Rickets in the physiotherapy

1. Rickets

2. Definition
• Rickets is the softening and weakening of
bones in children because of deficient
mineralazation at the level of growth plate

3. classification
• hypocalcaemic
• hypophosphaemic

4. cause
• nutritional
vit D defeciency
calcium defeciency
phosphate defeciency
• inherited
• secondary to liver and renal disease affect
metabolism of Ca PO4 VitD

5. vit D defeciency
• the most common cause of rickets
• source of vitamin D
exposure to sun
food (oily fish, eff yolk)
breast milk is poor in vit D

8. Vit D defeciency
• in children cause rickets and osteomalacia
• in adults cause osteomalacia

9. risk factors
• barrier to sun exposure
• dark skin
• exclusive breast feeding
• mother vit D defeciency during pregnancy
• northern latitude
• premature birth
• medications (anti-siezure)
• malabsorbtion (IBD, CF, kidney problems)

10. risk factor
• fat malabsorption
• obesity
• polluted climates

11. signs and symptoms
• leg pain
• weakness, excessive fall
• unable to walk
• delayed motor milestone
• fracture
• delayed dentition
• short, delayed growth
• bone deformities

12. Complications
• failure to grow
• abnormal curved spine
• bone deformities
• dental defects
• siezures
• hyperparathyroodism
• cardiopulmonary system
• depression

13. bone deformities
• bow legs
• knock knees
• abnormal curved spine
• soft skull
• thick ankle and wrist
• rackitic rosary ribs

15. x ray

16. Treatment and prevention
• sun exposure
• vit D rich food
oily fish, egg yolk, infant formula milk,
enriched cereal
• vit D supplment

17. hypophosphaemic
• Antacid (alamunium cause malabsuption)
• phosphate wasting renal disease
• tumor induced rickets

18. physiotherapy managment
• patients education
• prevent complications
• fall prevention exercise
• general muscle strengthening exercise
• fuctional training

19. proper sun exposure
• windows and glass block synthesis
• sunscreen block synthesis
• 5-30 minutes twice per week

20. • food rich in vit D
• fish, egg, fortified food
• food rich in calcium
• milk, cheese, green vegetables
• food rich in phosphate
• meet, dairy, nuts, whole grains