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Rehabilitation through play

Join us for a themed camp that combines fun with upper limb rehabilitation. This is the first fully proprietary bimanual therapy program in Poland, which was prepared by physiotherapists and occupational therapists from the Paley European Institute.

How it works

Each turn is tailored to the individual needs of the patient.

All classes are held at the Paley European Institute, in rooms suitable for the youngest.

Classes are held in a group of four, allowing interaction between participants.

One physiotherapist or occupational therapist works with each child.

Bimanual therapy

In the upper extremities, it helps children learn to use both hands simultaneously and practice activities necessary for daily life. It uses carefully planned and repeated exercises in games, which, combined with high intensity, guarantees the effectiveness of the therapy.

Cooking Tour

It is conducted for children who have undergone orthopedic surgeries such as polyarthrosis and ulnarization. Culinary classes allow them to develop their motor skills and exercise their upper limbs.

Travel turnout

Children with cerebral palsy (MPD) under hemiplegia are invited to play small travelers together, which actively supports the rehabilitation of the upper limbs.

Rehabilitation holidays

For whom.
Children and adolescents with musculoskeletal dysfunctions, mainly caused by cerebral palsy (MPD), congenital hip defects or other orthopedic conditions, who are scheduled for surgery (e.g. hip osteotomy, selective dorsal rhizotomy - SDR).
The goal is to optimally prepare the musculoskeletal system and improve the child's general condition and performance before surgery.
Main goals and objectives:
-Strengthening the muscles that stabilize the joints (especially the periarticular, trunk).
-Improving the range of motion in the joints, preventing contractures and fixed changes.
-Learning correct movement patterns as much as the child's condition allows, so that post-operative rehabilitation can be implemented more easily.
-Education of parents/guardians on exercise and care.
Methods and tools:
Individual physiotherapy (active, passive, assisted exercises).
Therapeutic massages, muscle relaxation techniques and joint mobilizations.
Exercises to improve overall fitness and coordination (e.g., on balls, balance platforms).
Consultation with an orthopedist, physiotherapist, neurologist or psychologist (as needed).

For whom.
Children after hip orthopedic surgery (e.g., osteotomy, acetabular reconstruction,
muscle lengthening, correction of femoral alignment).
Main objectives and goals:
-Restoration of muscle strength and restoration of normal range of motion in the hip joint.
-Learning correct movement patterns after correcting the biomechanics of the joint.
-Prevention of post-operative complications (adhesions, contractures, scars that limit movement).
-Improving overall fitness and mobility.
Methods and tools:
-Individual physiotherapy sessions focused on improving joint mobility, strengthening gluteal and adductor/adductor muscles.
-Occupational therapies focusing on activities of daily living (ADLs).
-Breathing techniques, tissue massage, lymphatic drainage (depending on swelling and tissue condition).
-Assistance with orthoses, orthopedic supplies, if indicated.

For whom.
Children following SDR surgery to reduce spasticity in the lower extremities in patients with MPD
(especially the spastic diplegia form).
Main objectives and goals:
- Maximizing the effect of surgery, i.e., lowering muscle tension.
- Learning new, correct movement patterns - often spasticity has so far compensated for the lack of stability, so it is necessary to strengthen the postural muscles.
- Improving gait function, balance, coordination.
- Continuation of preventive exercises to prevent contractures in the long term.

Methods and tools:-.
- Intensive exercises to strengthen the deep muscles of the trunk, antigravity muscles.
- Gait re-education with or without equipment (balconies, crutches, orthoses), depending on the child's condition.
- Neuromobilization therapies, work on deep sensation and motor control.
- Hydrotherapy, exercises in water (if the center is equipped with a rehabilitation pool).

Who it's for.
- Children with contractures, shortening of tendons and muscles, requiring repetitive, gradual correction of limb alignment.
- Usually used for children with MPD, foot defects (e.g., clubfoot), knee contractures, etc.
Main objectives and goals:
- Gradual lengthening of muscles and tendons through controlled positioning of the limb in a plaster orthosis.
- Prevention of deformity aggravation, and ultimately correction of existing deformities.
- Preparation for further motor rehabilitation already in corrected alignment.
Methods and tools:
- Assessment and measurement of joint angles before starting and during subsequent plaster dressing changes.
- Regular plaster changes (every 1-2 weeks) to further stretch the contracted structures.
- In parallel - exercises to strengthen muscles antagonistic to the stretched ones and gait re-education (if possible).
- Education of parents on care and control of the cast.

