Physiotherapy Physiotherapy

Physiotherapy

Our physiotherapists work with children and families to optimise their daily physical experience through the assessment, treatment and management of a range of conditions. We offer a high standard of care across a range of specialties including musculoskeletal, cardiorespiratory, neurological and oncological presentations.

At the Queensland Children’s Hospital (QCH), our approach is individualised, innovative and imaginative. We focus on patient centred care and support families by working towards common goals. We work with our colleagues in the community to support children through the hospital environment and towards longer term care. Our services are available to outpatients, day patients, inpatients, via telehealth services and through a number of specialist outreach services.

Who can access this service?

The Physiotherapy Department provides clinical services to children and adolescents aged from birth to a child’s 16th birthday (with some pre-determined exceptions).

Catchment area

This service is available to children living in Queensland, northern New South Wales and the Northern Territory.

Do I need a referral?

You will need a formal referral to access this service.

How do I get a referral?

Please speak to your paediatrician or Children’s Health Queensland (CHQ) health professional about being referred to the Physiotherapy Department.

Referral instructions

Children’s Health Queensland medical practitioners should use the Clinical Forms Catalogue on QHEPS to access Allied Health referral forms.

The Physiotherapy Department also conduct primary contact clinics at QCH and community centres. Please find further information in the relevant clinical services:

  • Congenital Talipes Equinovarus (CTEV)/ Club foot
  • Orthopaedic Physiotherapy Screening (OPSC) – MSK
  • Orthopaedic Physiotherapy Screening (OPSC) – Normal Variance
  • Rheumatology
  • Continence

About the team

Director

Kellie Stockton

At Children’s Health Queensland we have a large team of dedicated children’s physiotherapists and physiotherapy assistants and a number of internationally recognised team members. Our clinical teams are led by consultant and advanced physiotherapists and our broader team has a focus on developing and nurturing the next generation of children’s physiotherapists.

Find out more about how physiotherapy can help your child

Physiotherapy can help children who access a range of services at the QCH. Find out more about how physiotherapy can help your child.

Plastics and reconstructive surgery may be required for the face and/or body following burns, trauma and for some medical conditions including those present at birth. The surgery helps to reconstruct the tissue including the skin and muscles.

Acute burns can occur in many settings like scalds from hot coffees, contact injuries from campfire coals, friction injuries from motorbikes, significant flame burn injuries from house fires.

The burns/plastics physiotherapist works as part of a team known as a multi-disciplinary team (MDT) which includes burns and plastics doctors, physiotherapists, occupational therapists, social workers, nursing staff and sometimes other health professionals. This team works together to minimise the negative impacts associated with burns and trauma related injuries.

Services

Inpatients

Burns

A significant burn injury for a child varies in size depending on the child’s age. Significant burns may require an admission to hospital for ongoing management. A physiotherapist will often review children coming into hospital after an acute burn. The physiotherapist will assess how the injury affects the child’s movement and ability to perform daily activities. The physiotherapist will then promote return to usual activities, particularly if the burn involves the child’s legs.

Plastics

After a traumatic incident, children can have prolonged hospital admissions, particularly if they have multiple injuries involving the skin and muscle. The plastics doctors will refer these children to physiotherapy if they have a leg injury requiring surgery, an injury impacting on mobility or a long period of bedrest.

Outpatients clinics

Burns Clinics

All children who present with a burn injury are referred to the burns centre for management. Children and their families attending this usually see more than one health professional at this visit.

Plastics Clinics

All children who are admitted to hospital after a traumatic event requiring plastic surgery are followed up in an outpatient clinic. The plastics medical staff will refer to physiotherapy if there are any concerns around joint stiffness or overall mobility.

Why do you need to see a physiotherapist?

After a burn injury or plastics management, the following can arise:

  • Joint stiffness, dysfunction or immobility
  • Reduced mobility e.g. walking, running, jumping
  • Ongoing pain or swelling impacting on the child’s ability to return to normal activities.

 

Your physiotherapist may give you exercises, help you walk which may be with a frame or crutches and sometimes they will arrange splints.

The Child Development Service (CDS) helps to understand your child’s developmental challenges. Some children have difficulties across multiple areas. This service consists of a multidisciplinary team including physiotherapy, occupational therapy, speech pathology, social work, psychology, dietetics, nursing and a Developmental Paediatrician.

Prior to your first appointment, you may receive a phone call so the team can better understand your concerns and make the right appointment. It usually takes a number of assessment sessions over weeks or months to understand your child. These appointments are generally at one of our community centres but sometimes we also need to observe children in other settings like at school, childcare and home. At your first session, the CDS team will discuss what appointments your child will need. Once all the assessments are completed, your team will talk through their findings including whether a diagnosis is appropriate. Lastly, the team will help you identify goals and make a treatment plan.

