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Physiotherapy Involvement of Children Receiving Assessment for and Implant of ITB

Introduction. Physiotherapy involvement Test doseITB pump implant. Physiotherapist's. Community PhysiotherapistHospital PhysiotherapistResearch Physiotherapist. General Physiotherapy Input. Facilitate development, function and independence Maintain range of movementAssist in prevention of

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Physiotherapy Involvement of Children Receiving Assessment for and Implant of ITB

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    1. Physiotherapy Involvement of Children Receiving Assessment for and Implant of ITB Angie Earnshaw Senior Paediatric Physiotherapist Nottingham University Hospitals NHS Trust

    2. Introduction Physiotherapy involvement Test dose ITB pump implant

    3. Physiotherapists Community Physiotherapist Hospital Physiotherapist Research Physiotherapist

    4. General Physiotherapy Input Facilitate development, function and independence Maintain range of movement Assist in prevention of contractures Manage and normalise tone Facilitate and encourage normal movement

    5. Equipment Standing frame, sleep system Wheelchairs Specialist seating Orthoses Hydrotherapy / rebound therapy / horse riding

    6. Extended Role Limited monitoring of medical problems orthopaedic / spinal Initiation of new treatments botulinum, oral baclofen, ITB

    7. Delivery of Therapy Individual treatments Group sessions In school Health Centres Home Hospital Liaison

    8. Test Dose Discussion with child and parent / carer Advise on assessment pre and post test dose Tone Range of movement Muscle strength Gait Function Normal routine post test dose Contact community physiotherapist

    9. Pump Implant Positioning post-op Gentle stretches and pattern inhibiting activity Transfer into chair Progress mobility Begin rehabilitation E.g. strengthening, gait re-education

    10. Pump Implant - Practicalities Bring your childs own equipment Chair Walking aid Splints

    11. Post-op Advice No swimming / hydrotherapy until wound healed and checked No rebound / horse-riding / gym ball work for three months Caution with straps and belts

    12. Post-op advice contd Positioning not restricted Physiotherapy input 24 hour postural management

    13. Community Physiotherapist Ultimate responsibility for child is with the Community Physiotherapist Advise re-assessment once home and at appropriate time scales May advise increase physiotherapy input

    14. Ongoing Physiotherapy 6 9 months to stabilise tone and realise full potential Lengthen + stretch muscles Increase strength muscle fibre type Learn normal movement

    15. Any questions?

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