For whom.
-Children with excessive spasticity or activity of certain muscle groups, resulting in improper movement patterns or deformities.
- Mainly used in cerebral palsy to reduce abnormal movement and allow a more correct pattern to be trained.
Main goals and objectives:
- To reduce pathological motor patterns.
- Enabling the child to safely exercise in a specific limb position, which helps in re-education of movement.
-To support the treatment of spasticity in combination with other methods (e.g., Botox, motor rehabilitation).

Methods and tools:
- Application of so-called inhibitory casts (inhibiting casts) in a position that prevents uncontrolled bending, twisting or weight transfer to the wrong area.
- Concurrent occupational therapy and kinesitherapy to develop new movement patterns.
-Monitoring and possible modifications of the setting during the turnaround.

For whom.
-Children who have been treated with botulinum toxin (Botox) to temporarily reduce spasticity in specific muscle groups (e.g., for MPD, dystonias).
Main goals and objectives:
-Taking advantage of the "therapeutic window" - a period when reduced muscle tension allows for more effective stretching and learning of new movement patterns.
-Preventing the recurrence of contractures through intensive motor rehabilitation.
-Improving range of motion, strengthening antagonistic muscles and training functional activities.
Methods and tools:
-Intensive physiotherapy aimed at stretching and strengthening muscles that have received botulinum toxin injections.
-Orthosis, taping (e.g., kinesiotaping) to maintain proper joint alignment.
-Occupational therapy focusing on improving manual skills and daily activities.

Who it's for.
- Children with hemiplegia, hemiparesis or limb asymmetry, usually in the course of MPD.
- "babyCIMT" - dedicated to the youngest children, in whom we want to promote the use of the weaker limb at an early stage.
Main goals and objectives:
- Involves immobilization (e.g., in a brace, sleeve) of the dominant/faster limb to force use of the limb affected by the paresis.
- Intensive activity training (known as task practice) to allow functional improvement of the weaker arm/leg.
- Improving coordination, increasing strength and range of motion in the previously less-used limb.
Methods and tools:
- Occupational therapy in the form of games, manual and functional exercises performed mainly with the weaker limb.
- Gradual introduction of a variety of activities - from simple manipulations to more complex tasks
- Motivating the child through attractive forms of exercise, involving parents in the therapeutic process.

For whom.
-Children who, in addition to standard motor rehabilitation, need support in daily activities and encouragement to exercise in the form of play and practice.
- Especially recommended for children with difficulties in independence (ADL), motor coordination or movement planning.
Main objectives and goals:
- Combining rehabilitation with practical activities (cooking, excursions, thematic activities) to enhance motivation and independence.
- Improving coordination of hand movements, working with both hands, maintaining balance - during cooking, food preparation, daily activities.
- Practice motor planning and sequences of actions in natural settings.
Methods and tools:
- Therapeutic cooking - the child, together with therapists and parents, prepares food while learning how to cut, mix, measure ingredients.
- "Traveling" activities may include short trips, sightseeing, outdoor tasks.
- At the same time: elements of motor rehabilitation, strength training, coordination exercises tailored to the lesson scenario.

For whom.
- Children with impaired motor control, paralysis, paresis, especially when we want to strengthen or "recall" the work of specific muscles.
- Often used for MPD, meningo-spinal hernia, spinal cord injuries.
Main objectives and goals:
-Use of safe electrical impulses to induce muscle contraction and learn proper movement (e.g., during walking).
-Improving muscle strength and muscle coordination.
-Increasing the child's awareness of how a specific muscle group works.
Methods and tools:
-FES combined with walking training (e.g. stimulation of knee extensor muscles, dorsal flexors of the foot).
-Parallel kinesitherapy: functional exercises, gait re-education, water exercises with electrostimulation (if appropriate equipment is available).
-Education and instruction of parents, if home stimulation under the supervision of a specialist is possible.