The CDS is a short-term service. CDS will assist families who need ongoing support to link with the most appropriate service or funding option like NDIS.

To be eligible for the service children need to:

  • by referred by a doctor
  • have difficulties in more than one area of their development
  • be under 8 years and 11 months
  • live within the Greater Brisbane area (including Logan, Moreton Bay Region, Scenic Rim).

Services

There are multiple locations throughout the Greater Brisbane area all accessible through a central number – 1300 366 039.

  • Queensland Children’s Hospital, 6D, 501 Stanley Street, South Brisbane 4101
  • Browns Plains Community Health Centre, Cnr Middle Road and Wineglass Dr, Hillcrest 4118
  • Logan Community Health Centre, Level 1, 97-103 Wembley Rd, Logan Central (Woodridge) 4114
  • Coorparoo Community Child Health Centre, 236 Old Cleveland Road, Coorparoo 4151
  • Inala Community Heath Centre, 64 Wirraway Parade, Inala
  • North West Community Health Centre, 49 Corrigan St, Keperra 4054
  • North Lakes Health Precinct, 9 Endeavour Blvd, North Lakes 4054
  • Pine Rivers Community Health Centre, 568 Gympie Road, Strathpine 4500
  • Redland Health Services Centre, 3 Weippin St, Cleveland 4163
  • Wynnum-Manly Community Health Centre, “Gundu-Pa”, 20 New Lindum Rd, Wynnum West Q 4178

Why do you need to see a physiotherapist?

The physiotherapist is one member of the multidisciplinary team. The physiotherapist will assess how your child moves and how they utilise their senses such as vision for movement.

For intervention, they may be able to help with strategies to improve motor skills, posture, balance, coordination, motor planning, sensory-motor development and participation.

Common conditions

  • global developmental delay
  • autistic spectrum disorder
  • developmental coordination disorder
  • foetal alcohol spectrum disorder
  • failure to thrive
  • motor delays
  • dyspraxia
  • learning difficulties / cognitive impairment

Relevant Links

CHQ at Home provides physiotherapy treatment to eligible children in their own home. Physiotherapy assessment and treatment can occur in the patient’s home or school as part of the Hospital in the Home program, Post Acute Care or Hospital Avoidance service.  This service helps to organise the care children need, when they need it.

Services

Hospital In The Home allows children who are medically stable to access treatment at home rather than being in hospital. The multidisciplinary team consists of nurses, physiotherapists, occupational therapists and speech pathologists. Before leaving hospital, parents and carers receive a personalised care plan along with any necessary medication and equipment (e.g. crutches, braces, slings). Once a child has returned home, the team provide care, assessment, advice and support to children and their families within their home.

Post Acute Care service provides children with goal-orientated, short-term, community-based support. It ensures a safe and timely discharge. Physiotherapy can provide equipment, progress mobility and ensure safe transfers within the home environment.

Hospital Avoidance service offers in-home physiotherapy to children with complex medical needs when their respiratory status deteriorates. The service aims to reduce hospital admissions and help families to access services promptly.

Catchment area

Children must live within 30-40 minutes travel / 40kms of Brisbane’s city centre to receive this service.

How do I get a referral?

Speak with your child’s treating medical team about whether you might be a suitable candidate for the CHQ at Home services.

Why do you need to see a physio?

CHQ at Home Physiotherapy can help children with:

  • complex medical conditions who have additional respiratory needs,
  • children who have had orthopaedic procedures and are having difficulty mobilising and require progression of a home exercise program.

Your physiotherapist may give you exercises, use breathing devices or help you to walk.

Conditions we treat include:

  • Lung conditions including cystic fibrosis, bronchiectasis & primary cilia dyskinesia
  • Neuromuscular conditions, cerebral palsy, and other medically complex patients who have chest infections and difficulty coughing
  • Post-operative orthopaedic conditions
The Community and Allied Health service provides physiotherapy across a number of sites in the Greater Brisbane area. Telehealth options may be used when appropriate. Physiotherapy will provide a limited number of sessions (generally a maximum of 4-6 sessions within a 3-month period). Sessions will focus on:

  • helping families and carers to better understand their child’s movement and development
  • providing activities to practise at home
  • providing guidance and support if ongoing physiotherapy is needed
  • ensuring families know what to monitor and when to seek support following discharge.

Services

Torticollis Clinic

The Torticollis clinic is for infants with at least one of:

  • loss of movement in their neck
  • holding their head in a tilted position all the time.

If your child has a misshapen or plagiocephalic head they can only access this service if they also have a loss of neck movement and/or a tilted head position. This service does not provide nor fund corrective helmets. Families can attend private orthotists if they wish to arrange a helmet which needs to be self-funded.

