Pediatric Spasticity Management Program
Physical and occupational therapists provide treatment and parent education for management of spasticity, including serial casting, splinting, range-of-motion exercises, strengthening exercises, functional skills training, orthotics consultation, and therapeutic electrical stimulation. Our goal is to develop a one- to two-year plan for the management of spasticity, in collaboration with therapists, the patient and his or her family, the physician, and with other providers.
Pediatric Spasticity Management Assessment Clinic
The Spasticity Management Assessment Clinic provides comprehensive services to promote optimal achievement of functional independence in mobility and self care. A team of rehabilitation experts provides instruction to caregivers and patients on techniques and activities that support their goals. Participating patients will be evaluated on a monthly basis.
Advanced Management of Pediatric Spasticity Program (AMPS)
Some children with cerebral palsy have severe problems with spasticity, which may be improved with selective dorsal rhizotomy, intrathecal baclofen, or complex Botox treatments with serial casting to release tight muscles. Multi-level orthopedic surgery may be recommended to address the complications caused by untreated spasticity.
► More information on Mary Free Bed's Advanced Management of Pediatric Spasticity Program
Pediatric Spasticity Services
The Pediatric Spasticity Program & Clinic at Mary Free Bed Rehabilitation Hospital assess and manage spasticity in pediatric patients. Services include:
Oral medication option
Who Uses Pediatric Spasticity Services
Children who experience spasticity due to the following conditions:
Spinal cord injury
Pediatric Spasticity Services Explained
At your initial visit, a receptionist will obtain registration and confirm financial information obtained at time of referral. A nurse guides you through an orientation and performs an initial health assessment. You will also be evaluated by a physician and a therapist who will share impressions concerning management of your spasticity. In most cases, you see the same team of specialists on return visits.
Oral Medication Option
A trial of oral medications, such as baclofen, Zanaflex, Dantrium, and Valium, alone or in combination, is initiated if the stretching regime has proven to be ineffective in minimizing spasticity. Liver function tests are ordered to ensure that liver toxicity is not a problem brought on by oral medication management.
Orthoses may be used to support and/or brace joints to increase comfort and/or assist walking or other activity.The orthoses may also help to stretch muscles through prolonged positioning. An orthotist assists with fitting the orthoses and any ongoing adjustments that may be needed.
The goal of therapy is to help individuals with spasticity become as functional as possible.The physical therapist evaluates passive range of motion, functional skills, strength, and ability to provide the appropriate therapy to improve movement and mobility function. Part of the therapy may be to provide serial casting to help maintain range of motion.
The option of an intrathecal baclofen test dose may be offered to the patient and family. The test dose is administered at Mary Free Bed during a short stay admission. The day that the test dose is administered, the physiatrist, nurse and physical therapist are present to evaluate the effectiveness of the medication.They continually assess respiratory status, functional mobility, and spasticity. If the patient responds positively to the test dose and is in agreement to proceed with intrathecal baclofen pump placement then a referral is made to a neurosurgeon for consultation and placement. Once the pump is placed, it will be monitored on an ongoing basis for dose adjustments and refills at Mary Free Bed.
Pediatric Spasticity Treatment Team
The Pediatric Spasticity Clinic team works closely with each patient’s (primary care/referral) physician. Spasticity management starts out conservatively with a home exercise program, which includes stretching and range of motion.
We specialize in the care of patients with spasticity. A variety of specialists are available to best meet the needs of each individual patient.
Physician specializing in physical rehabilitation medicine
Pediatric physiatrists also dually board certified in pediatric medicine
Manages the medical care and directs the rehabilitation team for each patient
Evaluates each patient, develops and oversees nursing care plan
Focuses on patient’s self-care, comfort and education
Provides ongoing intrathecal baclofen pump management under direction of rehabilitation physician; works in collaboration with MFB inpatient nursing team and rehabilitation physician for 24-hour coverage of intrathecal baclofen issues.
Available for evaluation with a physician referral
Years of experience in the utilization of orthoses for spasticity management
Provides expertise in customizing and fitting orthoses to assist with comfort and activity
Conducts PT consultations within clinic visits and during intrathecal baclofen test doses
Available for outpatient therapy evaluations and treatment upon physician referral, with depth and experience in management of spasticity
Evaluates patient’s balance, flexibility, endurance, strength and muscle function as these relate to mobility in hospital, home, school and community environments
Provides hands-on therapy to improve movement and mobility function
Provides serial casting for lower extremities
Evaluates need for equipment to manage mobility in home, school and community environments
Available for outpatient therapy evaluations and treatment upon physician referral, with years of experience in management of spasticity
Evaluates and treats upper extremity movement and function, as well as areas of daily living such as eating/drinking, dressing, toileting, bathing, hygiene and cooking
Identifies need for special adaptive equipment to manage tasks of daily living and provides or customizes equipment to meet these needs
Provides splinting and serial casting for upper extremities
Contact the Pediatric Spasticity Program
Contact the Pediatric Spasticity Program for more information or to make a referral.
616.242.0395 or 800.790.8040
Outpatient Referral Form