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Orthopaedic Cerebral Palsy

The Orthopaedic Cerebral Palsy clinic cares for children with cerebral palsy and similar neuromotor conditions.
About

About us

The multidisciplinary clinic team at BC Children’s Orthopaedic Cerebral Palsy (CP) Clinic strives to provide excellent care to children with cerebral palsy and similar neuromotor conditions.

With expertise in assessment, surgical management, and post operative care, the Orthopaedic Cerebral Palsy team is dedicated to providing individualized, family centered treatment for each child.

The Orthopaedic CP team is responsible for the assessment and treatment of your child’s bones and muscles. We will look at how your child moves, assess his or her abilities, and work to prevent and treat deformities of the spine and limbs.

We collaborate with your child’s family, the community therapy team, and colleagues at Sunny Hill Health Centre, so we can provide comprehensive, coordinated orthopaedic management to improve the quality of life for children with CP and similar neuromotor conditions.




If your child is having surgery

Please call 604-875-2191 on the last business day before your child's surgery to receive the time of admission.


Richard D. Beauchamp

  • Accept new patients with the diagnosis of CP or CP like conditions
  • Confirm CP diagnosis through history taking, physical examination and conducting and reviewing specific investigations
  • Participate in hip surveillance
  • Refer to the Shriners Gait Lab at SHHCC where a detailed 3D testing will be done.
  • For those patients from a distance from BCCH, I will review submitted gait videos taken by the treating/community therapist and discuss treatment options prior to travelling to Vancouver.
  • With other members of the team , produce a comprehensive treatment plan which could include, continued observation, refer to orthotist for provision of orthosis, recommend other forms of intervention such as Botulinum toxin injections +/- casting, or formal operative intervention.
  • Post operative follow-up in conjunction with the OT, PT and RN in the clinic.


Physiotherapists: Stacey Miller, Kim Hesketh, Maria Juricic

  • Orthopaedic assessments during clinic visits
  • Collaboration with Orthopaedic surgeons
  • Coordinate post-operative care, equipment, therapy etc...
  • In-patient care and mobility post surgery
  • Liaise with community team
  • Resource to patients, families, and community therapists
  • Advocacy
  • Research


Occupational Therapist: Daphne O'Young

  • Orthopaedic upper extremity ROM assessment/review during clinic visits.
  • Upper extremity functional assessment pre- and post- surgical or Botox intervention (completed in the OT department). Standardized assessments may include video analysis for children with hemiplegia affecting their upper extremity (Assisting Hand Assessment or Shriner’s Hospital Upper Extremity Evaluation).
  • Provision of a home exercise program including stretches and strengthening ex’s for the upper extremity.
  • Post-Botox review at 2 weeks and 3 months to determine effectiveness and plan for future interventions as needed.
  • Upper and lower extremity splinting (signed Dr’s referral required).
  • Referrals and liaising with community teams or private therapists.
  • Collaboration with Orthopaedic surgeons.
  • Coordinate post-operative care, equipment, therapy etc...
  • In-patient care and mobility post surgery (inpatient OT is Mary Glasgow Brown)
  • Resource to patients, families, and community therapists.
  • Advocacy
  • Research


Nurse Clinician: Wendy Krishnaswamy 

  • Develop and assist interdisciplinary team in planning & development of pre & post operative care and treatment plans for children & adolescents in this specialty area
  • Utilize clinical nursing skills to assess, plan, implement and evaluate patient care for patients in the specialty area
  • Collaborate with Orthopedic Surgeons & interdisciplinary team
  • Assist in the coordination of resources required for orthopedic patients pre-operatively, intra-operatively and post operatively.
  • Collaborate and communicate with other health care professionals and service providers to ensure optimal patient care
  • Provide education and information for families & health professionals as required in the outpatient and inpatient clinical areas.
  • Liaison with various in-hospitals resources, services; community resources such as the Ministry for Children & Family Development, other hospitals, etc.
  • Assist with development of educational materials for the specialty area
  • Assist families with accessing in-hospital and community resources
  • Facilitate learning opportunities in the outpatient specialty area for nursing students and nurses who are members of the hospital Nursing Resource Team and who are currently working in the surgical area.
  • Provide support & advocacy
  • Research



 

Orthopaedic surgeons

Kishore Mulpuri, 
MBBS, MS (Ortho), MHSc (Epi)
Executive Assistant: Jennifer Farr
Office: 604 875 2054

Richard D. Beauchamp
MD, FRCSC 
Executive Assistant: Judy Woodward 
Office: 604 875 2627