Gross Motor Clinic

The Gross Motor clinic is for children from up to 8 years 11 months old with a gross motor delays (as outlined in the Red Flags Early Identification Guideline). This may include:

  • Delayed motor milestones from 6 months old – including concerns with head control, rolling, sitting, moving on floor, pull to stand, cruising, walking, running, jumping, balancing, catching, hopping, skipping and stairs
  • Not responding to general advice, monitoring and support
  • Unusual movement performance affecting participation in physical play with other children or physical function at home.

Children who have a neurological concerns should be referred to Initial Physical Assessment Clinic (IPAC) at Queensland Paediatric Rehabilitation Service (QPRS).

Why do you need to see a physio?

A physiotherapist can help to understand why your child has motor delays. The physiotherapist can help set goals and provide activities to help your child to participate. Activities may target:

  • teaching and practising motor skills
  • muscle strength
  • muscle length
  • tone and spasticity
  • joint range of movement
  • posture and postural control
  • balance
  • coordination
  • using both sides of the body
  • using senses to move (sensory-motor)

Equipment (and assistive technology) is sometimes helpful to progress family goals and minimise impact of long-term issues. Your physiotherapist can help identify if equipment will assist your child.

Conditions

  • Torticollis
  • Developmental Coordination Disorder
  • Motor Dyspraxia
  • Motor delays

Contact us

Ph: 1300 366 039 (Press 2 then 1 then 4)

Email: CDP_CAHS@health.qld.gov.au

How to Refer

All children are required to be reviewed and referred by a General Practitioner or Paediatric Medical Specialist to ensure medical oversight and shared care with the Community Allied Health Service.

External referrals use the Specialist Outpatient Referral Form

Internal medical officer referrals can be made via CRU/eRefer. Fax number for referrals: 1300 407 281.

Useful Links

The Physiotherapy Continence Service can help children experiencing difficulties with bladder, bowel and pelvic floor dysfunction. Constipation, accidental wetting and soiling are all quite common in childhood. Physiotherapy can help boys and girls up to adolescence to gain or regain control of their bladder (wee) and bowel (poo).

Services

Inpatients

During any hospital admissions, your doctor may refer your child to physiotherapy if they also have bladder/bowel and/or pelvic floor dysfunction. The physiotherapist will provide assessment and care appropriate for your child.

Outpatients

Referrals to the outpatient Physiotherapy Continence Service will be accepted from Specialist Medical Teams only. Some children referred to a General Paediatrician for bladder, bowel and/or pelvic floor dysfunction will be seen by a physiotherapist instead. This is called physiotherapy primary contact. Only children who are likely to benefit from physiotherapy intervention will be redirected in this way. Physiotherapists will provide clinical assessment and treatment for bladder, bowel and/or pelvic floor dysfunction for patients aged 6 years* and older.

*Physiotherapy intervention may be offered to children under the age of 6 years with consultation with Advanced Physiotherapist.

Why do you need to see a physiotherapist?

The International Children’s Continence Society (ICCS) recommends Urotherapy as a first line treatment for children with incontinence. Urotherapy is offered by Physiotherapists who specialise in bladder (wee), bowel (poo) and pelvic floor dysfunction.

Urotherapy includes:

  • Education on good bladder and bowel habits
  • Correct positioning on the toilet
  • Life-style advice regarding fluid intake
  • Prevention of constipation
  • Instruction on the use of bladder/bowel diaries
  • Pelvic floor muscle retraining (often with focus on pelvic floor muscle co-ordination and relaxation, not strengthening)

Conditions

  • Urinary incontinence (wee accidents)
  • Urinary (wee) urgency
  • Urinary (wee) frequency
  • Voiding (wee) dysfunction
  • Recurrent urinary tract infections (bladder infections)
  • Faecal incontinence (poo accidents/soiling)
  • Faecal (poo) urgency
  • Chronic constipation
  • Recurrent rectal prolapse
  • Pelvic pain syndromes

Useful Links

Children might not meet developmental milestones like other children their age due to a number of reasons, including:

  • Premature birth
  • Complications during pregnancy or delivery
  • Lack of opportunity – for example if a child is frequently unwell
  • Learning difficulties
  • Sensory difficulties
  • History of trauma
  • Syndromes
  • Disorders impacting on the nerves, muscles or bones

A physiotherapist, as part of a multidisciplinary team, can help to identify the underlying reason for motor delays.

Services

Inpatients

A physiotherapist may provide strategies to promote motor development for young children in hospital, especially if they have had multiple admissions, multiple surgeries or long stays in hospital.

Outpatient Clinics

CHQ specialists can refer children to see a physiotherapist if there are concerns with their motor development. A child may be referred if they have an unusual walking pattern or if the child is late to sit, crawl or walk. A physiotherapist will help to understand why a child is having these difficulties and provide some strategies to improve their function.

