In the case of a child with hemiplegia, the specific aim of physiotherapy will be to make them as physically two sided as possible. The physiotherapist may work on such things as balance, weight bearing on the affected side, and developing sensitivity in the affected hand.
Your child’s limbs may tend towards spasticity (increased muscle tone i.e. over-tightening of muscles), so the therapist will spend a lot of time stretching them. While your child is still very young, much of the therapy will be a question of doing things to them; as they grow, they will be encouraged to take a more active part in it themselves.
Exercising at home
Of course, for maximum benefit the exercises that the physiotherapist does with your child need to be practised every day. An important part of their task is to teach you to do them at home, and also to integrate therapy techniques into everyday activities. You might, for example, encourage your child to reach with their affected hand when you are passing them toys or food, or remind them to use both hands when appropriate – holding a beaker, for instance.
Progress may seem slow, and you and your child will both get sick of the phrase ‘both hands, please’! Try not to feel guilty if you seem to be getting nowhere – too much pushing can be counterproductive, and your child will work out for themselves whether a skill is useful or not.
Treatment may also include hydrotherapy (therapy in a special pool), since it is easier to exercise stiffer limbs in warm water.
The physiotherapist will also advise on special shoes or boots, or splints to help with standing and walking or with hand position. They can also tell you about specially-adapted bikes and trikes. Find out more about aids and equipment.
As your child grows older, they will increasingly prefer an alternative approach to physiotherapy, based on activities they enjoy.
As children grow they acquire all sorts of practical skills. They learn self-help skills such as feeding and dressing themselves, using the potty and the toilet.