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following case study will be critically commenting on the physiotherapy journey
and care of a 6-year-old child diagnosed with cerebral palsy (refer to Appendix
A). To provide quality person-centred care, it is essential that
physiotherapists have a set of values, behaviours, knowledge, skills and
expertise that allows quality healthcare for each patient (Health & Care
Professions Council 2014). Within the NHS, there are multiple disciplines of
physiotherapy, working with varying populations. Each have specific roles and
responsibilities, and at Sick Kids the physiotherapists are not only providing
treatment for the patient, but also helping with their development and quality
of life (The Chartered Society of Physiotherapy 2017). Additionally, by knowing
their role within a multi-disciplinary team, a physiotherapist is creating an
environment that will allow a patient the best possible treatment and
rehabilitation. Physiotherapists also need to treat patients with safe,
effective and person-centred care (NHS Education for Scotland 2017).

Furthermore, depending on the specific population that the physiotherapist is
working with, they are required to be able to communicate with the patient and
family members, to make sure that the proper information is being understood
and received. Therefore, for the purpose of this case study the physiotherapy
elements that will be critically examined are: physiotherapist roles and knowledge,
as well as the adherence to safe and effective person-centred care.

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role is a structural component of a group; they are a set of expectations for
behaviours associated with a specific position in a social setting (Petersen
2017). To meet the needs of this individual, it was essential that the
physiotherapist recognized the importance of their specific role within the
multi-disciplinary team at Sick Kids. Although this physiotherapist working
with the child postoperatively was not involved throughout the entire
diagnostic and rehabilitation process, they minimized that limitation and still
understood their role in maintaining her health and well being (Health &
Care Professions Council 2013). The physiotherapist also had knowledge about
the diagnosis and treatment to provide quality care and rehabilitation. A
weakness for this specific situation was that there are only a few SDR
surgeries in Scotland each year, which limits relatable cases. The
physiotherapist attempted to continue their development by educating themselves
with previous physiotherapy notes on the patient and research, for example
McLaughlin and colleagues (2002) found a significant advantage with regards to
function, for children with spastic diplegia who have had SDR surgery and
physiotherapy treatment. By having this knowledge, it allowed the
physiotherapist to know the importance of postoperative rehabilitation with
progressive exercises to help with strengthening muscles. More specifically,
when the physiotherapist was providing care to the patient, they adhered to the
chartered society of physiotherapy framework for quality healthcare. The
framework states that the physiotherapist must demonstrate how their knowledge
and understanding relates to physiotherapy and their individual scope of
practice (CSP 2011). For this patient, she has had physiotherapy for majority
of her life, so it was vital that they were treating her with the upmost care
and expertise, to allow her benefits for proper growth and development.

supporting a child with a physical impairment, there are many additional
responsibilities required from a physiotherapist to provide safe and effective
care. Within community physiotherapy, there are multiple interactions that the physiotherapists
need to make meaningful. A strength that occurred was the communication about
the importance of working on the rehabilitation. By doing this, the
physiotherapist was making every contact count (Bishop 2014). Previous research
by Van Wely and colleagues (2013) found that a physical activity program for
children with cerebral palsy helped improve social participation in life over
the long-term. Additionally, Nystrom and colleagues (2008) found that 8 weeks
of training exercises helped improve stride length and muscle strength in
children with cerebral palsy. The communication skills of the physiotherapist to
accentuate the importance of completing the exercises to the patient and her
parents were very significant. This allowed all parties involved in the child’s
journey to understand the strengthening exercises, and be able to practice them
when they were on their own. The physiotherapist also made sure that the child
was enjoying their experience by making the exercises fun and creating goals.

These additional elements that the physiotherapist provided for the patient,
has allowed them to build a rapport with the family and child. The relationship
between the physiotherapist and their patient has allowed them to provide
person-centred care, and when working with the child, the ability to provide
compassionate care is a fundamental component of physiotherapy (Health
Foundation 2014).  

this case study, there were specific elements of physiotherapy that were
examined. The role and knowledge of the physiotherapist working with a child
who has a neurological impairment and the importance of providing safe and
effective person-centred care. The findings will help further the advancement
of information surrounding physiotherapists working in environments with
children diagnosed with cerebral palsy.  

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