Common questions for physical therapists
Common questions
For children with cancer, staying physically active can be challenging. Encouraging movement can be done in many different ways and in various settings. Let children be active in and around their home, at playgrounds, and at sports clubs. Any activity can be done for a longer time, at a higher intensity, or more often. This also adds variety.
For example:
Every form of physical activity counts and has a positive effect.
Choose a way of moving that suits you best.
Make physical activity a regular part of daily life.
In the folder ‘Maximal movement’, you can read more about how a child can stay physically active.
To maintain muscle strength and physical fitness, it is first important to continue normal daily activities as much as possible. Standing up from a chair, climbing stairs, and walking longer distances outdoors all help support and improve strength and endurance. Once this basic level of activity is in place, more targeted training can be introduced.
Fatigue is a common and complex symptom in children with cancer and in survivors of childhood cancer. Finding a good balance between rest and activity is essential. It is important for a child to remain active and keep moving, as this can help reduce fatigue. As a (pediatric) physical therapist, you can help find this balance, and an occupational therapist or psychologist can also provide support in managing fatigue.
As a (pediatric) physical therapist, you can support children with neurological impairments in moving more easily again. These impairments may occur, for example, after a brain tumor. You support the child in practicing balance, walking, or other functional skills, and you may also look at adapting movements. This depends on the type and location of the brain tumor. In this way, you can treat children with ataxia, spasticity, or paresis.
It is important for children to stay active and play sports, both during and after cancer treatment. In general, you can assume that if a child is able to do an activity, they are allowed to do it. Children may also participate in sports when they have reduced immunity. If a child has a fever, it is wise to take things more slowly. There are, however, specific guidelines to follow.
For children with a bone tumor, there may be exceptions to this general rule. See ‘How does a child move with or after a bone tumor?’ for more information.
If a child feels fit enough, they may participate in any sport. When platelet counts are low, it is better to avoid contact sports. If a child practices scuba diving, always consult the physician first. The guidelines for sports and physical activity can be found here.
If your child has a VIT or central line, special rules apply. For example, swimming is not allowed with a VIT.
Before surgery, the bone may have limited load-bearing capacity. The hospital provides both the child and you as the treating professional with information about what is and is not allowed in terms of weight bearing. As a result of chemotherapy, surgery, and radiation therapy, muscles and joints may become stiffer. As a physical therapist, you support the child in improving joint mobility and strength, with the aim of restoring functional skills. Training can take place in the hospital, at home, or in a rehabilitation center. Prostheses are always fitted in a rehabilitation center. The ultimate goal is for the child to be able to walk, play sports, or ride a bicycle again.
Some treatments can cause pain in children. There are medications that can help reduce pain during and after treatment. There are also other ways to reduce pain and stress:
distraction, such as a pacifier, a stuffed animal, music, blowing bubbles, reading aloud, playing a game, or watching a video
relaxation exercises
warmth, such as a warm bath or a heating pad for abdominal cramps
cold, for example an ice pop for mouth pain
massage or gentle touch
hypnosis
If pain persists or is unexplained, contact the treatment team.