PCS case study exam question 29

[Sarah Johannigmeier]

I was reviewing my exam this evening, and I wanted to see if you had specific articles detailing frequency of therapy after SDR in relation to question 35 on case based exam. I know a lot of times the frequency/protocols vary based on facility/surgeon, but if you had a specific article that talked about length of time recommended for inpatient rehab versus outpatient services I would love to compare it to what our surgeons typically recommend. Thanks!

[Jessica Lewis]

A lot of the info I have for therapy after SDR comes from an AACPDM presentation by Caroline Colvin and Molly Thomas in 2018. It’s title is “An Evidence-Based Review of Physical Therapy Intervention for Individuals Who Have Undergone a Selective Dorsal Rhizotomy” found here: https://www.aacpdm.org/UserFiles/file/handouts/am18/bsh/BRK4-An-Evidence-based-Review-of-Physical-Therapy-.pdf

Here is another article that I think is helpful that isn’t listed in their powerpoint presentation:
Effect of selective dorsal rhizotomy in the treatment of children with cerebral palsy – Engsberg et al 2006

I think the downfall of a lot of the literature is that it never specifies what “intensive” therapy is. It only vaguely references it and never fully defines it. I think what we can gather from some of the literature coming out about dosing and PT, intensive would be at least 3-5 times per week or longer sessions less times per week.

At my hospital our guidelines are that the child will participate in therapy for 24-36 months after their SDR. 4-5x/week for 6 months post SDR, 2-3x/week from 6-12 months post SDR, and 1-2x/week 12-36 months post SDR. A lot of our patients also receive inpatient rehab immediately after the surgery for 2-3 weeks. Of course (unfortunately) insurance ultimately dictates if our children can actually do all of this.

[Sarah Johannigmeier]

Thank you- this was helpful!

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