LER: Pediatrics – November 2014

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Editor Message

1Limb-Jordana-nolabel

Parents are people too

With so much of healthcare now automated, and so many demands on each practitioner’s time, it’s dangerously easy to lose sight of patients as individuals. Yet often it’s the personal details that can make the difference between a successful outcome and a less successful one.

Knowing a little girl’s preference for twirly skirts, a practitioner can screen for brace components that might be prone to snags. Knowing a little boy’s favorite cartoon character can make possible the creative customization of orthotic devices he is more likely to wear.

For clinicians who treat pediatric patients, it’s also dangerously easy to stop thinking of patients’ parents as individuals. When your focus is on the child—as it should be—it’s understandable to think of his or her parents primarily as a means to an end, specifically a positive clinical outcome. And certainly there are effective strategies for managing parent behaviors in ways that will benefit the child in question (see “Parents: How to make them your clinical allies,” page 9).

But here’s another suggestion. Just as parents would prefer their children not view them as glorified cooks, cleaners, or cash machines, I suspect many parents also would prefer that their children’s practitioners see them as more than a means to an end. Try taking just a few moments out of each visit to talk to the parents about an aspect of their lives that isn’t clinical. It might make them a lot more collaborative.

Just as treating patients as people can motivate them to help themselves, treating parents as individuals with unique challenges can motivate them to help you help their children.

By Jordana Bieze Foster, Editor

News


Rates of chronic ankle instability in children are surprisingly high

Experts push for better sprain rehab – Primary ankle sprains often occur before adulthood, and a recent literature review from Australia suggests that some pediatric populations exhibit a high rate of ankle injury recurrence and chronic ankle instability (CAI).

By P.K. Daniel

Gait compensations vary in kids with limb length discrepancies

Location of shortening is key factor – Contrary to popular perceptions, children with limb length discrepancy (LLD) may each use multiple compensatory strategies when they are walking, depending on where their discrepancy is, and those gait patterns may present a dilemma for practitioners.

By Larry Hand

Below-knee amputation level has subtle functional effects

Syme, transtibial gaits are similar – The relative functional benefits of transtibial and Syme amputations in adults have been discussed in the medical literature, but few studies have addressed similar issues in pediatric patients.

By Hank Black

Features


Parents: How to make them your clinical allies

While the patient is always the practitionerʼs first priority, establishing a convivial relationship with a childʼs parents can mean the difference between victory and failure when it comes to diagnosing, treating, and rehabilitating lower extremity problems in pediatric patients.

By Shalmali Pal

Toe walking researchers revisit idiopathic label

Two recent literature reviews underscore the lack of high-level evidence to support the various treatments available for idiopathic toe walking. But new research is starting to fill that void, and is also engendering new theories about factors that may contribute to the condition.

By Larry Hand