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Pediatric Rehabilitation Medicine


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Pediatric Rehabilitation: definition, description, conditions treated, tests/procedures, hospital & programs with ped rehab services, advances in technology

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Pediatric Rehabilitation Medicine

  1. 1. Pediatric Rehabilitation Medicine Margarita Correa MD Improving Quality of Life
  2. 2. Pediatric Rehabilitation Medicine <ul><li>Is the sub-specialty that utilizes an interdisciplinary approach to address the prevention, diagnosis, treatment, and management of congenital and childhood-onset physical impairments </li></ul>
  3. 3. Pediatric Rehabilitation Medicine <ul><li>Rehabilitation management of children with physical impairments requires identifying functional capabilities and selecting the best rehabilitation intervention strategies with an understanding of the life of course of the disability and the continuum of care </li></ul>
  4. 4. Conditions Treated <ul><li>The Pediatric Physiatrist can provide hospital consultation, and as well as outpatient practice, including care of newborns, infants, children and adolescents with, but not limited to: </li></ul><ul><li>Cerebral palsy </li></ul><ul><li>Developmental delay, developmental disabilities </li></ul><ul><li>Spina bifida and other neural tube defects </li></ul>
  5. 5. Conditions Treated <ul><li>Brain injury </li></ul><ul><li>Spinal cord injury </li></ul><ul><li>Neuromuscular disease </li></ul><ul><li>Genetic syndromes </li></ul><ul><li>Metabolic Disorders </li></ul><ul><li>Brachial plexus palsy </li></ul><ul><li>Congenital, hereditary Lymphedema </li></ul>
  6. 6. Conditions Treated <ul><li>Musculoskeletal injuries </li></ul><ul><li>Rheumatic disease </li></ul><ul><li>Chronic pain syndrome </li></ul><ul><li>Peripheral neuropathy </li></ul><ul><li>Myopathies </li></ul><ul><li>Limb deficiency, amputee </li></ul>
  7. 7. Tests and Procedures <ul><li>Electromyography (EMG) & Nerve Conduction Studies (NCS) aid in the diagnosis of conditions or diseases related to muscles, nerves, motor neuron and neuromuscular junction </li></ul><ul><li>Botulinum toxin ( BOTOX ) injections for spasticity reduction and pain relief </li></ul>
  8. 8. Top 5 Rated Best Children’s Hospitals <ul><li>Children’s Hospital of Philadelphia </li></ul><ul><li>Children’s Hospital of Boston </li></ul><ul><li>Johns Hopkins Hospital </li></ul><ul><li>Children’s Hospital Denver </li></ul><ul><li>Rainbow Babies and Children’s Hospital, Cleveland </li></ul>
  9. 9. The Children’s Hospital of Philadelphia <ul><li>Division of Child Development and Rehabilitation Medicine </li></ul><ul><li>Therapies: Audiology, OT, PT, SLP </li></ul><ul><li>Inpatient Rehabilitation Unit, 18 beds: SCI, TBI, MSK disease, chronic pain and other chronic illness </li></ul><ul><li>Outpatient Rehabilitation Service: focused cerebral palsy, MSK disease and spasticity </li></ul><ul><li>Fellowship Training Program (Pediatrics, Genetics, Gastroenterology and Nutrition, Psychology, Social Worker. Adjunctive Faculty: Neurology, Psychiatry) </li></ul>
  10. 10. Children’s Hospital of Boston <ul><li>Pediatric Pain Rehabilitation Program </li></ul><ul><li>Psychology, PT, OT, Hydrotherapy, Tutoring and Medical Management </li></ul><ul><li>Several fellowships (Developmental and Behavioral Pediatrics, Neurodevelopmental Disabilities,Orthopedics/Pediatrics Sports Medicine) </li></ul>
  11. 11. Johns Hopkins Children’s Center <ul><li>Kennedy Krieger Institute </li></ul><ul><li>Clinical Departments (Audiology, Behavioral Psychology, Recreation, Neuropsychology, Nursing, Nutrition, OT, PT, Psychiatry, Social Work, Special Education, Speech and Language) </li></ul><ul><li>Outpatient Programs – 47 programs </li></ul><ul><li>Inpatient Programs (Neurobehavioral, Feeding and Pediatric Rehabilitation – BI, SCI, chronic pain, developmental disabilities and recovery from orthopedic surgery) </li></ul>