Christine M. Alvarez,
MD, FRCSC
Executive Assistant: Marilynn Timbrell
Office: 604 875 2178

Jeffrey Pike, 
MD, MPH, FRCSC
Executive Assistant: Vera Menzies 
Office: 604 632 0008

Therapists

Stacey Miller, MRSc, BSc (PT, Chem) 
Physiotherapist
604 875 2345 ext 4099
smiller4@cw.bc.ca

Kim Hesketh, MSc(PT), BKIH
Physiotherapist
604 875 2345 ext 7267 
khesketh@cw.bc.ca

Daphne O’Young, BSc (OT)
Occupational Therapist
604-875-2345 ext 5443 
doyoung@cw.bc.ca

Maria Juricic, BScPT
Physiotherapist
604 875 2345 ext 7274
mjuricic@cw.bc.ca


Nurse clinician

Wendy Krishnaswamy RN, BScN 
Orthopaedic Nurse Clinician
604 875 2345 ext 4942 
wkrishnaswamy@cw.bc.ca

Orthopaedic technologists

Fidel Brooks
Ricardo Botia
 
Prepare

To prepare your child for hip surgery, be an active member of your health care team. Ask questions and keep asking until you feel completely prepared for your child’s surgery and recovery.

Take a virtual tour of surgery 

Take a BCCH Surgical Virtual Tour to learn all about what will happen on the day or surgery.

Inform your community team

It is important to keep your team of community therapists aware of any treatment plans. They are a critical resource to helping you plan for the surgery. They may be able to help you set up your home and obtain equipment. The Orthopaedic CP physiotherapist and occupational therapist at BC Children’s Hospital will also contact them with your permission.

After surgery, keep your child’s community physiotherapist and occupational therapists updated on your child’s progress after the operation. Ensure they are aware of when your child will be discharged from hospital to home.

Plan ahead

Plan ahead for Equipment and Transportation Needs


Discuss Wheelchair Adjustments with Your Therapists

If your child did not use a wheelchair before the hip surgery, you will need to get a wheelchair on loan. If your child already has a wheelchair, it will likely need adjustments. We try our best to predict what type of cast your child will have but we don’t always know. It is best to be prepared for both types of casts, a petrie or hip spica. A wheelchair should:

  • be able to recline, almost fully
  • have elevating leg rests
  • be wide enough to fit the cast.

Please discuss your child’s wheelchair needs with the BC Children’s Orthopaedic CP physiotherapist or occupational therapist. They will work with your community team and seating therapist to assist you in finding an appropriate chair. 

Discuss New Ways to Transfer Your Child In and Out of His or Her Wheelchair

The way that your child moves from bed to wheelchair may need to change. If your child stood to transfer, they will now need to be lifted. If you lifted your child into their wheelchair, the cast may change how you are able to lift. 

The cast can be heavy and bulky. Small children can be lifted by scooping under their bottom and back. Children that are bigger may need to be transferred by two people. It may be necessary to use a mechanical lift if your child is too big to lift. Discuss transfers with your community therapists. 

After surgery, the BC Children’s CP Orthopaedic physiotherapist and occupational therapist on the inpatient ward will show you how to set up the wheelchair and perform the transfer that most suits you and your child.

Adjust Your Child’s Clothing

Tear away pants work well. For girls, dresses are perfect. You may need to buy clothes in a larger size to fit the cast. Because this is for the short term, you may want to look for some clothing in a thrift shop until the cast comes off. You can adapt pants, shorts, and underwear by splitting the side seams and adding VelcroTM to fasten the sides. If you have any questions, please discuss this with the Orthopaedic CP Clinic occupational therapist. 

Set Up Your Home

You may need additional equipment to help you care for your child.

  • Consider how you will toilet your child. A commode, bed pan, or urinal may be helpful.

  • If your child’s bedroom is upstairs, consider temporarily relocating their bed to the main floor.

  • The cast may not allow your child to sleep in their usual position. Consider whether your child’s bed will work if they have a cast. Discuss sleeping positions with your therapists.

Plan Your Transportation to and from BC Children’s

a) Getting to and from BCCH: 

  • The BC Children’s Family Resource and Support Centre has put together a document about "Getting to and from BCCH".

  • If you are coming from North BC or the East Kootnays Friends of Children may be able to help with transportation and/or lodging costs.

b) Transportation After Surgery:

The cast may change how your child will be transported in a vehicle. Safe transportation is possible with different equipment.