Infant Team

The Infant Team sees children under 12 months with complex presentations. The clinic is held at the QCH and the team is made up of a physiotherapist, occupational therapist and speech pathologist. Only CHQ specialists can refer to this clinic.

Child Development Service

The Child Development Service is a community-based service with access to a full multidisciplinary team (physiotherapy, occupational therapy, speech pathology, psychology, social work, dietetics, developmental paediatrician). This service helps you to understand your child, their strengths and weaknesses. It is a short-term, goal directed service designed to empower families with strategies to optimise their child’s development and participation. Medical officers including general practitioners can refer to this service.

Community Allied Health Service

This service has a Torticollis Clinic and a Gross Motor Clinic in the community. The Gross Motor Clinic sees children who have delays in just their motor skills like crawling, walking, running and jumping. The Torticollis Clinic sees babies who don’t have full movement in their neck. The physiotherapist will provide some short-term intervention and provide you with strategies to improve your child’s movement and participation.

Why do you need to see a physiotherapist?

A physiotherapist can help identify the underlying cause of motor delays, assist families to set goals and provide activities to help maximise your child’s function. Activities may target:

  • teaching and practising motor skills
  • muscle strength
  • muscle length
  • tone and spasticity
  • joint range of movement
  • posture and postural control
  • balance
  • coordination
  • using both sides of the body
  • using senses to move (sensory-motor)

Equipment (and assistive technology) is sometimes helpful to progress family goals and minimise impact of long-term issues. Your physiotherapist can help identify if equipment will assist your child.

If your child requires ongoing intervention, your physiotherapist will help to link you with the most appropriate service or funding source (eg NDIS).

Conditions

  • prematurity and adverse neonatal events
  • chronic neonatal lung disease
  • high risk of cerebral palsy
  • global developmental delays
  • chromosomal anomalies
  • autism spectrum disorder
  • neurological disorders
  • neuromuscular disorders

Useful Links

Haemophilia is a genetic disorder resulting in bleeding due to a low level of clotting factor. There are two types of haemophilia (haemophilia A and B), based on which clotting factor is lacking.  The blood disorder is classified as mild, moderate or severe based on the level of clotting factor. Bleeding can occur at many sites throughout the body. The joints are most commonly affected especially the ankles, knees and elbows.

Due to the inheritance pattern, males are more commonly affected.

Services

Acute bleeds

Suspected joint and muscle bleeds must be managed immediately due to potential long-term consequences. Haemophilia multi-disciplinary team (MDT) includes a haematologist, medical doctors, physiotherapist, psychologist, nurse practitioner and registered nurse. The team assess and manage acute bleeds in children with haemophilia. The physiotherapist will assess the affected joint or muscle. Treatment may include soft casting to immobilise a joint and advice regarding returning to activities.

Inpatient

Severe acute bleeds like bleeds around hip muscles may require an inpatient admission and a period of bed rest.

Outpatient Clinics

Patients with haemophilia are reviewed at regular intervals in the outpatient department by the haemophilia team. For patients with severe haemophilia, the physiotherapist will perform a joint health score annually.

Outreach Service

The haemophilia service provides outreach to hospitals throughout the state. A haematologist, nursing staff, physiotherapist and psychologist attend these clinics.

Why do you need to see a physiotherapist?

A physiotherapist can help identify:

  • muscle bleeds
  • joint bleeds
  • limitations in joint movement
  • assessment of function
  • assessment of walking and use of mobility aids as required
  • appropriate home activities

Conditions:

  • haemophilia A and B (severe, moderate, mild)
  • Von Willebrand’s Disease (severe)

Useful Links

Our nervous system includes our brain and nerves and together they control our muscles. When there is a problem with our nervous system, movement can become more difficult. This may present as:

  • asymmetries (differences between the left and right sides of the body)
  • altered tone or spasticity
  • reduced coordination
  • reduced motor control
  • reduced balance
  • reduced motor skills.

If these are not managed appropriately they can result in muscle contractures, pain and dysfunction.

Services

Inpatient services

A physiotherapist will often see children coming into hospital for neurosurgery or if they have had a brain injury. Where possible, the physiotherapist will review a child’s baseline function prior to brain surgery, which will assist in goal setting and follow-up intervention. This may include looking at motor skills, how a child walks or moves, posture, presence of tone or spasticity and how they move in response to their senses (eg using their eyes to catch a ball).  Physiotherapists may treat children with:

  • bleeds in the brain / acquired / traumatic brain injury
  • head injuries
  • hydrocephalus and shunts
  • tuberous sclerosis
  • brain tumours and spinal cord tumours
  • myelomeningocele and spina bifida
  • spinal cord tethering
  • epilepsy surgery
  • transverse myelitis
  • functional neurological disorders/functional somatic symptoms

Outpatient services

Physiotherapists provide outpatient appointments and attend multiple medical-led clinics to provide specialised support for children (and their local therapists) with conditions including:

  • Duchenne and Becker Muscular Dystrophy (DMD and BMD)
  • spina bifida
  • spinal muscular atrophy (SMA)
  • peripheral neuropathies like Charcot-Marie-Tooth (CMT)
  • myotonic dystrophies
  • congenital myopathies
  • brachial plexus palsies

Serial casting clinic

Serial casting is when a therapist casts a limb in a good position to help stretch muscles and change the posture of the limb. Often these casts are changed a few times to gradually increase the stretch and flexibility of the muscle. Your medical officer or physiotherapist can identify if this is appropriate for your child.

