Rehabilitation programs should be designed to allow the child to participate in his or her team training sessions to maintain the social benefits of staying within the team. In this section, the key components of high-quality rehabilitation for the child with ACL injury, and the options for ACL reconstruction surgical technique are described.
Rehabilitation progression The framework for progression through functional milestones is similar for ACL reconstruction and non-surgical treatment. Exercises and functional goals must be modified, not simply copied from the adult-oriented rehabilitation protocols that may be more familiar to many clinicians.
Although this has been successfully implemented in rehabilitation programs for adolescents and adults, it has not yet been documented as extensively in children. Potential treatment decision modifiers are outlined in Section 4.
Non-surgical treatment should last for at least 3—6 months.
Table 1 Diagnostic accuracy of clinical examination and MRI in intra-articular knee disorders adapted from Kocher et al 27 Section 3: During maturation, and throughout the onset of puberty, rehabilitation strategies that more closely resemble those used with adult patients are appropriate, due to the increase in androgenic hormones.
However, there are different expectations for progression and time to return to full participation in sport. The type of test and experience of the tester are highly likely to influence the results.
Parents or guardians should be active participants in the daily rehabilitation. Supplementary file 2 [SP2. Guidance for paediatric rehabilitation is extrapolated from clinical experience and research in adults, although it is uncertain whether adult principles apply to children.
To reduce the impact of existing or the risk of further meniscal or chondral pathology, degenerative joint changes and the need for future surgical intervention.
For all patients, rehabilitation progression must be guided by clinical and functional milestones box 2and return to full participation 34 is dependent on successfully achieving the return to sport criteria box 2. Clinicians who do not have access to appropriate strength assessment equipment should consider referring the patient elsewhere for strength evaluation.
Rehabilitation is also an excellent opportunity to train the uninjured leg, which might be important considering the risk of contralateral injury. The goals of treatment for the child with ACL injury are: To minimise the risk of growth arrest and femur and tibia deformity.
Specific clinical and functional milestones should be met before progressing from one phase to the next. There are two treatment options that can help the child with ACL injury with or without associated knee injuries achieve these goals: High-quality rehabilitation High-quality rehabilitation is a critical component in the management of ACL injury, and the principles of rehabilitation are the same, irrespective of whether the child has had an ACL reconstruction or has elected for non-surgical treatment.
To restore a stable, well-functioning knee that enables a healthy, active lifestyle across the lifespan.Approaches to Common Problems In this section you will find an approach to commonly encountered pediatric problems, organised by pediatric subspecialty.
In many cases it is not the final diagnosis but an approach to the presentation at hand which is the most useful to successful diagnoses and managment. Current Research Topics The NYU Pediatric Endocrinology faculty is a distinguished and dedicated group of individuals. They are widely recognized for their excellence and commitment about patient care, scholarship, and teaching.
Relevant consensus statement topic: Paediatric patient-reported outcome measures. is a viable and safe option in skeletally immature patients who do not have associated injuries or major instability problems.’ future research. Management of paediatric ACL injuries is strongly debated. Reflecting some of the concern and controversy is.
The AAP addresses important questions regarding pediatric practice and the health and well being of children by developing original research including practice-based network research.
Problem statement. Research question-specific questions to answer in addressing the research problem. Statement of purpose-summary of the overall goal.
II. Where to find a problem – Research Problems – Chapter 6 Notes. Paediatric Research Statement Problems `The Research Problem, Purpose and Question Definition of a Research Problem A situation in need of a solution, improvement, or alteration; or a discrepancy between the way things are and the way they ought to be.Download