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Monitoring Procedural Pain and Distress in a Child With Rett Syndrome

A Case Report

Swiggum, Mary PT, PhD; Grant, Lisa PT, DPT

doi: 10.1097/PEP.0000000000000651
CASE REPORTS
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Background and Purpose: Whole body vibration training is a viable option for children with Rett syndrome; however, the positioning requirements and intense vibration may be interpreted as pain.

Case: A 13-year-old girl with a diagnosis of Rett syndrome, Stage IV, participated. The Individualized Numeric Rating Scale was developed in collaboration with the caregiver and scored by a physical therapist and student physical therapists during 16 sessions of whole body vibration training.

Outcomes: The therapist and students reached 100% agreement on the Individualized Numeric Rating Scale ratings and successfully provided distractions to prevent pain and distress from reaching a level 5 out of 10 for 139 of 144 sessions.

Conclusion: This is the first case in the literature to demonstrate use of the Individualized Numeric Rating Scale with a child who is nonverbal during a potentially painful physical therapy procedure.

This case is an example of the Individualized Numeric Rating Scale used with a child who is nonverbal during a potentially painful physical therapy procedure.

Wingate University, Wingate, North Carolina.

Correspondence: Mary Swiggum, PT, PhD, Wingate University, Wingate, NC 28174 (lswigg@aol.com).

The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association