Why do you need to see a physiotherapist?

The physiotherapist can monitor changes in function and assist with optimising independence, mobility and function. They can assess and minimise complications like contractures (muscle tightness) and scoliosis. Intervention may include learning or relearning to move and walk, strengthening and stretching exercises and helping to advise on or arrange assistive devices such as orthoses and mobility aids. Physiotherapists assist in improving movement, through:

  • strengthening
  • stretching
  • improving stability and control
  • casting
  • splinting
  • helping to decide on orthotics
  • mobility aids and wheelchair advice.

Some children also have respiratory difficulties and they can access the respiratory physiotherapists in the team to help with secretion removal and reduce work of breathing.

Some children require ongoing intervention or equipment for when they go home. The physiotherapist will provide information and advice on equipment hire and appropriate ongoing services such as NDIS.

You may be asked if your child can participate in research trials. Participation in research is voluntary.

Useful links:

During a child’s cancer treatment, it is likely they will be in contact with a physiotherapist. Physiotherapists work with the other members of the oncology and aim to keep your child active.

Services

Inpatient

The physiotherapist may be asked to review your child during their inpatient stay to assist with movement and sitting out of bed. Even when your child is unwell, it is still important to encourage and motivate participation in activities.

Outpatient

Children may also see a physiotherapist as an outpatient. We attempt to provide appointments that are convenient for both the child and family. Timing of the intervention is dependent on blood counts and treatment cycles. A physiotherapist will review and monitor your child throughout the continuum of their oncology treatment and care.

Why do I need to see a physiotherapist?

Physical activity is a key contributor to maintaining good overall health:

  • increased physical activity has numerous health benefits leading to an increase in overall physical and psychological well-being
  • immobility or low levels of activity during cancer treatment is known to compromise everyday function, aerobic capacity, mobility and muscle strength.

Many children undergoing cancer treatment experience changes in their motivation or ability to be physically active. A physiotherapist can assist in maximising movement and function, maintaining general conditioning and muscle strength. This includes bed mobility, walking, and maintaining maximal independence with functional activities.

Physiotherapy will be tailored to each child’s physical and medical status. For example:

  • Movement and strengthening exercises to maintain muscle strength and joint movement in the upper and lower body.
  • Bed mobility (getting in and out of bed and sitting on the edge of the bed).
  • Encouraging mobility as tolerated – for some children, this may be a walk to the bathroom and for others it may be a walk around the ward.  If there are difficulties with walking or balance, the physiotherapist will decide what assistance, aid, or supervision is required to keep the child safe.
  • Physical exercise, which may take place in a variety of locations:
    • in hospital rooms
    • around the ward or in a ward therapy room
    • in the oncology day unit
    • in either the public garden or allied health therapy garden (depending on individual precautions)
    • in the physiotherapy gym or allied health therapy rooms.
  • Rehabilitation following surgery.
  • Planning for return to home, school or community.
  • Some children benefit from hydrotherapy and families will be encouraged to organise a Chronic Disease Management Plan through their GP. QCH does not have a hydrotherapy pool.

Accessing mobility aids

If a child becomes deconditioned or unwell during treatment, the physiotherapist may recommend a walking aid or wheelchair.  The Queensland Children’s Hospital Physiotherapy Department has a range of mobility aids that can be loaned to families while your child is an inpatient.

For outpatients requiring a mobility aid, we recommend families hire equipment externally.  The physiotherapist can provide information about external hire options.

Reason for referral to physiotherapy:

  • respiratory changes
  • posture and gait imbalance such as vincristine neuropathy, avascular necrosis
  • movement and mobility concerns
  • developmental concerns
  • evidence of neurological changes affecting function/mobility

Conditions:

  • leukemias (eg acute lymphoblastic leukaemia – ALL, acute myeloid leukaemia – AML)
  • lymphomas (eg Hodgkin lymphoma)
  • brain tumours
  • bone tumours (eg osteosarcoma)
  • children undergoing bone marrow transplant
  • other solid tumours

Useful links

Orthopaedics manages musculoskeletal conditions. This includes the bones, muscles, joints, ligaments and tendons. The orthopaedic team includes orthopaedic doctors, physiotherapists, occupational therapists, nursing staff and social workers. Physiotherapists provide care for children with musculoskeletal conditions including injuries and after surgery. Injuries may be from sporting accidents, motor vehicle accidents or falls from play equipment. Some children with medical conditions like Cerebral Palsy and Osteogenesis Imperfecta may require intervention and support to return their usual activities.

