Journal of Pediatric Rehabilitation Medicine - Volume 2, issue 3
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Journal of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach is an international journal designed to parallel the multi-disciplinary team approach of caring for a child with an acute or chronic disease. The issues will primarily be themed and broad in scope including, but not be limited to cerebral palsy, traumatic brain injury, spinal cord injury, spina-bifida, amputation, muscular dystrophies of all types, stroke, cancer, mental retardation, developmental delays, and others.
The aim is to include a wide range of experts who care for children with the above diagnosis. Authorship by two different disciplines is requested though not required to encourage an interdisciplinary and collaborative approach. The goal is for the reader to obtain not just the medical perspective, but also nursing, occupational, physical and speech therapy, psychology, home care, etc., in providing the most comprehensive care for children. Manuscripts will be blinded and peer reviewed with appropriate feedback. Statistical analysis will be reviewed by the biostatistician. Readers are encouraged to submit and or suggest case reviews, commentaries, editorials, original research, conference schedules, or reviews.
Abstract: Care for the child with limb deficiency or amputation is optimized when provided by an interdisciplinary team. A center specializing in the care of children with limb loss is typically the best choice and has the most experience in providing up to date, evidence based practice. The child and his/her family must be integral members of the team and optimal functional outcome requires recognizing and addressing their expectations and goals. We present an overview of rehabilitation…strategies, including prosthetic management, for children with lower extremity limb loss.
Abstract: Congenital hand anomalies can cause substantial functional problems. There are multiple situations where there is lack of stable pinch and/or grasp that can be improved by surgical intervention. An example of reconstructive surgical intervention in each of three specific congenital hand anomalies is presented: hypoplastic thumb, absence of the fingers, and insufficient length and stability of the digits. Focus is on the approach to the patient, surgical treatment and the goals achieved. It is important…to mention that other techniques may be preferred by other surgeons, and may also yield excellent results.
Abstract: Children of all ages, regardless of any limb loss, need to play. Sports and recreation needs vary from person to person and by age. Adapting upper extremity prostheses for play, sport, and recreation is an option. The decision making process regarding the use of adaptive prostheses should involve a team-oriented approach which places the patient at the center of the team. When an individual chooses to adapt his/her prosthesis, the treating prosthetist is invaluable. The type…of adaptation depends on the particular activity. As technology continues to improve, the barriers that exist for an individual with a limb deficiency will continue to be challenged. There are a number of resources and groups dedicated to helping limb deficient individuals achieve a greater level of independence by allowing them to interact with their peers through both recreation and competitive sports.
Abstract: Congenital limb deficiencies/hypoplasias are a heterogeneous group of anomalies that range from mild abnormalities of little long-term clinical significance to the severe limb-reduction defects spectrum associated with fetal thalidomide exposure. This article reviews the approach to the prenatal evaluation of congenital limb deficiency/hypoplasia and provides an overview of selected limb reduction defects along with a discussion of etiology and genetic aspects. A case report detailing the prenatal evaluation of a fetus with a…skeletal dysplasia illustrates the importance of a comprehensive, multidisciplinary and dysmorphology-based approach.
Abstract: Children with limb deficiencies/amputations are best managed by a multidisciplinary team comprised of physicians specializing in their care, prosthetists, and therapists. For a successful functional outcome, the rehabilitation team will need to consider the goals of the child and parents as they select appropriate components that will aid and not overwhelm the child. The prosthesis will need to accommodate growth and development and withstand the rigors of use during play. The child will benefit from a…team approach to introduce, train, and problem-solve the process of prosthetic restoration. We examine strategies for decision making for children with upper extremity limb deletions that will allow appropriate component selection to ensure the prosthesis will be accepted and improve function for the child.
Abstract: Introduction: Care Coordination is the health care delivery model that has been implemented in the prosthetic clinic at the Shriners Hospital for Children – Canada. In delivering comprehensive, family-centered services, it is important to evaluate the extent to which patients and families perceive coordinated care to occur. Aim: To evaluate the delivery of Care Coordination services to our patients and families in the prosthetic clinic, and to identify strengths and areas for improvement. The…time required to provide coordinated care was also evaluated. Methods: The MPOC-20 was administered to the parents of 23 lower extremity deficiency or amputee patients seen in the prosthetic clinic over a 14-month period. Results: Providing coordinated and comprehensive care related to involving families as part of the team was the most frequently reported strength of the prosthetic clinic Care Coordination. Providing information to families about their child's progress and having information and resources available were areas identified as needing improvement by approximately 30% of respondents. Those with complex health needs required five times the amount of Care Coordination devoted time than the average patient. Conclusions: The MPOC-20 proved to be a useful tool to highlight areas for improvement in the prosthetic clinic and to validate aspects of care coordination that were appreciated by families.
Keywords: Care Coordination, family-centered care, MPOC, limb deficiency, pediatric
Abstract: Land mines are particularly a problem for children. The deaths and loss of body parts have been publicized, but the secondary effects – the loss or maiming of parents, the loss of physical and social space the loss of access to education, and the loss of cultivatable land with the resultant malnutrition and sickness, are less frequently considered. "Explosive Remnants of War" (ERW) is becoming the generic term to refer to land mines, unexploded ordnance, improvised…explosive devices and cluster bombs. The United Nations estimates that there are currently as many as 100 million unexploded landmines with an equal number stockpiled around the world waiting to be planted. Mines are designed to be difficult to locate and their clearance is costly. Children in at least 80 countries are at risk due to ERW. The type of mine, the proximity of the child to the explosion, and location of the mine in relation to the child's body are the important determinants of the nature and severity of the injury. Children are especially susceptible to picking up explosive remnants thinking they are toys. The result is commonly loss of the hands, facial injuries, blindness and deafness. Rehabilitation for these children is extremely difficult due to remoteness and the limited resources available.
Keywords: Children and explosive remnant of war, landmines, rehabilitation, amputation