  • If your child will be riding in a van and there is room for a wheelchair and your child’s cast, it may be possible for your child to ride in the van in his or her wheelchair using tie downs for your child’s wheelchair.

  • Detailed information on car seats that will accommodate a hip spica or petrie cast is available in the information pamphlet “Hip Spica Body Cast: Introduction to the Hip Spica Body Cast”.

  • An E-Z On Modified VestTM allows a child to lie flat in the back seat of a vehicle. Please ask the Orthopedic CP team where these are available.

 
Gillette Children’s Specialty Health Care 2010


If the above equipment will not work for your child and vehicle, please discuss the following options with your child’s Orthopaedic CP team.

  • Handi-Dart provides transportation for persons with temporary or permanent physical or cognitive disabilities that are sufficiently severe that they cannot, without assistance, use conventional transportation services. Applications should be submitted several weeks before surgery to allow processing time. You will need a member of the Orthopaedic CP team to fill out the verification section of the application.

  • It may be necessary for your child to be transferred by ambulance. If this is required the Orthopaedic CP Team and the ward nurses will assist you with planning this.

4. Prepare for Going Home

Plan to Take Time Off Work and Ask Family and Friends for Help

Your child will require extra care during the period of time after the surgery. Think about how much time you will need off work. Ask your family members and friends to help if possible.

Develop a Discharge Plan That Will Work For You

Care of a child in a large cast can be difficult. Consult with your community physiotherapist and occupational therapist to try to find solutions for your concerns. If you still feel you will be unable to care for your child at home, please discuss this with the Orthopaedic team at BC Children’s.

Arrange Post Operative TherapyIt is important to arrange physiotherapy for the time when your child comes out of their casts. Your child will need therapy to help begin range of motion exercises, progress weight bearing, and to ensure they return to their previous activities. This will ensure the best possible outcome from the surgery. The orthopaedic clinic physiotherapist will help arrange services if needed. 

Plan Your Child’s Return to School 

Children can return to school when they’re feeling up to it. You may consider having your child return for a few hours to start. You will need to discuss your child’s additional needs with the staff at the school prior to their returning. If your child is unable to attend school, ask the school principal or counselor to help you arrange home tutoring.

Follow-up

Pamphlets

Scoliosis Surgery  
Caring For Yourself After Surgery To Correct Scoliosis 
Halo Thoracic Brace 
C-Spine Clearance Guidelines 

\There are many questions you might have about what will happen after your child has surgery. Below you can find information on some of the most common questions and concerns. If you have any other questions please discuss them with the Orthopaedic CP team.

How Long Will My Child Be in the Hospital?

For a VDRO and/or pelvic osteotomy most children will stay at BC Children’s Hospital (BCCH) for 5 to 7 days. 

Pain Management Following Orthopaedic Surgery

Pain after surgery is normal. During your child’s hospitalization at Children’s Hospital, the Acute Pain Service team will provide expert pain service to manage your child’s pain problems. Their mission is to “STOP PAIN HURTING”. The Acute Pain Service anaesthetist and nurse clinician are experts in managing pain and will see your child daily while in the hospital. 

This team will work together with your child’s orthopaedic surgeon and the nursing staff to create and optimize a pain management plan to provide as much comfort with minimum risk or side effects. 

The pain-relief medications used are those that are appropriate for the severity of pain your child is experiencing. The Acute Pain Service team will follow your child until your child is comfortable enough to manage with oral medication alone or via a Gastrostomy Tube for those children who receive medications that route.

Resources:


Assessing Your Child’s Pain After Surgery:

Managing your child’s pain is important. Since pain from surgery can be very intense in the beginning, your child will be given stronger pain medicines immediately after the surgery. There will then be a step-down to weaker medicine as recovery and pain relief progress.

Your child’s nurse will regularly ask and assess your child’s pain to find out how well the medicine is working. Parents & caregivers are a critical part in helping the health care team to recognize when your child is in pain. 

Depending on your child’s age and ability, he/she may be able to tell the nurse how much pain he/she is feeling. The nurses in the hospital will use a pain scale asking your child if he hurts a little or a lot.

If your child cannot speak or does not understand about their pain, there are other ways to check pain. To assess pain, your child’s nurse will also watch your child for signs such as crying, moaning, fussing, frowning, playing or sleeping. Watch your child carefully and see what you think. Parents often know if their child has pain or is uncomfortable in any way. It is very important for parents to let their child’s nurse know what their child’s behaviour is like when they are in pain and any other comfort measures that help.

Speak to your child’s nurse if you think your child is in pain!

