Physical therapy focuses on improving gross and fine motor skills; balance and coordination; strength, flexibility, and endurance; posture; and cognitive and sensory processing and integration. Physical manipulations, exercise, heat, cold, electricity, and massage are used to achieve these goals. Exercise also produces generalized benefits related to improved body image, body mechanics, sleep, and mood. One randomized, controlled trial provided evidence of efficacy for youth with chronic musculoskeletal pain (Jones et al. 2007), and one yielded support for those with fibromyalgia (Stephens et al. 2008). Results from case series are promising for the use of physical therapy for complex regional pain syndrome (Sherry et al. 1999). Preliminary research has not yet consistently yielded support for youth with arthritis (Takken et al. 2008). Further research with children and adolescents is needed.
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