“How could I apply this information?”
Clinicians should consider a combination of factors (some of which were measured in this study) that contribute to successful recovery after single-event multilevel surgery (SEMLS).
As a parent of a young teen who underwent SEMLS with 5 osteotomies (high surgical burden), my son had to work extremely hard under duress of pain and swelling to recover to his presurgical level of function. While physical rehabilitation is an important focus of the study, there is a mental component that is equally as vital due to the rigor of such a postsurgical program. Consideration of psychological support for children and families would be beneficial during the recovery rehabilitation program.
“What should I be mindful about when applying this information?”
Dose, defined as the frequency of therapy (occupational therapy [OT] and physical therapy [PT] visits), is associated with better recovery after surgery. This study combined both OT and PT visits and did not provide important details such as the types of intervention. Therapy was provided at one center during an inpatient rehabilitation stay in addition to a high-frequency outpatient program. This level of therapy frequency or inpatient rehabilitation may not be available or accessible to all children undergoing SEMLS. Results from this study highlight an urgent need to collect detailed information about therapy after surgery and across centers.
As a parent, one should be mindful that other factors may contribute to successful recovery. Examples of other factors include involving families in decision-making and setting goals (family-centered) and increasing therapy sessions prior to surgery (prehabilitation) to build strength, both of which were not measured in this study. Increases in therapy frequency are likely not accessible to all; thus, providers should consider innovative ways to increase access and equitable delivery of services.
Amy F. Bailes, PT, PhD, PCS
Director of Physical Therapy Research
Division of Occupational Therapy and Physical Therapy
Cincinnati Children's Hospital Medical Center
Department of Rehabilitation Sciences
University of Cincinnati
Lori J. Poliski, MEd
Parent of William, a teen with cerebral palsy, spastic diplegia GMFCS II