When your child sees a Health Professional, eg Consultant or Physiotherapist, or you read a medical or educational report, medical terminology may be used. Ask your Physiotherapist to explain anything you are unsure of, as it is important you understand your child’s condition. These words are used very commonly and rarely explained.
Terms you will see describing a condition include acute, which describes a condition or symptom that has started suddenly. It is the opposite of chronic which describes a problem that has lasted 3 months of longer. It is not an indication of severity as is commonly believed. Acute and chronic will generally be used to describe musculo-skeletal pain, for example acute knee pain, chronic back pain.
Skills and Abilities
may be described in terms of developmental milestones, which are the skills that children learn as they grow and develop and the approximate age a baby or child would typically achieve these them, eg sitting at 6-months, crawling at 10-months, walking at 1-year. As a child becomes older their abilities are likely to be expressed in the categories of Gross Motor Skills (GM) and Fine Motor Skills (FM). Fine motor skills describe dextrous activities using hands, e.g. writing, sewing, whilst Gross Motor Skills are the PE type activities such as walking, running, hopping and jumping. Generally Occupational Therapists tend to specialise in helping children with their fine motor skills and Physios with their gross motor skills, but of course there is overlap when a child is looked at as a whole.
Muscle Tone or Postural Tone
will probably be described by your Physiotherapist and within a Physiotherapy report. Muscle tone is complex, but essentially it is the amount of tension that the muscle has. It is important to remember that muscle tone is on a continuum, a child can have normal muscle tone that is a bit on the high or low side. The muscle tone affects postural control and postural stability – the background control a child’s body needs to stabilise themselves so they can perform smooth coordinated movements. If this postural control is too low or too high it will affect a child’s coordination. A child with low muscle tone will be described as hypotonic, or having hypotonia, their muscles will feel soft and will offer less resistance to movement. Hypertonic and Hypertonia describe high muscle tone, causing all or part of a child’s body to feel stiff or firm. Spasticity is a type of hypertonia. Associated Reactions are often described with postural tone, they are the abnormal increase in muscle tone in a limb, often seen when a hemiplegic arm flexes, when a child is excited or working hard. Not to be confused with associated movements which are normal involuntary movements, eg arm swinging when walking.
A Physiotherapy Report
will almost inevitably contain descriptions of the actions of muscles and the movements of joints. The movements of the body are complex and there are hundreds of words to describe how joints and body parts move. Some of the terms used more frequently are described below using the picture of ‘Karate Kid’ to help.
- Flexion refers to a bending movement that decreases the angle between two body parts (left elbow and knee), whereas extension refers to a straightening movement that increases the angle between two body parts (right elbow, right knee and fingers).
- Abduction is a movement away from the midline (both legs and left arm) and adduction is towards the midline. Medial (or internal) rotation is a rotating movement towards the midline and lateral (external) rotation is a rotating movement away from the midline (left leg).
- Pronation moves the palm of the hand so that it is facing downwards (both forearms).
- Supination moves the palm of the hand so that it is facing upwards.
- Dorsiflexion is a movement at the ankle, whereby the foot moves towards the shin (left leg).
- Plantarflexion refers the movement that points the foot away from the shin (right leg). When the ankle is in a neutral position between dorsiflexion and plantarflexion – ie at 90° it is called Plantigrade.
- Eversion is where the foot turns so the sole of the foot rotates outwards into a valgus position and inversion is where it turns in so the soles face each other into varus.
Kids Physio can provide specialist assessments and reports for Statutory Assessment of Special Educational Needs (SEN Statements), SEN tribunals, Expert Witness Reports.