For whom.
Children who need to improve physical fitness, endurance, motor coordination.
It can be aimed at a wide range of patients with various neurological and orthopedic conditions, but also at children who are overweight or have postural problems.
Main objectives and goals:
-Gymnastic general development exercises, taking into account the child's limitations and needs.
-Increasing muscle strength, flexibility, postural stability.
-Forming the habit of regular physical activity.
Methods and tools:
-Group and individual activities using mats, rehabilitation balls, tapes, gymnastic ladders.
-Breathing, stretching, strengthening, coordination exercises.
-Movement games and activities appropriately adapted to the capabilities of the participants.

For whom?

-Children with feeding disorders, food selectivity, swallowing difficulties or oral aversions (often in MPD, autism, genetic diseases).
-Toddlers with sensory problems related to food.
Main objectives and goals:

-Assessment and therapy of disorders of the oral-facial apparatus, restoration of normal reflexes and patterns of sucking, swallowing, biting.
-Gradual introduction of new foods, textures, tastes - breaking sensory barriers.
-Teaching correct eating posture and supportive feeding techniques (for parents/guardians).
Methods and tools:

-Feeding therapy (including methods such as SOS Approach to Feeding, BLW - if adapted).
-Oral exercises: speech therapy massages, stimulation of the speech apparatus and facial muscles.
-Consultation with a nutritionist, speech therapist, neurologist, psychologist - multi-specialist approach.

For whom?

- Patients qualified for bone lengthening procedures (femur, tibia or humerus).- Individuals with congenital or acquired limb shortening, length disproportion, deformities affecting gait function.
- Patients with axis defects for whom lengthening is part of comprehensive orthopedic treatment.
- Individuals preparing for a procedure using external systems (Ilizarov apparatus) or lengthening nails (e.g., Precice).
- Children, adolescents and adults who want to strengthen the body and learn to load the limb according to the therapeutic plan to reduce the risk of complications during lengthening.
Main goals and objectives of the turnout

Optimal preparation of muscles, joints and tissues for the bone lengthening process, which requires very good flexibility and strength.
- Strengthening stabilizing muscles (core, hip girdle, anti-gravity muscles) to prevent secondary deformities during distraction.
- Improving ranges of motion - especially of the hip, knee and ankle - which are crucial to avoid contractures during lengthening.
- Teaching correct movement and gait patterns so that the patient enters the procedure with optimal biomechanics.
- Education on how to load the limb according to the orthopedic plan (full, partial, no loading).
- Psychophysical preparation - getting used to the process, equipment, daily demands of therapy.
- Reducing the risk of complications such as contractures, muscle weakness, imbalances or compensations.
Methods and tools

- Intensive exercises to strengthen postural muscles, stabilizing the pelvis and lower limbs - key to maintaining proper alignment during extension.
- Soft tissue stretching and therapy - especially the ischiofemoral group, quadriceps, hip flexors and calf muscles.
- Range of motion training with emphasis on maintaining full mobility at the hip, knee and ankle.
- Gait re-education, sometimes using equipment (crutches, walkers, orthoses) to prepare the patient for mobility after surgery.
- Sensomotor and balance exercises to improve limb control and pelvic stability.
- Neuromobilization therapies to promote proper nerve conduction when tissue tensions change during lengthening.
- Functional training - sitting down, standing up, stairs, position changes to be performed daily during recovery.
- Stress-relief exercises to safely work on gait and muscle strength with minimal stress.
- Instruction in the use of orthopedic equipment, skin care, comfort care during possible maintenance of external braces.
- Patient and family education - rehabilitation plan, possible reactions of the body, distraction schedule, basics of self-therapy.

Who is the turnout for?

