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Physical Therapy Dose After Orthopedic Multilevel Surgery Varies by Ambulatory Status in Children With Cerebral
Kelly Greve1, Amy F Bailes, Nanhua Zhang
1Board-Certified Clinical Specialist in Pediatric Physical Therapy, Division of Occupational Therapy and Physical Therapy, Division Patient Services Research, Department of Pediatrics (Dr Greve), Division of Occupational Therapy and Physical Therapy, Division Patient Services Research, Department of Pediatrics (Dr Bailes), Division of Occupational Therapy and Physical Therapy, Division Patient Services Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine (Dr Greve) Division of Biostatistics and Epidemiology (Dr Zhang), Division of Pediatric Orthopaedic Surgery (Dr Long), Division of Biomedical Informatics (Drs Aronow and Mitelpunkt), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine (Drs Greve, Bailes, Zhang, and Aronow), University of Cincinnati, Cincinnati, Ohio; and Department of Rehabilitation (Dr Mitelpunkt), Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Physical therapy (PT) dose for children with cerebral palsy (CP) after multi-level surgery (MLS) varied by ambulatory status. Ambulatory children received more PT visits, higher intensity, and more time for gait training.
Area of Science:
- Pediatric rehabilitation
- Cerebral palsy research
- Orthopedic surgery outcomes
Background:
- Cerebral palsy (CP) significantly impacts motor function.
- Multi-level surgery (MLS) is a common intervention for CP.
- Understanding post-surgical physical therapy (PT) is crucial for optimizing outcomes.
Purpose of the Study:
- To characterize the physical therapy (PT) dose for children with cerebral palsy (CP) following multi-level surgery (MLS).
- To examine how PT dose varies based on ambulatory status and surgical burden.
Main Methods:
- Retrospective review of electronic medical records for children with CP undergoing outpatient PT post-MLS.
- Data extraction focused on PT dose components: Frequency, Intensity, Time, and Type.
- Analysis compared PT dose between ambulatory and non-ambulatory children, and by surgical burden.
Main Results:
- Seventeen children (mean age 9 years) were included; 10 were ambulatory and 12 had high surgical burden.
- A total of 345 PT visits were recorded in the year after MLS, with generally above-average intensity.
- Ambulatory children received significantly more visits, higher intensity, and greater time dedicated to pre-functional activities and gait compared to non-ambulatory peers.
Conclusions:
- Physical therapy dose following MLS in children with CP is not uniform and varies significantly by ambulatory status.
- The findings highlight a need for developing evidence-based PT guidelines tailored to the ambulatory capabilities of children with CP post-surgery.
Purpose:
To characterize physical therapy (PT) dose for children with cerebral palsy (CP) after multi-level surgery (MLS) and examine variation by ambulatory status and surgical burden.
Methods:
PT dose (Frequency, Intensity, Time, Type) data were extracted from electronic records of children with CP who received outpatient PT the year after MLS.
Results:
Seventeen children, mean 9 years, female (n=10), ambulatory (n=10), and high surgical burden (n=12) were included. In the year after surgery, 345 visits occurred. Intensity across visits was above average. Time was greatest for pre-functional activities, gait, and transitions/transfers. Types most often delivered were neuromuscular, musculoskeletal, and education/training. Ambulatory children received significantly more visits, higher intensity, and time in pre-functional activities and gait than non-ambulatory children. No differences in type by ambulatory status and PT dose by surgical burden were found.
Conclusion:
PT dose varied the first year after MLS indicating the need for guidelines by ambulatory status.
Video Abstract:
Supplemental Digital Content available at: http://links.lww.com/PPT/A516.
