Position statement - medical interventions - plain english

Responding to Medical Interventions
After surgery or BOTOX® injections it is important to have therapy. At Cerebral Palsy Alliance our physiotherapists (PT) and occupational therapists (OT) will work with clients and families before and after treatment. In order to get a good result Cerebral Palsy Alliance will work with families and hospitals before surgery or BOTOX® injections happen. We cannot provide therapy
if we have not been involved in planning. Ongoing research means that medical treatments for people with cerebral palsy have improved. People with cerebral palsy now have access to a range of different procedures that may assist them. However, the increase in the range of treatments available has not been matched by an increase in funding to support therapy after medical interventions. This means it is very important for our staff at Cerebral Palsy Alliance to be involved as early as possible in planning for medical interventions. This helps us to provide appropriate support for an individual and their family. There are 4 major medical treatments that we can support you with: 2. Single Event Multi Level Surgery (SEMLS) Responding to Medical Interventions
1. BOTOX® Injections
A child or adult with cerebral palsy may have BOTOX® for different reasons. Mostly it will be to relax a muscle that is very tight. Relaxing a muscle can help a person use that part of their body more effectively. This can help the person achieve a functional goal that is important to them. After BOTOX® has been injected into a muscle therapy may be required to stretch and/or strengthen that muscle.  Using a splint  Using a cast  Following an exercise program We believe therapy after BOTOX® is a high priority and children who need therapy will often be ‘red flagged’. This means they will be seen as a priority and should not have to wait to be seen. However, it is important to remember that the sooner we are involved in planning for BOTOX®, the better we can plan our support to you. Research shows that the most effective therapy after BOTOX® involves structured activities around functional goals. Experts all over the world agreed on this. But there is not a lot of information on how much therapy should occur after BOTOX®. Our staff continue to be involved in research to identify the most effective level of therapy support. Therapy after BOTOX® is not as common for adults with cerebral palsy as it is for children. But as there are more requests for this treatment, this may change. Therapy after BOTOX® will only be offered by Cerebral Palsy Alliance
if we are involved in planning with the family and hospital team
before the treatment.
Responding to Medical Interventions
Before BOTOX® the client / family will:  Contact Cerebral Palsy Alliance as soon as they know they are going to have BOTOX®  Attend an appointment at the hospital  Hear why BOTOX® and therapy need to happen together  Talk about the aims of therapy  Have an assessment with staff at the hospital and Cerebral Palsy Alliance  Complete any necessary paperwork After BOTOX® staff at Cerebral Palsy Alliance will:  Make a time to provide a follow up assessment  Provide therapy sessions (usually a maximum of 4)  Decide with the client / family how and where therapy will be provided  Talk to staff at the hospital about an individual’s progress 2. Single Event Multi Level Surgery (SEMLS)
Single Event Multi Level Surgery (SEMLS) means that a selection of muscles and bones are operated on at one time. SEMLS is the best way to help children and young people with cerebral palsy correct deformities.  Improve or maintain mobility  Reduce  Help a child spend less time in hospital Therapy after SEMLS is very important. Cerebral Palsy Alliance does provide therapy. It can take up to 2 years to recover from SEMLS. Current research shows that regular physiotherapy and hydrotherapy leads to positive results. Therapy after SEMLS will only be offered by Cerebral Palsy Alliance
if we are involved in planning with the family and hospital team
before surgery.
Responding to Medical Interventions
 A physiotherapist from Cerebral Palsy Alliance will plan with the family  A physiotherapist and occupational therapist from Cerebral Palsy Alliance will visit home to find out about equipment that may be needed o The hospital will only provide the equipment needed straight after  Staff from Cerebral Palsy Alliance may visit the school once if needed o There is standard letter that can be filled out for parents to give to the After SEMLS Cerebral Palsy Alliance will:  Arrange a home visit  Provide physiotherapy for up to 6 months  Offer a gym group (weekly) or physiotherapy (fortnightly) for 6 – 12 months  Offer weekly hydrotherapy (where available)  Offer psychology support if it is needed (where available) 3. Intrathecal Baclofen Pumps (IBP)
A small number of people with cerebral palsy will have an Intrathecal Baclofen Pump. This means that a small pump is placed under the skin to help the muscles relax. In the future it is thought that more people with cerebral palsy will have this type of pump. Therapy after Baclofen Pump Surgery will only be offered by Cerebral Palsy
Alliance if we are involved in planning with the family and the hospital team
before surgery.
Responding to Medical Interventions
 A therapist from Cerebral Palsy Alliance will plan with the team at the hospital  A therapist from Cerebral Palsy Alliance will write a report  A therapist from Cerebral Palsy Alliance will give feedback to the hospital about how  If asked, a therapist from Cerebral Palsy Alliance will contact the school and give 4. Selective Dorsal Rhizotomy (SDR)
A small number of children with cerebral palsy between the ages of 3 – 7 years will have a Selective Dorsal Rhizotomy. This means that nerves in the spinal cord are cut in order to reduce spasticity in muscles of the legs. This type of surgery is very intense and involves a lot of therapy. Therapy after SDR will only be offered by Cerebral Palsy Alliance if we are
involved in planning with the family and hospital team
before surgery.
Responding to Medical Interventions
 A physiotherapist and occupational therapist from Cerebral Palsy Alliance will plan with the family and the team at the hospital  A therapist from Cerebral Palsy Alliance will arrange a home visit and develop  Physiotherapy will be offered weekly for a period of at least 6 months  Hydrotherapy will be offered weekly for a period of 6 months  A therapist from Cerebral Palsy Alliance will organise equipment for possible  Every 2-3 months a therapist from Cerebral Palsy Alliance will do a home visit to  Group physiotherapy will be offered after 6 months of individual therapy and  If asked, therapists from Cerebral Palsy Alliance will visit the preschool or school

Source: http://img.cerebralpalsy.org.au/__data/assets/pdf_file/0011/3602/Position_Statement_Medical_Interventions_Plain_English.pdf