Physiotherapy for Children with Cancer (Ages 0 - 4)
Outlined below are some of the helpful tips I learned while working as a student physiotherapist in Paediatric Oncology .
PHYSICAL ACTIVITY
Physical activity and play are very important before, during, and after your child’s treatment. Staying active can help your child:
Keep muscles and bones strong
Maintain independence
Keep their lungs clear and strong
Help them clear certain chemo drugs faster
Improve cancer-related fatigue and decrease pain
Improve sleep pattern and appetite
Ease problems with constipation
A child’s occupation is play, therefore keeping “physio exercises” fun is very important.
< 1 year old
Should be physically active throughout the day using interactive play
1 - 4 years old
180min of physically active play of varying intensity throughout the day
5 years old
At least 60min of moderate-high intensity play throughout the day
REDUCING SEDENTARY TIME
Sometimes throughout your child’s treatment they will feel unwell and will want to stay in bed. This is okay for short periods of time but can have negative consequences in the long term.
Below are some strategies to help your child stay active when they’re feeling unwell:
Ankle pumps / ankle circles
Reaching with arms, bending/straightening elbows, and wrist movements
Sitting in a chair for meals instead of sitting in bed
Walking to the bathroom when able
Doing a short walk after bathroom breaks when your child is already up
Standing for activities, such as coloring
Even small bouts of activity can help your child stay strong when they’re feeling unwell.
PERIPHERAL NEUROPATHY
Some chemo medications, like Vincristine, can cause peripheral neuropathies. A peripheral neuropathy occurs when there is damage to a nerve which can result in loss of sensation or muscle function. Symptoms usually start in fingers or toes and may progress up the hands and feet. Signs and symptoms include:
Numbness, tingling and/or pins/needles
Difficulty with fine motor tasks such as doing up buttons, zippers or tying shoelaces
Weak grip strength
Changes in gait / walking
If you notice any of these symptoms, promptly notify your medical team so that they can assess for peripheral neuropathy and monitor the situation.
SAFETY CONSIDERATIONS FOR PHYSIOTHERAPY EXERCISES
Always wear safe, appropriate footwear for the activity (Ex. sneakers)
If platelets are low, be careful not to bump into things
If hemoglobin is low, be careful when first standing up or changing positions, your child may feel dizzy/light-headed
Take rest breaks as needed
Do not let your child jump off of anything > 6 inches from the floor
PHYSIO ACTIVE PLAY IDEAS
< 1 year old
Tummy time
Rolling
Reaching
Grasping
Crawling
Sitting
1 - 5 years old
Sitting
Crawling
Cruising
Walking
Climbing stairs
Stand to play crafts, coloring, barbies, race car driving, etc
Squatting to pick up a toy and place it on a table
Squatting to pick up a basketball and throw it in the net
Kicking a ball
Throwing a ball
Scavenger hunts for pictures hidden on the walls
Baseball
Hockey
WII sports games
Mimicking different animals (Ex. Standing like a flamingo on one leg, stomping your feet like an elephant, flapping your arms like a bird)
Playing tug-a-war with an exercise band
RESOURCES
CSEP: Canadian physical activity guidelines for the early years – 0 – 4 years
CSEP: Canadian physical activity guidelines for children 5 – 11 years
Cancer.ca
Sports and exercise for children and young people with cancer: a parent’s guide – www.cclg.org.uk