Services

Inpatients

A physiotherapist will see children when their injury, surgery or condition has affected their function. Care on the ward may include support to move, walk and participate in daily living so they can go home. Usually children are given exercises and sometimes they need equipment like crutches. Once children go home, they might be followed up in a number of settings or clinics.

Outpatients

Outpatient appointments with physiotherapy are focused on rehabilitating from injury, improving musculoskeletal conditions and returning to usual activities/sports. This may include stretching tight joints/muscles, strengthening weak muscles, improving technique and optimising function. Care will usually involve a home exercise program. Outpatient clinics include:

  • clubfoot (CTEV)
  • musculoskeletal
  • STIC (Soft Tissue Injury Clinic)
  • OPSC (Outpatient Physiotherapy Specialist Clinic) is a physiotherapy first-contact clinic. Some children who are referred to an orthopaedic consultant may be redirected to OPSC if physiotherapy appears to be the most appropriate pathway for the child. If the physiotherapist still thinks an orthopaedic consultant is required for the child’s care then they will be redirected back accordingly.

Specialist Outpatient Clinics

Orthopaedic physiotherapists also attend the orthopaedic specialist outpatient clinics. These include:

  • fracture clinics
  • general orthopaedic clinics
  • upper limb and brachial plexus clinics
  • spinal clinics
  • limb reconstruction clinics
  • club foot clinics
  • foot clinic

Why do you need to see a physiotherapist?

Orthopaedic physiotherapists help get you back to moving and participating after an injury or surgery. They provide exercises so you can return to your previous activities. Exercises may aim to:

  • improve your strength
  • improve joint movement
  • improve muscle length
  • improve motor control
  • improve endurance
  • help with walking and moving.

Sometimes the physiotherapist will teach you how to use equipment like crutches.

Conditions

  • post traumatic orthopaedic surgery (eg fixation of a fracture)
  • post elective orthopaedic surgery (eg scoliosis correction)
  • musculoskeletal injury (eg ankle sprain or ACL tear)
  • musculoskeletal conditions (eg Osgood Schlatters Disease)
  • congenital orthopaedic conditions (eg brachial plexus palsy, CTEV)
  • chronic conditions (eg osteogenesis imperfecta)

Useful Links:

Persistent pain affects one in five children and young people during their development, and can be associated with significant distress and disability.

The Queensland Interdisciplinary Paediatric Persistent Pain Service (QIPPPS) provides assessment and management services for children and young people experiencing persistent pain. We aim to support these children and their families to return and stay engaged in their lives, one step at a time.

Our interdisciplinary team consists of a physiotherapist, a pain specialist, senior medical officers, psychiatrist, a nurse practitioner, psychologist, occupational therapist and music therapist. Our team uses a biopsychosocial approach. This means the team consider and address the complex nature of pain including social, psychological, biological and medical reasons.

Presentations include:

  • widespread musculoskeletal pain (including joint pain)
  • back pain
  • upper or lower limb pain
  • complex regional pain syndrome
  • pain at multiple locations
  • headaches
  • abdominal pain
  • neuropathic pain
  • nociplastic pain (no clear underlying pathology).

Why do you need to see a physiotherapist?

As persistent pain is complex and affects many areas of a young person’s and their family’s life it is best assessed and managed by the whole team.

The physiotherapist looks at how pain affects your daily function (e.g mobility, school, sports, hobbies). They will help you understand your pain experience and the mind-body link through fun and practical learning opportunities. Your physiotherapist will guide you through exercises and strategies to regain strength and condition and get back to your activities.

Who can access this service?

Referrals are accepted

  • for children experiencing persistent pain
  • from paediatricians, specialists and GPs ideally with investigation of biomedical drivers
  • up to a child’s 18th birthday (patients are usually transitioned to adult services by this time)
  • living in Queensland and northern New South Wales.

For patients living remotely, the pain team can work with local services for pain management. Telehealth can be used to liaise with patients, families and local services.

Useful links

Queensland Interdisciplinary Paediatric Persistent Pain Service referral template (QH staff only) (PDF)

Physiotherapists are an integral part of the multidisciplinary team within the Paediatric Intensive Care Unit (PICU).  Physiotherapists use comprehensive assessment and treatment techniques which encompass the respiratory, cardiovascular, neurological and musculoskeletal systems.

