Physical modalities of therapy in pediatric rheumatic diseases

The approach to rehabilitation management of childhood rheumatic disease differs in many ways from that of adult disease. Among the special considerations are the effects of chronic musculoskeletal inflammation in a growing and developing individual and the tendency of children to tighten their joints into positions of comfort, with fewer problems resulting from ligamentous laxity and instability. A comprehensive management approach includes much more than simply using medications--the tendency for the disease to exert deforming forces on the limbs must be constantly fought by a vigorous program of rehabilitation; education and psychologic support must be provided to the patient and family; potential problems must be discussed with the school; financial and vocational issues must be addressed.