  12. 12. Children’s Hospital Denver <ul><li>Inpatient Rehabilitation Program </li></ul><ul><li>Neurotrauma Rehabilitation Team </li></ul><ul><li>Rehabilitation Clinics, Sports Program </li></ul><ul><li>Neuropsychology in the Department of Rehabilitation </li></ul><ul><li>Brain STARS (Strategies for Teams and Re-education for students with acquired brain injury) </li></ul>
  13. 13. Rainbow Babies and Children’s Hospital, Cleveland <ul><li>Rehabilitation and Sports Medicine </li></ul><ul><li>Spasticity clinic </li></ul>
  14. 14. Cincinnati Children’s Hospital <ul><li>Inpatient Rehabilitation Unit </li></ul><ul><li>Outpatient Rehabilitation Services </li></ul><ul><li>Specialty Clinics (General Pediatric Rehabilitation, Spasticity Clinic, W/C/Seating, EMG, Spinal Cord, MSK Oncology, Neuro-Oncology, Muscular Dystrophy Association, Limb Reconstruction, Brachial Plexus, Stroke, Cerebral Palsy, Myelomeningocele) </li></ul>
  15. 15. Nemours/Alfred I duPont Hospital for Children <ul><li>Rehabilitation (Brain Injury Program, Comprehensive Inpatient Program, Day Program, Outpatient Therapy – PT, OT, SLP, Cognitive Remediation, Neuropsychology. </li></ul><ul><li>Outpatient Evaluations: PMR, PT, OT, SLP, Neuropsychology </li></ul><ul><li>Diagnosis: Brain Injury, SCI, Stroke, Near-Drowning, Anoxia, NMD, Amputations, Burns, RSD, Post-Orthopedic surgeries </li></ul>
  16. 16. Rehabilitation Institute of Chicago <ul><li>Pediatric Rehabilitation Services (cerebral palsy management, pediatric Lokomat walking therapy, pediatric feeding support services, adolescent pain management program) </li></ul><ul><li>LIFE Center (Living with Pediatric Disability Resources) </li></ul>
  17. 17. Pediatric Lokomat
  18. 18. New Technology <ul><li>Neurorehabilitation and Robotics </li></ul><ul><li>Dynamic stander to control osteoporosis </li></ul><ul><li>Wheelchair-Mounted Manipulator </li></ul><ul><li>Virtual Reality Rehabilitation and Recreation </li></ul><ul><li>Sensory Motor Enhancement </li></ul><ul><li>A Body Powered Hand for Toddlers : Easy Feed Hands for the Growing Child </li></ul>
  19. 19. Neurorehabilitation and Robotics <ul><li>Children with cerebral palsy suffering from sensory and motor impairments that affect their upper extremity function </li></ul><ul><li>Current studies show that robotically-facilitated repetitive movement training might be an effective stimulus for normalizing upper extremity motor control </li></ul>
  20. 20. Neurorehabilitation and Robotics <ul><li>When Virtual Reality simulations are interfaced with robotic devices, movement tracking and sensing, and haptic glove systems, they can provide an engaging, motivating, and adaptable environment </li></ul>
  21. 21. Control of Osteoporosis <ul><li>Dynamic stander to apply reciprocating forces that mimic the walking gait to the lower limbs of immobilized children </li></ul>
  22. 22. Wheelchair-Mounted Manipulator <ul><li>The use of robotic manipulators to augment upper extremity function has been limited by the availability of a means to control multiple degrees of freedom simultaneously to generate smooth and efficient movements </li></ul>
  23. 23. A Body Powered Hand for Toddlers: Easy Feed Hands for the Growing Child <ul><li>The design builds on observations of children's natural hand use patterns and their cognitive skills. Young children frequently transfer objects from hand to hand. The Easy-Feed Hand takes advantage of this hand use pattern as children transfer objects to the prosthesis with the sound hand </li></ul>
  24. 24. THANKS