Muscle Spasms After Orthopedic Surgery:

What is a spasm? It is an uncontrolled, usually fast, muscle jerk that might or might not be visible to others. Spasms are often related to increased pain your child is experiencing.

Muscle spasms can be common after your child’s orthopedic surgery. When muscles are cut or stretched during the surgery, they can react by going into spasm. It is important to know that your child may also receive a medication to help control muscle spasms.

If your child has been taking medicines to manage his/her muscle spasms already before having surgery, the amount (dosage) of the medicine might be increased for a period of time post operatively and when they go home from the hospital.

After the Surgery: Taking Care of Your Child’s Pain at Home 

Some things you should know about your child’s post-operative pain:

  • Children do not all feel pain the same way
  • Your child will likely have pain after his/her surgery.
  • In the days after the surgery, the pain should get better, not worse
  • Pain medicines will help your child hurt less. Always follow the directions given to you by the nurse, doctor, nurse practitioner or pharmacist.
  • Comforting your child will help him/her relax & relieve pain.
  • Distracting your child can also help relieve pain.
  • Comfort & distractions can be as important as giving medicine to your child.
  • Check how much pain your child has 1 hour after you give pain medicine.

The day you go home from the Hospital:

Before you leave the hospital, your child’s nurse, surgeon, doctor or nurse practitioner will tell you how you can help your child when he/she hurts. You may be given a prescription for pain-relief medications and be advised about giving medicines that are available without a prescription for pain relief.

The day he/she goes home, if your child is in pain, you can give him/her some pain relief medicine regularly during the rest of the day, and the next few days too, if needed.

You will help your child to hurt less, by giving pain-relief medicine regularly in the first few days after your child is home.

Tips:

  • Follow the directions of the prescription medication bottle and the non-prescription pain-relief medication bottle/package.
  • Pain after surgery is normal.
  • Do not wait to give pain relief medicine until your child is in a lot of pain.
  • For many children it is good to give pain-relief medicine in the morning to get their day started and at bedtime to help with sleep.
  • Taking pain relief medicine regularly (even at night) is important.
  • Prevention of pain is better than treatment. It is important to give pain medicines regularly.
  • Pain relief medicine works better if your child takes the medicine before the pain gets strong.
  • After the first few days, when your child hurts less, give the medicine only when he needs it. You will know when he/she says it hurts. The way he/she acts may also show you that your child is in pain. Some pain-relief medicines can cause stomach upset. Avoid giving these medicines on an empty stomach.
  • Parents can help make the best pain relief decisions for their own child because they know their children best.

Note: If your child was given medicine to manage “muscle spasms”continue to give the medicine as prescribed by the Orthopedic Surgeon/Doctor.

If your child is still in pain or muscle spasms are getting worse or if you have questions/concerns:

Please call your Doctor, Orthopaedic Surgeon’s office or the Orthopedic Nurse Clinician for advice.

Resources:

There is a Pain Diary: Pain after Orthopedic Surgery available to you for your use. 

What to expect in the following weeks of recovery:

You can expect ups and downs with pain relief. It is common to have times when your child’s pain increases – especially when their activity, home exercise program and physiotherapy increases.

Tips:

  • Some children have discomfort when their casts are removed in the weeks following surgery. It is important to give your child some pain-relief medicine before this procedure.
  • Some children experience anxiety or pain when their position is moved or during any range of motion/home exercise/physiotherapy sessions, especially the first time their legs are moved.
  • Consider giving your child pain-relief medicine 30 minutes to 1 hour before a therapy/exercise session is planned to improve comfort. 
     

Will My Child Have A Cast?

Yes, most children will return from the operating room in a cast. The type of cast will depend on the surgery.

Cast

Other Positioning Support

Type of Surgery

Petrie Cast

Spica Cast

Abduction Splint

Abduction Pillow

Adductor Lengthening

 

VDRO

 

 

VDRO + PO

 

 

Hanging Hip

 

 

Femoral Head Resection

 

 

Femoral Head Resection and Valgus Osteotomy

 

 

 

Petrie (or Broomstick) Cast

Most children who have a VDRO and adductor muscle lengthening will have this type of cast. This cast starts up at the groin and goes all the way to the ankles. The legs are positioned out straight and are spread wide apart. They are kept apart by putting a wooden bar between the two casted legs. 

Sometimes this type of cast is used for children who have had both a VDRO and pelvic osteotomy. If this is true, the doctor may limit the amount your child is allowed to flex their hip for a few weeks after the surgery. This means that your child may not be able to sit up all the way. This will be reviewed with you once your child is on the hospital unit after surgery.

