Physical Therapy

According to the updated standards of care for SMA the main treatment goals for children with non-sitter (Type 1) SMA include helping with function, reducing, as far as possible, impairment and helping children tolerate different positions.

Stretching

This includes using supports and splints, active-assistive and passive techniques, supported supine and standing frames and casts. Chest bracing is recommended to stabilise posture and to promote function. Neck bracing is often used to support the head, particularly if your child has no head control or it is not fully developed. The aim is to reduce the risk of asphyxiation while upright. Upper and lower limb supports are used to promote function and range of motion.

Positioning

Seating systems and postural supports should include supine positioning with rolls, beanbags, moulded pillows or wedges. Customised and moulded wheelchair seating systems and customised sleeping systems would be recommended. The updated standards of care recommend the use of strollers and power wheelchairs with recline and tilt options, and adapted seating systems to promote mobility.

Mobility and exercise

The updated standards of care also recommend using assistive technology and adaptive equipment to promote function. With proper head and neck support and constant supervision some children with non-sitter (Type 1) SMA can safely take part in aqua therapy.

Chest physiotherapy

Chest physiotherapy is an important part of managing SMA, particularly during illness, around surgery and to help clear your child's airway and improve breathing.

According to the updated standards of care for SMA the main treatment goals for children with sitter (Type 2) SMA are to prevent contractures and scoliosis and to maintain, restore or promote function and mobility.

Stretching

Stretching techniques include those that can be achieved manually and by using supports, splints, active-assistive stretching, supported standing and standing frames and positioning. Stretching should be carried out or supervised by physical or occupational therapists. You will be instructed in how to carry out daily stretching activities.

Positioning

Spinal supports are recommended for posture and to promote function. Neck bracing is often used for safety and transportation. Static, dynamic and functional supports are used for positioning and standing. Supported standing is important to help your child stretch their legs and also to promote bodily functions, bone health and spine and trunk posture.

Mobility and exercise

It is recommended that your child should have an electric or power wheelchair with custom postural support and seating systems. Lightweight manual wheelchairs or power-assisted wheels can help your child push themselves if they are strong enough. Exercise programmes and activities can help encourage muscle activation in order to help maintain and improve function, strength, range of motion, endurance, balance and daily activities. Recommended exercises include aqua therapy, aerobics and general conditioning with and without resistance.

Chest physiotherapy

Chest physiotherapy is also an important part of managing SMA, particularly during illness, around surgery and to help clear your child's airway and improve breathing.