Rehabilitation turnout after corrective osteotomy is intended for:
- Patients after corrective osteotomy of the lower extremities (including femurs and tibias).
- Individuals with limb axis disorders, deformities affecting gait or locomotor function.
- Children and adults requiring re-education of gait patterns after correction of bone alignment.
- Patients in whom the goal is to improve stability, muscle strength and regain full function after surgery.
- Individuals with cerebral palsy or other neurological disorders, if the osteotomy was part of comprehensive treatment

Main goals and objectives of the turnout

Maximizing the effect of the surgery, i.e. improving the axis of the limb, compensating for the length or alignment of the joint.
- Learning new, correct movement patterns, eliminating compensations created before surgery.
- Strengthening the stabilizing and postural muscles that must take over the function of protecting the joints after correction.
- Improving gait function, balance and coordination to restore the most economical and safe way of moving as possible.
- Reducing the risk of recurrence of deformities, by maintaining a normal range of motion and regularly working on tissue flexibility.
- Prevention of contractures and overload, especially during periods of increasing stress on the limb.
- Acceleration of return to full activity, including sports or more intensive functional therapy.
Methods and tools used during the turnaround

- Exercises to strengthen the deep muscles of the trunk and anti-gravity muscles, responsible for the stability of the pelvis and lower extremities.
- Gait re-education - with or without the use of assistive equipment (balconics, crutches, orthoses), depending on the patient's capabilities and the recommendations of the orthopedist.
- Range of motion and tissue mobilization training to increase muscle flexibility and improve joint function after surgery.
- Neuromobilization therapies and work on deep sensation, which allows for better control of the limb after a change in biomechanics.
- Sensorimotor exercises - working on balance boards, sensorimotor cushions, platforms.
- Functional training, including standing up, sitting down, climbing stairs, position changes, assisted squats.
- Weight-bearing exercises to safely work on gait and muscle strength with minimal stress.
- Manual techniques and soft tissue therapy to reduce protective tension and promote recovery.
- Instruction in the use of orthopedic equipment, skin care, and attention to comfort during resting positions
- Patient and family education - proper strategies for moving and safely loading the limb during healing.

For children with MPD (cerebral palsy)

Aims and objectives:

Movement improvement and prevention of contractures.
Improving independence in ADL, communication, social functioning.
A variety of therapy methods: NDT-Bobath, Vojta (for the youngest), PNF, occupational therapy, hydrotherapy.

For children with SMA (spinal muscular atrophy)

Aims and objectives:

Strengthening respiratory muscles, maintaining as much muscle strength and range of motion as possible.
Prevention of scoliosis, contractures, prevention of respiratory complications.
Breathing support exercises (breathing techniques, cough assistants), orthotic support.

Children with meningo-spinal hernia

Aims and objectives:

Physical rehabilitation with emphasis on strengthening muscle parts relieved by paralysis, stabilizing the spine.
Learning how to move effectively (e.g., in orthoses, in a wheelchair), preventing orthopedic deformities.
Training of activities of daily living, taking care of urinary and skin hygiene (prevention of bedsores).

With genetic diseases

Aims and objectives:

A comprehensive approach depending on the type of disease (e.g., Down syndrome, muscular dystrophies, rarer metabolic diseases).
Multispecialty care - physiotherapy, occupational therapy, speech therapy, psychology.
Adaptation of methods to the child's cognitive abilities and level of motor development.

Each turnout has its own specifics based on the therapeutic goal and the group it is aimed at. The common denominator, however, remains:

Individualized approach - assessing needs, setting goals and customizing a rehabilitation plan.
Multidisciplinary team - physicians (orthopedist, neurologist), physiotherapists, occupational therapists, speech/neurologists, psychologists, nutritionists, orthotists.
Parallel education of parents - to continue the recommended exercises and care principles at home.
Continuing therapy at home - consolidating the effects of the turnout is key to the child's long-term functional improvement.

Rehabilitation camps are an intensive form of improvement, often combined with attractive activities (play, excursions, cooking), which increases children's motivation and promotes better results.

Physiotherapy doesn't have to be boring!

Play is a natural environment for children and one of the ways they learn about the world. By introducing elements of physiotherapy into play, we make children engage in exercises and do not treat them as an unpleasant chore. They form a bond with the therapist, which is based on cooperation and mutual trust. And this is a key element to effectively achieve therapeutic goals.

Agata Przybylowska
physiotherapist at Paley European Institute