 

Hip Spica Cast

If you child has both a VDRO and pelvic osteotomy, he or she may have a hip spica cast. This is a body cast that starts around the nipple line and covers all or part of your child’s legs. It does not allow the body to flex at the hips and your child will not be able to sit upright in this cast. Your child will be lying nearly flat. . The surgeon will choose this type of cast because it is more stable and provides more protection by limiting all movements at the hip. 

Detailed information on caring for your child in this type of cast is available in the information pamphlet “Hip Spica Body Cast: Introduction to the Hip Spica Body Cast”. 

 

If a cast is not required, your child may need alternative positioning devices such as an Abduction Splint or Abduction Pillow.

If your child uses ankle foot orthotics (AFOs), the occupational therapist may mold resting foot splints that fit over top of the cast to keep your child’s feet in a good position.

How Can We Prevent Pressure Sores?

While your child is in a cast or splint it is very important to watch their skin. Children in casts and splints are at risk for pressure sores.

For detailed information about what a pressure sore is, why and where they happen, and how to prevent them please read the The Added Pressure of Surgery: Preventing Pressure Sores After Your Child’s Surgery 
 

How Long Will the Cast be on?

The Petrie or Hip Spica cast will be left on for 3 to 6 weeks. The length of time in the cast will depend on the type of operation and the amount of healing seen on x-ray.

What Happens After the Cast Comes Off?

Once the cast is taken off, positioning is important as the bones and muscles continue to heal. The occupational therapist may make an Abduction Splint. This is a splint that is custom made for your child. It holds the legs wide apart, similar to the Petrie cast. The splint may be required all the time for a few more weeks or just at night time. Or your child may be given a special pillow, called an Abduction Wedge, which straps to their legs and keeps the legs wide apart, to use at night time


Abduction Splint

When the cast comes off, your child will be able to move more and sometimes this will hurt. This is not unusual and should decrease within a few weeks. In order to help minimize discomfort you should bring some pain medication to the clinic on the day the cast is being removed.

Do not force any movements when moving your child’s hip. This may damage the plate and screw fixation in your child’s hip. This is especially true in children who are not able to walk because their bones are not as strong. 

After the cast comes off, your child can typically return to their usual wheelchair seating. It is recommended that the wheelchair have a wide pommel or another method of keeping the legs separated. 

After the surgery, you may notice that the leg on the side of your child’s surgery is shorter. This happens because the head of the femur (ball) was tipped down into the socket. This leg length will not get worse over time and the growth of the leg will not be affected. 

When Can My Child Stand or Walk?

If your child is having a VDRO or PO, he or she will not be allowed to stand or put any weight on their legs for several weeks. When your child can begin to stand will depend on how quickly their bones heal. This is different for each child. Your child will usually allowed to begin putting some weight on their legs at 6 weeks. The pool is a great place to gradually begin weight bearing. Full weight bearing may not be allowed until up to 3 months after surgery. X-rays will be used to determine when your child is ready to stand. If your child’s surgery is a soft tissue procedures, such as an adductor lengthening, there are no weight bearing restrictions.

What Will It Be Like at Home? 

Your child’s physiotherapist and occupational therapist on the hospital unit will review what your child can and cannot do after surgery. They will show you how to move your child in the cast and teach you how to position your child so they are comfortable. The nursing staff will review how to perform personal care while your child is in the cast and how to care for the cast. 

How Long Is the Recovery Period?

Each child has different abilities and, therefore, recovery will also differ for each child. We expect it will take your child at least 6 months to return to the same level of functioning as before the surgery. It may take up to a year to regain full strength and mobility. Physiotherapy is important during this time period. 

What Follow Up is Required? 

Your child requires continued monitoring of their hip development after the surgery. As your child grows, there is a risk that the problem will occur again. Therefore, it is very important that you return to the Orthopaedic Clinic for follow up visits. 
If you child had plates or screws placed in their hips these may be taken out 1 year after their first surgery. This will be done during another surgery. Your child will stay in the hospital for 1-2 nights and they may not be able to stand or put weight through their legs for 2 weeks. There is no casting or splinting required when plates and screws are removed.

Tab Heading

If your child is having surgery

Please call 604-875-2191 on the last business day before your child's surgery to receive the time of admission. 

Please see the Hip Diplacement Surgery section and the Lower Extremity Surgery section for information about the types of surgery performed, as well as how to prepare and follow-up. 

