Physical Therapy Dose After Orthopedic Multilevel Surgery Varies by Ambulatory Status in Children With Cerebral Palsy: A Pilot Study

Abstract

Purpose: To characterize physical therapy (PT) dose for children with cerebral palsy (CP) after multi-level surgery (MLS) and examine variation by ambulatory status and surgical burden. Methods: PT dose (Frequency, Intensity, Time, Type) data were extracted from electronic records of children with CP who received outpatient PT the year after MLS. Results: Seventeen children, mean 9 years, female (n=10), ambulatory (n=10), and high surgical burden (n=12) were included. In the year after surgery, 345 visits occurred. Intensity across visits was above average. Time was greatest for pre-functional activities, gait, and transitions/transfers. Types most often delivered were neuromuscular, musculoskeletal, and education/training. Ambulatory children received significantly more visits, higher intensity, and time in pre-functional activities and gait than non-ambulatory children. No differences in type by ambulatory status and PT dose by surgical burden were found. Conclusion: PT dose varied the first year after MLS indicating the need for guidelines by ambulatory status. Video Abstract: Supplemental Digital Content available at: http://links.lww.com/PPT/A516