INSTRUCTIONAL COURSE DETAIL

TUE, 27 OCT: 1:00 PM – 5:00 PM

FACULTY

Kaitlin MacDonald, MOT, OTR/L
International Center for Spinal Cord Injury at Kennedy Krieger Institute Baltimore, MD

Meredith Budai, PT, DPT, ATP
International Center for Spinal Cord Injury at Kennedy Krieger Institute Baltimore, MD

Julie Cagney, PT, DPT
International Center for Spinal Cord Injury at Kennedy Krieger Institute Baltimore, MD

Courtney Porter, PT, DPT
International Center for Spinal Cord Injury at Kennedy Krieger Institute Baltimore, MD

DIAGNOSIS

PRIMARY: Spinal Cord Injury, Other, Clinical Practice

SECONDARY: Tumor, Transverse Myelitis (TM), Acute disseminated encephalomyelitis (ADEM), Guillan Barre, Acute Flaccid Myelitis, Arterial Venous Malformtation (AVM)

FOCUS

Technology, Pediatric, Neuroplasticity

ABBREVIATED DESCRIPTION

Spinal cord injury and rare neurological disorders in pediatrics have lifelong consequences for children. The goal of therapy is to facilitate “normal” neurodevelopmental milestones. By providing input above and below the level of injury, activity based rehabilitation promotes neural recovery and reorganization while offsetting chronic complications, improving function, and facilitating achievement of milestones. Rehabilitation professionals must work as a team to adapt services and equipment to meet the needs of pediatric patients. This presentation illustrates the first steps in a lifelong activity-based rehabilitation program to facilitate ongoing development, minimize complications and help each child achieve his or her maximum potential.

ABSTRACT BODY

Spinal cord injury (SCI) and rare neurological disorders in pediatrics (0-21) have lifelong consequences for children developmentally and in family life. The goal of therapy for the pediatric population is to facilitate “normal” neurodevelopmental milestones. By providing input both above and below the level of injury, activity based rehabilitation (ABR) promotes neural recovery and reorganization while offsetting chronic complications, improving overall function, and facilitating achievement of milestones. Implementing this practice in pediatrics presents unique challenges for the rehabilitation team. In young children with neurological insults, therapists have to incorporate the acquisition of developmental milestones, while addressing the loss of motor and sensory function and the cognitive implications that presents. Doing all of this in a medical system built for adults, requires professionals with equal parts skill, creativity, and compassion. This course will explore the benefits and illustrate the principles of ABR as applied to pediatrics as well as the benefits of early mobility on pediatric development through case presentations and a review of the literature. Cases will discuss the use of advanced technology and therapeutic modalities. Interventions include the use of aquatic therapy, weight bearing, locomotor training, mass practice, task specific practice, and functional electrical stimulation, to increase activity, improve mobility, facilitate development, and promote neurological recovery.

In addition, independent mobility via various adaptive devices can augment recovery and progress development. Research supports that cognitive, psychosocial, emotional, and visual perceptual milestones develop with independent mobility. Children with impaired mobility are at increased risk of developing skeletal muscle abnormalities, such as scoliosis and pelvic malalignment. In addition to the developmental benefits, mobility and intensive ABR can decrease the risk of orthopedic abnormalities, cardiovascular complications, and neuromuscular impairments. This presentation will exemplify the first steps in a lifelong activity based, home and community rehabilitation program to facilitate ongoing development, minimize complications and help each child achieve his or her maximum potential.

LEARNING OBJECTIVES

Define Activity Based Rehabilitation (ABR) and describe the application of ABR principles for pediatrics.
Identify considerations for pediatrics that differ from the adult population.
Apply current literature to explain and classify the areas of pediatric development, such as cognition, social interaction, visual perceptual skills, and orthopedic structures that would benefit from equipment, which promotes early mobility.

Intended Audience

Occupational Therapists, Physical Therapists, Pediatricians, PM&R doctors, neurologists

COURSE OUTLINE

Introduction to ABR (Julie Cagney)
Pediatric Development (Julie Cagney)
ABR and pediatrics (Courtney Porter)
What to do with those with no hope (Courtney Porter)
Equipment considerations/modifications for the pediatric patient (Meredith Budai)
Rare neurological diagnoses and special cases (Meredith Budai)
Case Studies (Kaitlin MacDonald)
Conclusion (Kaitlin MacDonald)
Questions

BIO SKETCHES

Kaitlin MacDonald, MOT, OTR/L has been an occupational therapist with the International Center for Spinal Cord Injury (ICSCI) at Kennedy Krieger Institute since July of 2010. In addition, she works per diem for Kennedy Krieger Institute’s Home and Community Program. She received her Bachelor of Health Sciences and Masters of Occupational Therapy from Saint Francis University in Loretto, Pennsylvania. She presents nationally on Activity-Based principles and pediatric rehabilitation. She is currently completing the Pediatric Certificate Program at Drexel University. Her clinical interests include pediatrics, functional electrical stimulation, aquatic therapy, seating and mobility, and assistive technology. She is experienced as a land and aquatic therapist for children and adults with neuromuscular diagnoses.

Julie Cagney, PT, DPT is a clinical specialist at the International Center for Spinal Cord Injury at Kennedy Krieger Institute in Baltimore, MD. She received her Bachelors of Science at the Pennsylvania State University in 2007 and her DPT from The University of Southern California in 2010. She completed her Pediatric PT Residency at Kennedy Krieger Institute, University of Maryland Medical Center, and Johns Hopkins Hospital. She presents nationally on Activity-Based Rehabilitation principles and their application in pediatrics. Her research interests are in pediatric assessment and treatment following neurological insult. She is experienced in wheelchair prescription, gait and orthotics, and developmental handling.

Meredith Budai, PT, DPT, ATP is a clinical specialist at the International Center for Spinal Cord Injury at Kennedy Krieger Institute in Baltimore, MD. She received her Bachelors of Science and Bachelors of Health Sciences in 2006 and her Doctorate of Physical Therapy in 2008 from Duquesne University in Pittsburgh, PA. Meredith has been a certified assistive technology professional (ATP) since 2011 and is on the board of examiners for rare neurological disorders. She has presented nationally on activity based rehabilitation principles and their application in pediatrics and with seating and positioning recommendations. Her clinical interests are pediatrics, functional electrical stimulation, casting and orthotics and seating and mobility. She is experienced in wheelchair prescription, aquatic therapy, and land therapy for children and adults with neuromuscular diagnoses.

Courtney Porter, PT, DPT has been a physical therapist with the International Center for Spinal Cord Injury (ICSCI) at Kennedy Krieger Institute since June of 2012. She received her Bachelor of Health Sciences and Doctorate of Physical Therapy from University of the Sciences in Philadelphia, Pennsylvania. Her clinical interests include functional electrical stimulation, and aquatic therapy. She is experienced as a land and aquatic therapist for children and adults with neuromuscular diagnoses.