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Friday, 21 June 2013

Why Physiotherapists and OTs need to be on the frontline with Physical Activity promotion in Schools

Physifun is an organisation that originates from a medical background. It was founded by a physiotherapist and trains up OTs and physios to become facilitators and trainers for further education and training of teachers and parents in schools. Thus, I like to see Physifun as a bridge between the health sector and the education sector. However, one massive aim of Physifun is to get children moving and exercising and this is considered to be the "Sport" sector. I am writing this blog because I want to motivate other physios and OTs to take on this role of being the "glue" with all of these sectors: health, education and sport. We need to be on the frontline speaking to the teachers, educating the parents and motivating the children so that everyone knows that it is possible to get involved in physical activity, no matter how "clumsy", "low toned" or "unsporty" you are. Therapy should not be seen as "therapy" by these children-it should be seen as an opportunity to practise and make perfect! Children need to see it as something that is fun and also something that they can do with their peers-not the peers that are the "jocks" of the class, but the freinds that, like themselves, find standing on one leg hard, or catching a bouncing ball tricky. 

 I just feel, from the outside looking in, that there are many organisations who are getting very excited about the concept of getting children active (the research is so convincing that this is the key not only to health, but also to cognitive ability and behavioural management of children in schools), but still no one (or, is there anyone out there?) is addressing the actual problem of HOW DO WE GET to THE ROOT of the problem: that is, getting the "NON SPORTIES" exercising. At the moment, everyone acknowledges the problem (that the kids who don't have the motor skills end up avoiding exercise, and they are the ones that ultimately are the drainage on our healthcare systems), yet not one organisation has put together a clean package of intervention education for those who are working with these kids. 

Being a physiotherapist with a sports background and a child with DCD (Developmental Coordination Disorder), I was heartbroken when I read the research regarding children with motor difficulties- Most of them will have a learning difficulty and or behavioural difficulty; they are 3 times more likely to be obese (than their peers) and not participate in sport; many have low self esteem and high school drop out rates, depression, social does not make for great bed time reading! Knowing the research into the cognitive benefits of exercise and knowing how a child's self esteem can be increased by participating in physical activity, I made it my mission to teach my daughter the skills that she needed to become an active confident individual. Then, the more I read the research, the more I realised that these children thrive on intervention (physio and OT intervention). Improvements are seen in their motor skills if you train them; they have the capability of learning skills but it just takes a lot longer and needs to be broken down for them. They get lost in big high-functioning groups of sporting activity, but put them into an environment where they feel safe and unthreatened, surrounded by similar children with similar difficulties, these children learn new skills and thrive. Then, get the teachers and parents on board and you have a recipe for success. 

And so, Physifun was founded. I created Gross motor exercise programmes (which included use of the gym ball, core stability/Pilates exercises, yoga & postural exercises, balance and coordination) which were designed to be run by a few of the teachers at the school-I was their trainer and their mentor, but did not run the day to day classes. All the teachers at the school received training about what the programmes were all about-who to refer, the kinds of children to choose for the motor skills group and they were taught ways that they could help improve these children's posture and concentration during class, strategies to deal with behaviour associated with sensory difficulties (these often accompany motor difficulties and learning difficulties), I created presentations for other parents of similar children; I created more Inservice training sessions for the teachers so that they could know about the latest research about the brain and education (things we wonder about like use of Omega 3 oils; drinking water, the causes of dyslexia and the use of Vision gym or exercises, Brain gym, Multiple intelligences ) etc etc. And then I rolled it out to other schools and after receiving a grant from the Surrey County council I implemented the programme in 10 schools in Surrey.

Physifun was well received in the UK in state schools but now I am here in SA and I want to make a difference. I am running a weekend course for OTs and physios in September and  would like to spread my message: I truly believe that physiotherapists and OTs are the important link between a child's health and their education. Who else understands the reasons why these children are not exercising? Who better knows about exercise programmes? Who better knows about core stability training, balance and coordination exercises and the reasons why a child does not perform in these areas? If the answer is Physiotherapists, then why, I ask the physiotherapists out there, is there NOT ONE physiotherapist being asked to speak at the Discovery Vitality  Wellness and Fitness Convention( We are the professionals that need to be going into schools and teaching the teachers. We should be speaking at Fitness conventions about children and how to get them exercising!

Vitality has a fantastic programme for schools and exercise. They have created a wonderful fundamental motor skills training exercise programme which is meant to be implemented in the early years of Junior primary. However, are these coaches and teachers being taught how to deal with the children that don't cope with learning these skills first time round? Yes, they explain how to break down the task of catching a ball, but what inevitably happens when a teacher is faced with 40 kids, 5 of whom can't catch the ball? Is that teacher really going to take the time to go over and over that task with those children in a hands on way? It is very difficult, so perhaps they are then advised to contact their local physio or OT. So, yes, it is known and acknowledged that we need to encourage fundamental motor skills before we can teach sport, but there is no training to the coaches or the teachers about how to identify these children who are having difficulties, nor how to actually help them on a smaller scale basis. The problem, which is what do we do when these children don't have the ability to keep up with the rest of the group, has not been dealt with. This is where we need to up our game as physiotherapists and occupational therapists.  These kids will go by the wayside and get labelled as unsporty unless we as physios or OTs step in, educate the teachers and give teachers solutions to cater for these kids. If we can get this population of children even just a little bit motivated to get moving/exercising, we will be instilling a habit of a lifetime which, I hypothesise, will inevitably prevent health issues, heart disease Diabetes etc later on in life. (That is research that still needs to be done and /or published).

So, colleagues out there, I really hope you will see how important it is that we jump onto this bandwagon, before it leaves us behind! We are ideally placed in our community to be the go between : between the child and the parent; the child and the teacher and the child and their coaches. We need to get out there and educate teachers and coaches as to how they can help these children improve their motor skills even just during the day whilst they sit in the classroom, through posture, good furniture and ways to improve their proximal and core stability.