If the joint now is used over an extended period in this spare position the joint structures adapt to the spare position and a malposition of the joint develops. Further on irreversible destruction of cartilage and bone is possible. The purpose of physiotherapy is to prevent incorrect positions from the beginning and to maintain the natural joint mobility. If malpositions are already present we try to restore the joint mobility as far as possible and to protect the joints from incorrect positions and incorrect usage. Since the treatment must be adapted individually to the single child, the single treatment is indispensable.
Group therapy can only serve as supplement.
It is important to carry out the treatment in a way, that a child accepts it. This way children of any age can be treated. Their parents should be integrated into physiotherapy and should learn the basics themselves so that they can conduct the treatment at home independently. Likewise muscle strengthening exercises must not be carried out as long as joint malpositions and changes of joint structures due to inflammation exist. 4.4 Application of Heat or Cold Local application of heat or cold can effectively support the treatment of rheumatic diseases.