Purpose: The physical therapist’s role in treatment of scoliosis is not comprehensively covered in physical therapy school curricula, and advanced CE training is required to develop competence in this area. This abstract describes a model to share knowledge and establish a consultation program within a team of 15 therapists, thereby improving management of scoliosis throughout the outpatient clinic, where over 1500 pediatric clients receive therapy.
Description: At an outpatient pediatric clinic, two physical therapists completed certification training in International Schroth 3-Dimensional Scoliosis Therapy. Our intent for this training was to gain the expertise needed to treat clients with Adolescent Idiopathic Scoliosis (AIS), and indeed in the 18 months following certification the certified therapists treated 13 newly referred clients with AIS. In addition to that outcome, the therapists adapted some of the learned strategies to treatment of scoliosis that occurs with neurological and neuromuscular conditions and used these strategies with 8 clients on their existing caseloads. Clients with neuromuscular scoliosis had primary diagnoses that included Cerebral Palsy, Spinal Muscular Atrophy, Spina Bifida, Developmental Coordination Disorder, and various genetic conditions. The two Schroth-certified therapists provided inservice training on basic positioning, assisted exercises, home programming, bracing and monitoring recommendations to the department of 15 staff. All therapists were then invited to request consultation by a Schroth-certified PT as needed. Over an 18-month time period, 9 of the 13 non-certified PTs requested help with a total of 11 clients with diagnosed scoliosis and 2 clients needing screening for scoliosis. Eleven of the consultations resulted in scoliosis-specific strategies added to therapy sessions, including positioning for improved symmetry, active use of an extremity to reduce ribcage protrusion and/or shift spine toward midline, and appropriate use of support under pelvis or shoe. Ten consultations resulted in changes to client home programs, including side lying positioning on concave side of primary curve, modifications to wheelchair positioning, improved symmetry in desk sitting, and brace wear time recommendations. Five consultations resulted in changes to TLSO recommendations in either structure, wear time, or referral. Twelve parents indicated appreciation of the consultation provided by a colleague of their therapist, and 100% of the staff PTs indicated increased confidence in their ability to manage their clients’ scoliosis.
Summary of Use: The cost of continuing education and certificate trainings is high, and specialty areas within pediatric physical therapy are numerous. Clinics benefit from establishing methods of sharing knowledge and creating consultants among their staff to elevate care for all clients.
Importance to Members: This model demonstrates that all clients receiving services at an outpatient clinic can benefit from the clinic’s investment in training when information is used and shared effectively.
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