About us

The multidisciplinary clinic team at BC Children’s Orthopaedic Cerebral Palsy (CP) Clinic strives to provide excellent care to children with cerebral palsy and similar neuromotor conditions.

With expertise in assessment, surgical management, and post operative care, the Orthopaedic Cerebral Palsy team is dedicated to providing individualized, family centered treatment for each child.

The Orthopaedic CP team is responsible for the assessment and treatment of your child’s bones and muscles. We will look at how your child moves, assess his or her abilities, and work to prevent and treat deformities of the spine and limbs.

We collaborate with you, your child’s community therapy team, and colleagues at Sunny Hill Health Centre, so we can provide comprehensive, coordinated orthopaedic management to improve the quality of life for children with CP and similar neuromotor conditions.


 

Orthopaedic Surgeons

Kishore Mulpuri
MBBS, MS (Ortho), MHSc (Epi)
Executive Assistant: Jennifer Farr
Office: 604 875 2054

Lise Leveille
MD, FRCSC 
Executive Assistant: Melissa Hart
Office: 604 875 2627

Christine M. Alvarez
MD, FRCSC
Executive Assistant: Marilynn Timbrell
Office: 604 875 2178

Jeffrey Pike 
MD, MPH, FRCSC
Executive Assistant: Vera Menzies 
Office: 604 632 0008

Therapists
Stacey Miller, MRSc, BSc (PT, Chem) 
Coordinator, Child Health BC Hip Surveillance Program for Children with Cerebral Palsy
604 875 2345 ext 4099
smiller4@cw.bc.ca or hips@cw.bc.ca

Tanya St John, MSc PT
Physiotherapist
604 875 2345 ext 7267 
tstjohn@cw.bc.ca

Maria Juricic, BScPT
Physiotherapist
604 875 2345 ext 7274
mjuricic@cw.bc.ca

Daphne O’Young, BSc (OT)
Occupational Therapist
604-875-2345 ext 5443 
doyoung@cw.bc.ca

Nurse Clinician
Wendy Krishnaswamy RN, BScN 
Orthopaedic Nurse Clinician
604 875 2345 ext 4942 
wkrishnaswamy@cw.bc.ca

Orthopaedic Technologists
Fidel Brooks
Ricardo Botia

 

Orthopaedic Surgeons

  • Accept new patients with the diagnosis of CP or CP like conditions
  • Confirm diagnosis of CP through history taking, physical examination and conducting and reviewing specific investigations
  • Together with other members of the team, produce a comprehensive treatment plan which may include
    • Continued observation
    • Recommendations for bracing (orthotics)
    • Recommendations for interventions such as botulinum toxin injections, serial casting, or surgical intervention involving the bones and muscles
  • Surgery for bones and muscles
  • Post operative follow-up in conjunction with the OT, PT and RN in the clinic.
  • Participate in hip surveillance
  • Refer to the Shriners Gait Lab at SHHCC where a detailed 3D testing of how a child walks will be done.
  • Refer to other specialists when necessary 
  • Research

Physiotherapists

  • Orthopaedic assessments during clinic visits
  • Collaboration with Orthopaedic surgeons on treatment recommendations
  • Coordinate post-operative care, equipment, and therapy
  • In-patient care and mobility post surgery
  • Liaise with community team
  • Act as a resource to patients, families, and community therapists
  • Advocacy
  • Research

Occupational Therapist

  • Orthopaedic upper extremity ROM assessment/review during clinic visits
  • Upper extremity functional assessment pre- and post- surgical or Botox intervention (completed in the OT department)
  • Creation of a home exercise program including stretches and strengthening exercises for the upper extremity
  • Upper and lower extremity splinting (signed Dr’s referral required)
  • Liaise with community team
  • Coordinate post-operative care, equipment, and therapy 
  • Act as a resource to patients, families, and community therapists
  • Advocacy
  • Research

Nurse Clinician

  • Utilize clinical nursing skills to assess, plan, implement and evaluate patient care
  • Collaborate with Orthopedic Surgeons & interdisciplinary team
  • Assist in the coordination of resources required for orthopedic patients pre-operatively, intra-operatively and post operatively
  • Provide education and information for families & health professionals as required in the outpatient and inpatient clinical areas
  • Liaison with various in-hospitals services, community resources such as the Ministry for Children & Family Development, and other hospitals
  • Assist families with accessing in-hospital and community resources
  • Provide support & advocacy
  • Research
 
SOURCE: Orthopaedic Cerebral Palsy ( )
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