Reasons your child may need a physiotherapist in PICU

Respiratory management – Physiotherapists may be required to assist with the clearance of secretions in your child’s airway, improve lung recruitment and prevent respiratory complications in children breathing for themselves or those requiring additional support.

Developmental input – Infants with a prolonged PICU admission or other specific indicators may be reviewed by a physiotherapist to assess for developmental concerns and provide management strategies to facilitate appropriate positioning and early return to movement and play.

Rehabilitation after acute illness – There is substantial evidence around the longstanding physical impairment experienced by patients who have had ICU admissions.  Rehabilitation is part of our unit’s standard clinical practice and has multisystem benefits including preventing muscle deterioration and joint contractures, assisting recovery of the cardiopulmonary system, reducing delirium and decreasing PICU and hospital length of stay.

Other acute needs – Early post-operative mobility, management of neurological issues after trauma, management of patients with burns, musculoskeletal concerns.

Referral Process

All children in PICU are screened by the physiotherapy team and treatment will be following discussion with the PICU team.

The Paediatric Palliative Care Service (PPCS) is a multi-disciplinary team (MDT), consisting of consultants, medical staff, a nurse practitioner, nurse co-ordinators, occupational therapy, physiotherapy, music therapy, social work, welfare and pastoral care. The service also has links to the local respite centre, Hummingbird House. Children with life limiting conditions (both cancer and non-cancer) may be referred to the service. The team works in partnerships with the child’s primary treating team (eg the Oncologist).

The goal of the service in palliative care is to improve the quality of life in children once treatment for a cure has ceased.  This is achieved via the palliative approach that aims to limit unnecessary investigations and deliver the right type of care, in the right setting, at the right time.  The team considers the physical, emotional, spiritual and psychological needs of the child to ensure care is individualised.

Services

Children may be seen by a Physiotherapist as an inpatient, outpatient or via telehealth services.

Why do you need to see a Physiotherapist?

Physiotherapists can provide the child and family with:

  • Promoting function and mobility, including hire of equipment e.g. wheelchairs and walkers
  • Developmental assessment and advice such as assistance with positioning
  • Support to link with community organisations or NDIS for therapy or equipment needs
  • Respiratory needs including assessment and coordination of ongoing respiratory care at home.

 

Physiotherapists work with other team members to minimise the amount of time in hospital. This may consider respiratory care, bed mobility, encouraging independence and planning for the home environment.

Conditions:

  • Oncology patients
  • Cardiology patients
  • Long stay inpatients > 8 weeks
  • Patients with a neuromuscular or neurological condition
  • Patients not supported under community organisations or NDIS

Useful links

Physiotherapy has an important part to play in many paediatric patients accessing CHQ services with conditions that affect the respiratory system. Physiotherapists work within multidisciplinary teams across a number of services that care for and support the patient groups above such as respiratory medicine, neurology, immunology and general paediatrics.

Services

Patients with respiratory conditions accessing CHQ services receive physiotherapy via a number of in-hospital and out of hospital services. These can include:

Inpatients

Inpatient care is provided when children are acutely unwell or have planned admissions to improve their health. Once patients have recovered or had an improvement in their health they can be followed up by a physiotherapist in a number of settings.

Outpatient clinics 

Physiotherapy clinics and multidisciplinary clinics occur daily during the week to assess and provide interventions to patients to maintain and improve their health and quality of life.

Telehealth services

Physiotherapy assessments and interventions may be provided to patients with using telehealth. This service can be arranged using various forms of technology in the home setting.

Outreach services

CHQ respiratory service provides multidisciplinary outreach clinics to a number of regional hospitals and indigenous communities throughout Queensland. Patients are seen in their local communities or closer to home and managed in partnerships with their local teams which often includes the physiotherapist within that hospital/community setting.

Why do you need to see a physio?

Physiotherapists provide respiratory patients with airway clearance programs, prescribing exercise to improve fitness, muscle strength and managing breathlessness as well as managing complications from respiratory disease such as musculoskeletal problems. Physiotherapy interventions are provided to patients based on current evidence and recommendations from national and international standards of care. The most optimal settings as outlined above is determined in conjunction with the patients’ physiotherapist and their treating team.

Conditions

  • Cystic Fibrosis
  • Bronchiectasis
  • Chronic suppurative lung conditions
  • Chronic Neonatal Lung disease
  • Airway abnormalities
  • Patients with immunological conditions who find it difficult to fight off lung infections
  • Patients with neuromuscular conditions that experience difficulty moving and clearing their lungs

Useful Links

The rheumatology team care for children with inflammation (swelling). Some conditions like juvenile idiopathic arthritis cause the inflammation. Sometimes the inflammation can be caused by too much stress on the joints and muscles like when children have joint hypermobility. The rheumatology team is a multi-disciplinary team (MDT) and includes rheumatologists, physiotherapists, occupations therapists, social workers and nursing staff. This team works together to minimise the negative impacts associated with some of the conditions.

