Pediatric Physical Therapy:
Abstracts: Abstracts of Platform and Poster Presentations for the 2006 Combined Sections Meeting: Poster Presentations
1Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
Occupational and physical therapists working in pediatrics are likely to encounter children with esophageal atresia (EA), tracheoesophageal fistula (TEF), or a combination of these two conditions. It has been estimated that up to 70% of children with EA and/or TEF have associated developmental anomalies or defects. Although an abundance of medical information is readily available regarding these conditions, no literature has been found that provides a general overview of these conditions as they relate to therapy, let alone any specific information for occupational and physical therapists regarding implications for treatment interventions. With that in mind, this review offers an overview of EA/TEF, providing a knowledge base for the practicing pediatric therapist while presenting specific care implications to serve as a guide when treating young children with these conditions.
Esophageal atresia with or without tracheoesophageal fistula is the most common congenital malformation of the esophagus. There are six major classification types, with the Gross system most commonly used. The most common type of EA/TEF consists of a proximal EA and a distal TEF (Gross Type C). These congenital anomalies occur approximately during the third and fourth weeks of embryonic development. Several diagnostic tools are used in the diagnosis and intervention of EA/TEF, depending upon the type and severity of the anomaly. Surgical intervention is typically required soon after the infants birth. Medical complications of EA/TEF include multiple system anomalies, the vertebral, anorectal, cardiac, tracheal, esophageal, renal and limb (VACTERL) association, dysphagia, gastroesophageal reflux, respiratory problems, tracheomalacia, diminished pulmonary function, and recurrent TEF after initial repair. The implications of EA/TEF as these anomalies relate to occupational and physical therapy impact the methods used for feeding because of poor esophageal motility and aspiration, positioning the child during feeding and gross motor activities, as well as timing of therapy sessions to reduce the incidence of gastroesophageal reflux. In addition, pulmonary compromise, scoliosis and other chest wall deformities may be addressed through therapeutic intervention.
Summary Of Use:
To provide information regarding implications for treatment interventions for occupational and physical therapists working with children with EA/TEF. Referenced tables depicting incidence, diagnostics, medical and surgical treatments, associated complications, and therapeutic interventions are also presented.
Importance To Members:
As the survival rate continues to rise for children born with various medical conditions, a constant flow of information is needed in order to educate occupational and physical therapists working in the pediatric setting. Information regarding diagnostics, complications, surgical interventions and treatment implications is needed in order for the pediatric therapist to maintain a current base of knowledge.