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• Evidence-based treatments
• Hippotherapy
• Physical therapy
• Making physical therapy fun
• Physical therapy over a lifetime

Evidence-based treatments

Evidence-based research is the only valid criteria that we use to choose appropriate treatments for our patients. Unfortunately, there are a lot of treatments that are available to the public that are not evidence-based.  Hyperbaric oxygen is the one that gets the most attention.  It’s heavily promoted and there’s really no research that supports something like that.  However, there are many other evidence-based therapies that we can use.  Somebody once said that because a lot of the data is anecdotal, like “I know somebody who did really well with that treatment”, that anecdotes are not data.  Just because a dozen people did well with a certain treatment that does not mean that the treatment works.  It still needs to undergo rigorous scientific study.

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Hippotherapy

Hippotherapy (therapeutic horseback riding) is helpful to a child’s posture.  The warmth of the horse also relaxes tight adductor muscles.  But so important:  it is fun and good for the soul.  And children are justly proud of their accomplishments. 

-Carol Nolan, RN, BSN, Registered Nurse, Cerebral Palsy Program

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Physical therapy

One of the big interventions that we recommend a lot of the time for kids with CP is physical therapy.  Some kids love physical therapy, and some have a harder time with it. It’s extremely beneficial for kids with CP to help stretch their tight muscles.  For kids who have difficulties with their breathing; we have them doing a lot of chest physical therapy to help them clear the secretions from their lungs. Some kids really enjoy that sensation.

-Emily Davidson, MD, MPH, Pediatrician, Complex Care Services, Developmental Medicine Center

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Making physical therapy fun

The things that I think kids are most resistant to are the same old boring exercises day in and day out, which I totally understand. I’m not very good at doing exercises myself so probably wouldn’t do them if I had to do them forever. The things that we are trying to do is find activities, recreational activities, and different ways of doing things that are interesting to the child. Sometimes that means changing up what they’re doing. If the child gets botox injections while doing six or eight weeks of conventional therapy with some strengthening, maybe they can start doing aquatic therapy or hippotherapy after that acute period of six-eight weeks is over. So it’s changed up a little bit so that it’s not as boring. Certainly some of the things that we do, which is really gratifying and that both they kids and the families really like, is when we introduce a child to a power mobility, an electric wheel chair. For a child who hasn’t been able to propel or move themselves around their environment by themselves, to give them the ability to do that is one of the more fun things to do.

-Susan Riley, PT, MS, DPT, PCS, Physical Therapist, Cerebral Palsy Program

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Physical therapy over a lifetime

What’s important for families to know is that their children, by virtue of the disease, are going to have to be involved in some sort of physical therapy or exercise throughout their lives, but that does not necessarily mean continuous physical therapy throughout their lives. There may be episodes of intensive therapy and then maybe when the therapy is not so intensive, they’re doing another program that’s appropriate for them at home to maintain what they’re doing. Then, if they have a procedure, intervention, or come across new challenge that they need help addressing, we can help with that. For example, a child has been in an elementary school and now he is going to middle school. And now, instead of being in one classroom he is going to be throughout a whole building. That may be a time to increase the PT a little bit and figure out how is this child going to negotiate busy hallways? What are we going do about classroom accessibility? If the child’s in a wheelchair, is there a desk or a table in every room the child needs to go in that he can get to? If he needs to go up and down stairs and his balance isn’t very good on stairs, do we work on balance so that he can continue to do that? Or do we get elevator keys? So, there will be times that things will change, but it’s important to  know that it doesn’t necessarily mean that for every week of your child’s life he or she have to have two physical therapy sessions.

-Susan Riley, PT, MS, DPT, PCS, Physical Therapist, Cerebral Palsy Program

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