5-Year Impact Factor: 0.9
Volume 34, 12 Issues, 2024
  Viewpoint     July 2024  

Addressing the Paediatric Physiotherapy's Unmet Needs

By Kiran Yameen


  1. Ziauddin College of Physical Therapy, Ziauddin University, Karachi, Pakistan
doi: 10.29271/jcpsp.2024.07.848

This viewpoint emphasises the vital role that paediatric physiotherapy plays in satisfying children's rehabilitation requirements, especially those of children with chronic illnesses and impairments. It highlights issues including inadequate education and a lack of personnel, underscoring the need for individualised care in a variety of paediatric settings. The letter promotes more knowledge, financing, and research to improve the quality and accessibility of paediatric physical therapy services offered worldwide. It urges medical practitioners and legislators to address these significantly unmet needs in order to improve developmental outcomes and assure children's optimal physical well-being through the prioritisation of early intervention and tailored therapy.

Key Words: Paediatric physiotherapy, Rehabilitation, Physical therapy.

This viewpoint is written to bring attention to paediatric physiotherapy, a crucial but frequently disregarded section of the physiotherapy profession. While physiotherapy is vital in assisting people of all ages, to regain their mobility and quality of life, it is important to acknowledge the special requirements of the paediatric population as well as the enormous unmet needs in this regard. A major and increasing percentage of paediatric critical care unit (CCU) admissions involve children with disabilities and chronic illnesses, significantly affecting the demand for rehabilitation services in this setting.1 There is a major workforce discrepancy in rural areas concerning the availability and training of healthcare workers (especially in the rehabilitation sector), exacerbating the challenges faced in providing adequate paediatric physiotherapy services.2 We must address these challenges and prioritise paediatric physiotherapy to ensure that children receive the specialised care and support they require for optimal physical development and wellbeing.

The World Health Organisation (WHO) estimates that 15% of people worldwide are disabled, with over 240 million children worldwide living with disabilities.3,4 The majority of these children reside in low- and middle-income countries (LMICs).4 In Pakistan, the disability ratio is 3.4%.5 The National Database and Registration Authority has assessed data from the Pakistan Bureau of Statistics and found that 295,093 children in Pakistan have a physical disability.6

Physical therapists (PTs) specialising in paediatric care address neuromotor problems and developmental delays in children of all ages, from newborns to teenagers. They focus on growth and development, syndromes, and diagnostics.7 Children’s physiotherapists possess expertise in assessing, recognising, diagnosing, and treating physiological disorders and abnormalities in movement. They offer specialised care in orthopaedics, congenital anomalies, neurology, neuropsychiatry, breathing, and preterm care catering to children up to the age of 19 years.8-10

Today's PT professionals follow a structured university-level curriculum that includes advanced research-based doctoral (PhD) and post-doctoral degrees, master level programmes in subspecialities, and entry-level doctor of physical therapy (DPT). Physical therapy is a primary healthcare profession with several established subspecialities, such as manual and musculoskeletal, neurological, cardiovascular and pulmonary, sports, gynaecological, geriatric, community-based, and paediatric physical therapy. Some disciplines, such as neurological physical therapy, which is further divided into paediatric, adult, and spinal cord injuries have recently expanded into super specialities. After physical therapy education was first offered in the 1950s, there were only about 4–5 physical therapy institutions by 2007. However, as of right now, 80–90 institutions provide physical therapy degree programmes.11

Children who are at risk of disability demonstrate how early physical therapy can change lives.12 This highlights the beneficial effects of early systematic surveillance and individualised care, reinforcing the need for timely interventions in the lives of the paediatric population and improving the paediatric population's physical well-being and developmental outcomes.

To fill the gap and increase access to these essential services for the paediatric population, it is also crucial to acknowledge and address the strengths and weaknesses of physiotherapy services. As we work to make sure that children have access to the high-quality care they require, we must consider these perceptions. Paediatric physiotherapy faces opportunities and challenges that are not restricted to one area but are encountered globally.13 This can be continued to improve the accessibility and quality of these services for the paediatric population, safeguarding their wellbeing and future health, by acting on the insights offered by professionals and stakeholders.

To fulfil the unmet needs of paediatric physiotherapy, it is crucial to comprehend parental perceptions and preferences. The findings of a previous study by Haq et al. showed how paediatric physical therapy is collaborative and how important it is for parents to decide how their children will be taken care of. It is better to modify care to meet the particular requirements of the paediatric population by recognising and embracing parental perspectives.14

The workforce and training are challenges for professionals in this field. Lack of rehabilitation professionals, healthcare workers with inadequate training and knowledge, and an unequal distribution of these personnels globally, especially in LMICs, have all restricted access to rehabilitation services.15 To make sure that physiotherapists have the skills to provide the greatest care for children, it is essential to address these needs. A 2017, WHO report titled “Rehabilitation 2030: A Call for Action”, stated that creating an adequate, well-trained, and multi-occupational rehabilitation workforce is essential to improve rehabilitation in the healthcare system.16

Early intervention, increased accessibility, parental opinions, and workforce considerations are all essential elements to underline the urgency of addressing the unmet needs of paediatric physiotherapy. We must promote more understanding, funding, and research for paediatric physiotherapy services. By doing this, we can support a healthier, more inclusive society for everyone as well as the future of our paediatric population.

