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Lower-extremity surgery for children with cerebral palsy: physical therapy management
1Kennedy Institute for Handicapped Children, Baltimore, MD 21205.
Insights
Physical therapy is crucial for children with cerebral palsy undergoing orthopedic surgery to improve musculoskeletal alignment and function. This article details presurgical assessments and postsurgical management, including interventions after soft tissue surgery and cast removal.
Area of Science:
- Orthopedics
- Pediatrics
- Physical Therapy
Background:
- Cerebral palsy often involves spasticity, impacting musculoskeletal alignment and function.
- Orthopedic surgery is frequently performed to address these issues in children with cerebral palsy.
- Improving functional abilities and musculoskeletal alignment is a key goal.
Purpose of the Study:
- To discuss physical therapy interventions for children with cerebral palsy undergoing orthopedic surgery.
- To outline presurgical assessment and postsurgical management strategies.
- To review specific protocols for post-operative care.
Main Methods:
- Review of presurgical assessment of posture and movement.
- Discussion of interventions following soft tissue surgery (hips and knees).
- Examination of management protocols after hip spica cast removal.
Main Results:
- Effective presurgical assessment can predict functional changes.
- Specific interventions are required immediately post-soft tissue surgery.
- Post-cast removal management is critical for functional recovery.
Conclusions:
- Physical therapy plays a vital role in optimizing outcomes for pediatric orthopedic surgery in cerebral palsy.
- Tailored presurgical and postsurgical interventions are essential.
- Management protocols should address immobilization, positioning, and therapeutic activities.
Abstract:
The purpose of this article is to discuss physical therapy for children with cerebral palsy who undergo orthopedic surgery. Children with spasticity (increased tone) often undergo surgical procedures to increase the length of the hip, knee, and ankle musculature in an attempt to improve musculoskeletal alignment and functional abilities. Presurgical assessment of posture and movement to determine potential for change in function and postsurgical management are discussed. Intervention immediately following soft tissue surgery at the hips and knees and intervention at the time of cast removal for those children immobilized in a hip spica cast are reviewed. Specific postsurgical management protocols related to immobilization in splints/casts, positioning, and treatment activities are presented.