Other medical situations, experienced by children, that our therapists are also experienced in treating include:

Amputation
An amputation is the removal of a part or an entire limb (arm or leg). This can be due to an accident or trauma, but can also be done as part of a planned surgery. The primary reason for amputations in the US are: disease (70%), trauma (22%), congenital abnormalities (4%), and a tumor (4%). Surgical amputation is generally done to relieve pain or when the limb has a tumor or disease. Planned surgical amputation can also be performed when there is a severe deformity in the arm or leg. Physical therapist work hand-in-hand with prosthetists, who create a limb for the child. The child will need to work with a physical therapist on gaining extra strength in their core and in the muscles surrounding the amputated area. The therapist works with the child and family on care and cleaning of the limb/area of the amputation. Therapy sessions also concentrate on walking, getting up and down from the ground, and moving around on the floor with and without the prosthetic limb. Children and caregivers must also learn to don and doff (put on and take off) the prosthetic limb.
 
Prematurity
Any baby born 3 or more weeks early is considered to be premature. In the USA, half a million babies a year are born prematurely. This number has increased 36% over the past 25 years. 70% of premature babies are born between 34-36 weeks gestation. These babies are considered “late preterm” 13% are born between 32-33 weeks gestation and are considered “moderately preterm”. 10% are born between 28-31 weeks gestation and are called “very preterm”. Babies are born prematurely for a variety of reasons. There could be a problem with the placenta or uterus of the mother, an infection in utero, chronic health problems such as high blood pressure in the mother. Multiples, such as twins or triplets, tend to be born earlier. Problems that affect premature infants include: respiratory/ breathing difficulties, decreased ability to regulate their body temperature, vision problems (retinopathy of prematurity), a bleed on the brain known as intraventricular hemorrhage (IVH), stomach issue known as necrotizing enterocolitis (NEC), heart problems, jaundice, anemia. Physical therapy is extremely important in the neonatal intensive care unit and beyond. An IVH or hemorrhage on the brain can lead to mild to severe delays in gross motor skills as well as cognitive delays. Babies may have low or high muscle tone due to the brain bleeds that needs to be addressed in order for the baby to begin to achieve their developmental milestones. Babies as young as 2-3 months can begin receiving physical therapy services to address gross motor delays and to be monitored for other delays such as in fine motor, speech, and cognition.  
 
Cancer
Around 10,000 children under the age of 15 are diagnosed with cancer each year. Childhood cancers tend to occur suddenly and without early symptoms. They also tend to have a high cure rate. The most common forms of pediatric cancers are leukemia, brain tumors, lymphoma, and soft tissue sarcoma. Physical therapy is important for children with cancer. Therapy can help to decrease pain through gentle massage, positioning, and passive range of motion. Cancer and its treatment can cause a child to become very weak and have poor endurance. This affects their ability to function at home and often to walk. Physical therapy can assist the child in gaining strength through gentle therapeutic exercises. Gait and transfer training is important for children and their caregivers to learn.
 
Traumatic Brain Injury (TBI)
Traumatic Brain Injury or TBI is one of the leading causes of acquired disability and death in infants and children. 475,000 TBI’s occur in children 0-14 every year. They cause about 2,700 deaths per year. A TBI is an injury to the brain caused by the head being hit by something such as in a fall or car accident. It can also be caused by shaking an infant very hard (such as in shaken baby syndrome). TBI’s changes how a child moves, acts, thinks and learns. The symptoms can be very different depending on the location of the injury to the brain and how severe the injury was. The physical changes that can be seen are related to the child’s ability to speak, see, and hear. They can experience severe headaches or seizures. Paralysis may be present or increased spasticity of one or more limbs. Fine and gross motor skills such as writing or walking may be affected. Cognitive changes are often present as well. Short and long term memory may be decreased as well as the ability to concentration. Speech and the ability to read may be altered. Judgment and planning skills are often affected by the injury to the brain. Physical therapists work with children who have had a brain injury to return them to age appropriate gross motor skills. If the injury occurs prior to the development of many of their gross motor skills, pediatric physical therapists work to help the young child achieve the gross motor skills appropriate for their age. Increased tone or spasticity can interfere with gait and balance. Balance and gait training is often a large part of the treatment plan.
 
Post Fracture in Children
Children are at risk for injury as they are very active. However, they tend to heal faster than adults because they have a thicker, stronger membrane covering their bones than adults do. Boys tend to fracture more than girls. These fractures often occur during sporting events. Children tend to have more arm fractures than legs. Children are typically cast anywhere from 2 to 6 weeks depending on the location and the severity of the fracture. During these weeks, the child can become tight and weak as they are unable to move the affected limb. They often need a short period of physical therapy to loosen up the joint, strengthen the affected muscles, and teach function or gait. Especially in leg or lower extremity fractures, children may have non-weight bearing or unable to put any weight on the leg while the cast was on. Then the cast comes off and the child may be afraid to put weight on the limb. It can also be painful for awhile. Physical therapist come up with a plan to help the child get back to the way they were running, walking, and jumping prior to their injury.
 

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