Services

Inpatients

Children may be in hospital for multiple tests to help make a diagnosis. Sometimes children under the rheumatology team are in hospital for their care. This allows for more intensive treatment and access to all services over a short period.

Outpatients

Rheumatology Clinics

The rheumatology team has an outpatient clinic once a month. Children and their families attending this clinic will usually see more than one health professional at this visit. The clinic is designed to reduce the number of visits the family need to make to the hospital.

Physiotherapy Rheumatology

Physiotherapy also provides clinics for clients with Rheumatology so they can target physiotherapy goals.

Why do I need to see a Physiotherapist?

Many people would not be aware children can develop pain or stiffness around their joints. This can make normal activities more difficult such as walking, dressing, attending school, playing with friends and joining in sporting activities. A physiotherapist can assist by providing advice and exercises to maintain mobility, strength and flexibility and they can recommend equipment to make everyday tasks easier.

Referral

To see a rheumatology physiotherapist, a rheumatology doctor working in Queensland Health must refer your child.

Conditions

  • Juvenile Idiopathic Arthritis (JIA)
  • Systemic Lupus Erythematosus (SLE)
  • Juvenile Dermatomyositis (JDM)
  • Vasculitis
  • Hypermobility (including Ehlers Danlos Syndrome)
  • Connective tissue disease
  • Scleroderma
  • Chronic recurrent multifocal osteomyelitis (CRMO)

Useful links

The physiotherapist works with the other members of the cardiac and surgical teams. The physiotherapist helps with breathing and getting up shortly operations. Early mobility helps to reduce complications such as lung problems and deep vein thrombosis (DVT). It can also help your child to go home and return to their previous activities faster.

Outpatient Services

Pulmonary Hypertension Clinic

This is a specialist clinic providing services to Queensland children with a diagnosis of Pulmonary Hypertension.

Physiotherapists will initially consult with you and your child to assess changes in symptoms before performing a monitored 6 Minute Walk Test.  This test assesses exercise capacity, your child’s cardiovascular and respiratory response to exercise, progression of cardiac disease and/or the effect of new medication / therapy on function.  Physiotherapists may also provide advice around safe activity and exercise as well as equipment prescription if needed.

Pectus Excavatum / Carinatum Clinic

Pectus deformities are common changes to the shape of the chest. They are generally caused by an abnormal overgrowth of cartilage between the ribs and sternum pushing the sternum inward (excavatum) or outward (carinatum).  Management may range from exercise therapy, to wearing a brace or surgery. Correct posture, exercises to increase spine and chest flexibility, lengthen tightened muscles and strengthen weakened muscles is a vital component in managing chest wall deformities.

A physiotherapist will assess your child in the clinic and provide a home exercise program.  If your child requires surgery, they will also be seen on the ward after surgery to begin early mobility and exercises.

Why do you need to see a Physiotherapist?

Physiotherapists will often see children after open surgical procedures (larger incisions not keyhole surgery). They will begin deep breathing exercises, sitting out of bed and walking.

After cardiac surgery, physiotherapists will provide advice about activities to avoid post-operatively and exercises to aid posture and chest / spine mobility.

All infants who have cardiac surgery will be screened by a physiotherapist for developmental concerns post-operatively due to the known risk of these children experiencing developmental delays throughout childhood.  The physiotherapist will educate you on how to facilitate early return to normal play and positioning, including tummy time.

Useful Links

The Queensland Children’s Hospital physiotherapy department recognises that infants and children can require physiotherapy across the whole week, and at times during the night when acutely unwell.

On-Call Service

A consultant may request an on-call physiotherapist to review a child between 16.00 and 07.30. There is a clear procedure with indications for physiotherapy review focused around reducing the deterioration of a child’s condition.

Weekend and Public Holiday Service

There is a limited weekend service provided to children who meet the criteria for physiotherapy management. Children may be seen over the weekend to assist discharge home following orthopaedic surgery or if they require chest physiotherapy to improve lung function.

There will always be a physiotherapist onsite between 07.30 and 16.00 and new referrals are assessed based on clear guidelines.

Physiotherapy provide Hospital in the Home services on weekends.

This service is available at

Allied Health (6a)
Queensland Children’s Hospital
Level 6
501 Stanley Street
South Brisbane
QLD 4101
View map

Contact details

t: 07 3068 2850 | 07 3068 1111 (hospital switchboard)

e: QCH-Physio@health.qld.gov.au

Operating hours

Monday to Friday, 7.30am-4pm.
Prioritised inpatient services are also available on weekends and public holidays where required.

Related services

Queensland Children’s Hospital

Child Development Program

Queensland Paediatric Rehabilitation Service

Resources

NDIS