry out an assessment and that will tell me which things you need to work on. So that’s really great that you’ve got your shorts on today, cause that will let me see your joints really clearly. I’ll get you to take your shoes and socks off now and I’ll prepare the bed. And then we can do your assessment. Okay Susan, do you want to come over and have a lie down on the bed for me? That’s perfect. This is an electric bed, it goes up and down. Okay. So I’m just gonna put you up just now. All right? Are you ready? It that okay? Yeah. I’m just going to check and see if there’s any swelling in the knees. Okay. Let me know if anything is sore, okay? Oh, they’re a little bit tight. You have been doing a bit of growing, have you? Okay, going to have a little look at how
strong your muscles are. Okay. Can you lift your leg up to touch my hand? Try and hold it there with your muscles. Good, brilliant. Could you come and sit at the end of the bed for me? That’s super. Push your leg forward against my hand. Keep pushing. Good. Okay, so we finished your knee assessment now, but obviously if you had a sore or stiff neck or shoulder, we would do a full assessment of your neck or shoulder. So what do you do next? Well, once we’ve worked out what’s wrong with the child’s knee, we would then give them a set a specific exercises to follow. So we would normally get the child a sheet of exercises, that looks something like this, okay. And we would go through them one by one, with me teaching you what to do. Then when you get home, your mum and dad can help you to do them every day. Okay? Do you want to have a lie down again on your back? So the first exercise I’m going to show you, is one we would give to a child, if they were needing to strengthen up their quadricep muscles. Okay. What I’m gonna get you to do, if you can pull your toes up towards me, push your knee down onto my hand, and then can you lift your leg up off the bed, keeping your knee nice and straight. Try and hold it there for ten seconds. And back down. When you do them at home, we would get you to maybe do about seven of those in a row. If you needed to stretch out your hamstrings, we would do that in a bit of a different way. All right? If we bend your knee up for that one, if you put your hands at the back of
your thigh. Relax that head back, up towards the ceiling. Okay. I’m gonna let go, you keep it there. Good job. And again we would get you to do it several more times when you’re at home. And it tells you what to do on the sheet. If you want to sit up over the edge of the bed now. And I can show you another exercise that you would maybe do, to strengthen up your quad muscles. Okay. So how often you need to do these exercises? We normally encourage children to try and do them two times day, maybe before school and after school. Or if you don’t have much time in the mornings, then maybe after school and before bed. So you don’t have to have a ball like this at home, you could use a big rolled-up bath towel or a teddy. Just something that you can give a good
squish. Right. I’m going to get you to put the ball between your feet. Can you squeeze it for me? I want you to keep squeezing it and now straighten your legs. Now slowly lower your legs. Can you only do these exercises or can
you do other sports as well? Absolutely, we encourage children with juvenile arthritis to do sports, because it often complements what we’re working on in physiotherapy. It keeps you nice and strong and it keeps your joints really flexible. So children with juvenile arthritis, do they like to do these exercises? Sometimes yes, sometimes no and sometimes it can be a bit difficult to get into the routine of doing the exercises. So sometimes we might use distraction to keep them on track, like listen to music or with younger children we quite often use a reward chart. So that they get into the habit of doing
them every single day. Then maybe get a treat at the end of the week. Thank you so much for showing me all these exercises and filming with me today. Not at all, I look forward to seeing it.

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