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Postsurgical Therapy for the Individual with Cerebral Palsy

  • Karen R. TurnerEmail author
  • Betsy Mullan
  • Nicole Needles
  • Danielle Stapleton
Living reference work entry

Abstract

Orthopedic surgery is quite common in the management of children and youth with cerebral palsy, utilized to correct and prevent musculoskeletal deformity and optimize movement function. It is most successful when undertaken as a process involving a multidisciplinary team of surgeons, medical and rehabilitation specialists, and physical and/or occupational therapists. The achievement of functional mobility goals happens through an intentional and thoughtful process of preoperative preparation, perioperative management, and intensive postsurgical rehabilitation within the setting of a medical team with family partnership.

Postsurgical therapy begins acutely in the hospital setting to initiate range of motion, early mobility, and caregiver education. The acute therapy sessions also address assistive device and seating system needs. The transition from acute care to other therapy settings such as home-based, inpatient rehabilitation, comprehensive outpatient rehabilitation, school-based, or episodic outpatient physical therapy will depend on patient, caregiver, and medical team goals (Miller, Cerebral Palsy. Springer Science and Business Media, New York, 2005a). Implementation of these services may occur sequentially, concurrently, or individually and should be accompanied by a home exercise program. The goals of postsurgical therapy for the child with cerebral palsy include: preserving and progressing available joint range of motion and strength, improving functional use of affected limbs, advancing functional mobility, increasing comfort, and inhibiting reoccurrence of the corrected deformity.

Keywords

Cerebral palsy Postsurgical therapy Postsurgical rehabilitation Postsurgical physical therapy Postsurgical occupational therapy Postoperative therapy 

Abbreviations

AAROM

Active assisted range of motion

AD

Assistive device

ADL

Activity of daily living

AROM

Active range of motion

BMI

Body mass index

FWB

Full weight bearing

GMFCS

Gross motor functional classification system

GMFM

Gross motor function measure

HEP

Home exercise program

HHD

Hand held dynamometer

IEP

Individualized education plan

ITBP

Intrathecal baclofen pump

KI

Knee immobilizer

LE

Lower extremity

LRAD

Least restrictive assistive device

MMT

Manual muscle test

NWB

Non-weight bearing

OOB

Out of bed

PIP

Proximal interphalangeal

PM&R

Physical medicine and rehabilitation

POC

Plan of care

PROM

Passive range of motion

PWB

Partial weight bearing

ROM

Range of motion

SEMLS

Single event multi-level surgery

SLC

Short leg cast

TFTS

Timed floor to stand

TLSO

Thoraco-lumbo-sacral orthosis

TUDS

Time up and down stairs test

TUG

Timed up and go test

UE

Upper extremity

WBAT

Weight bearing as tolerates

6MWT

Six minute walk test

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Karen R. Turner
    • 1
    Email author
  • Betsy Mullan
    • 2
  • Nicole Needles
    • 3
  • Danielle Stapleton
    • 4
  1. 1.MPT, BSPTS-C1Nemours: A.I. duPont Hospital for ChildrenWilmingtonUSA
  2. 2.Physical TherapyOPT Therapy Services, Ltd.WilmingtonUSA
  3. 3.DPTNemours: A.I. duPont Hospital for ChildrenWilmingtonUSA
  4. 4.PT, DPTNemours: A.I. duPont Hospital for ChildrenWilmingtonUSA

Section editors and affiliations

  • Nancy Lennon
    • 1
  • Margaret E. O’Neil
    • 2
  1. 1.AI duPont Hospital for ChildrenWilmingtonUSA
  2. 2.Columbia UniversityNew YorkUSA

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