In conclusion, healthcare professionals, decision-makers, and the public are urged to acknowledge this unmet need and respond accordingly. We can significantly influence children's lives and we cannot afford to neglect this duty.

The author declared no conflict of interest.

KY: Conception or design of the work, drafting and framework, and critical revision for the important intellectual content.


  1. Choong K, Koo KK, Clark H, Chu R, Thabane L, Burns KE, et al. Early mobilization in critically ill children: A survey of Canadian practice. Crit Care Med 2013; 41(7):1745-53. doi: 10.1097/CCM.0b013e318287f592.
  2. Khan F, Amatya B, Sayed TM, Butt AW, Jamil K, Iqbal W, et al. World health organisation global disability action plan 2014-2021: Challenges and perspectives for physical medicine and rehabilitation in Pakistan. J Rehabil Med 2017; 49(1):10-21. doi: 10.2340/16501977-2149.
  3. Wijeratne T, Dodick DW, Lewis SL, Guekht A, Pochigaeva K, Grisold W. World brain day 2023 - Brain health and disability: "Leave no one behind". J Neurol Sci 2023; 451: 120720. doi: 10.1016/j.jns.2023.120720.
  4. Smythe T, Chen S, Rotenberg S, Unger M, Miner E, Seghers F, et al. Do children with disabilities have the same opportunities to play as children without disabilities? Evidence from the multiple indicator cluster surveys in 38 low and middle-income countries. EClinicalMedicine 2023; 67:102361. doi: 10.1016/j.eclinm. 2023.102361.
  5. Rafi K, Masood-ul-Hasan S, Tabassum S. Attitude, practice and preparedness of dental practitioners for providing oral care to patients with speech and hearing impairment. J Uni Col Med Dentistry 2024; 3(1):7-12. doi:10.51846/jucmd.v3i1.2749.
  6. Government of Pakistan. (2020). Disability details from NADRA. Pakistan Bureau of Statistics. Available from: https://www.pbs. gov.pk/content/disability-statistics.
  7. Srushti Sudhir C, Sharath HV. A brief overview of recent pediatric physical therapy practices and their importance. Cureus 2023; 15(10):e47863. doi: 10.7759/cureus. 47863.
  8. McCoy SW, Bartlett DJ, Yocum A, Jeffries L, Fiss AL, Chiarello L, et al. Development and validity of the early clinical assessment of balance for young children with cerebral palsy. Dev Neurorehabil 2014; 17(6):375-83. doi: 10.3109/17518423.2013.827755.
  9. Embarek-Hernandez M, Gueita-Rodriguez J, Molina-Rueda F. Multisensory stimulation to promote feeding and psychomotor development in preterm infants: A systematic review. Pediatr Neonatol 2022; 63(5):452-61. doi: 10.1016/j.pedneo.2022.07.001.
  10. Yildirim C, Asalioglu A, Coskun Y, Acar G, Akman I. General movements assessment and Alberta infant motor scale in neurodevelopmental outcome of preterm infants. Pediatr Neonatol 2022; 63(5):535-41. doi: 10.1016/ j.pedneo.2022.06.002.
  11. Shakil-ur-Rehman S, Karimi H. Emerging physical therapy as an autonomous and specialized health care profession. J Islam Int Med Coll 2017; 12(1):1-2.
  12. Fourdain S, Simard MN, Dagenais L, Materassi M, Doussau A, Goulet J, et al. Gross motor development of children with congenital heart disease receiving early systematic surveillance and individualized intervention: Brief report. Dev Neurorehabilit 2021; 24(1):56-62. doi:10.1080/17518423.2020.1711541.
  13. Camden C, Mulligan H, Cinar E, Gauvin C, Berbari J, Nugraha B, et al. Perceived strengths and weaknesses of paediatric physiotherapy services: Results from an international survey. Physiother Res Int 2023; 28(1): e1974. doi: 10.1002/pri.1974.
  14. Haq S, Nazeer T, Haq MZ. Perception of the parents, physiotherapists and allied health professionals about the role of physiotherapy in the rehabilitation of the children with cerebral palsy-A case study of district Bhakkar. SJESR 2020; 3(2):354-9. doi: 10.36902/sjesr-vol3-iss2- 2020(354-359).
  15. Demey D, Dieye SO, Feipel V, Holey LA, Kruger J, Le VT, et al. International collaboration to improve physio-therapists' training, Viet Nam. Bull World Health Organ 2022; 100(11):733-8. doi: 10.2471/BLT.22.288 100.
  16. Gimigliano F, Negrini S. The world health organization “rehabilitation 2030: A call for action”. Eur J Phys Rehabil Med 2017; 53:155-68. doi: 10.23736/S1973-9087.17.04746-3.