Teen Hematology and Gynecology Program

Through its Teen Hematology and Gynecology program, Children's treats the following conditions:

The aquatic therapy program is available to patients from infancy to young adulthood. The patients served are variable and include children with musculoskeletal disease or injury, neuromuscular disease or injury, connective tissue disease, pain syndromes, developmental delay, gait disturbance, profound weakness, hemophilia, and oncology diagnoses. The aquatic therapy program is available at both the Minneapolis and St. Paul campuses.

The program in St. Paul is unique, relative to the pool available. The pool features a variable speed treadmill, adjustable floor depth, resistive jets, underwater video cameras with live video display and water temperature maintained at 92 degrees. This allows for functional treatment that can be individually tailored to the height and ability of the patient, allows for gait analysis and training, controlled resistive turbulence and provides video feedback during session.

All aquatic sessions are one-to-one and allow for caregiver presence in water to assist in the development of aquatic home program. All therapists have pediatric expertise with additional competencies in aquatic therapy. Their goal is to make the aquatic experience as positive and enjoyable as possible for each child and family.

191450-1

Many walking and leg pain issues in children are related to ankle range-of-motion limitations. These range-of-motion limitations cause pain, abnormal walking patterns, fatigue, muscle cramps and damage to other joints.

The serial casting program at Children's Hospitals and Clinics of Minnesota is designed to address the need to improve ankle flexibility. The goal of serial casting is to increase the length of the calf muscles through growth, not through stretching. Fiberglass casts are applied weekly at slight tension. They cause no pain, and can appropriately lengthen tight muscles while preserving the muscle's strength potential.

Our program is unique among casting programs because it does not depend on a prior injection of Botox and because casts are applied by a physical therapist. We have a 93% success rate in attaining the target range of motion.

Serial casting has been used successfully to treat:

  • toe walking
  • contractures due to cerebral palsy and other neurological problems
  • limitations from peripheral neuropathy due to treatment for childhood cancers
  • foot and ankle pain
  • lower leg trauma

The post-casting program involves wearing foot orthotics to assist with maintaining the range of motion and physical therapy to help develop a good walking pattern. A child's primary physician can refer for services. A course of serial casting typically lasts between 6 and 10 weeks. During that time there is no limitation on the physical activities of the child except that the casts cannot get wet.

Serial casting is offered at three sites: Minneapolis, St. Paul, and Minnetonka.

Children's Hospitals & Clinics of Minnesota offers Pediatric Constraint Induced Movement Therapy (PCIMT). Constraint Induced Movement Therapy is a program to improve movement and strength in a child who has weakness on one side of the body.

A constraint (cast or splint) is applied to the stronger arm and hand to limit movement for four weeks. This encourages more movement of the weaker arm and hand. The child then participates in six hours of therapeutic training and re-education for 21 days over the course of the four weeks.

Children's offers a full program and a modified program. Both methods have led to reports of improved movement in children with hemiplegia. Many of the research studies have used different tools to measure the amount of change, making it difficult for us to accurately compare the methods.

The modified program requires less time commitment from families, and therefore, may be more accessible in some cases. The full program provides more therapeutic training and re-education, which have been found beneficial in studies published thus far. In those situations where identical length of treatment was used, the children who received the full program of PCIMT and were able to practice more demonstrated greater change than the children who received a modified program of PCIMT.

Full Program of PCIMT

What is the full program of PCIMT?

The full program of PCIMT consists of 6 hours of therapy each day for 21 days over the course of four weeks. In addition, your child will wear a constraint 24 hours a day for 4 weeks. Treatment goals will be set based on needs identified collaboratively between the family and the therapist. Treatment will be given in a child-friendly environment and consist of a mix of typical daily activities such as getting dressed and eating along with age appropriate gross motor play (crawling, climbing) and fine motor play (picking up toys, manipulating objects). Your child will participate in extensive practice and repetition of movements and problem solving and will receive positive praise and reinforcement of desired movements and skills.

How is my child constrained?

A full-length fiberglass cast will be placed on your child's dominant arm and hand. The cast will have an opening on one side that will allow the staff to remove the cast once per week to check your child's skin and provide an opportunity to stretch and move the arm. Although it is possible for the cast to be easily removed by a parent or the treating therapist, we ask that it be removed for brief periods only by the casting therapist.

Modified program of PCIMT

What is modified CIMT?

The modified program of PCIMT consists of four 1-hour sessions of therapy each week for 4 weeks and 1-2 hours of practice each day at home with a parent or caregiver. Your child will wear a soft splint for constraint 24 hours a day, except for hygiene breaks. Treatment goals will be set based on needs identified collaboratively between the family and the therapist. Treatment will be given in a child-friendly environment and consist of a mix of typical daily activities such as getting dressed and eating along with age-appropriate gross motor play (crawling, climbing) and fine motor play (picking up toys, manipulating objects). Your child will participate in practice and repetition of movements and problem solving and will receive positive praise and reinforcement of desired movements and skills.

How will my child be constrained?

A pre-fabricated wrist and hand splint from Benik will be used. It limits movement in the wrist, hand and fingers of the dominant side. Although it is possible for the splint to be easily removed by a parent or the treating therapist, we ask that it be removed for brief periods only when the child needs to bathe.

Who is eligible for constraint therapy?

In order to participate a child must be one year of age or older and diagnosed with a neuromotor disability that results in one upper extremity being significantly weaker than the other. The child should be medically stable and have no uncontrolled seizures at the time of treatment.

Who do I call if I have questions?

Call Kathy Grinde, PT, at (763)416-8712 to discuss any questions you have regarding our programs.

Information about referrals

All children seen for PCIMT require a physician's order. If you would like your child to be evaluated, we suggest you speak with your primary care physician to discuss if this would be an appropriate treatment for your child.

Who pays for the PCIMT program?

Children's accepts many forms of private insurance, medical assistance and group plans. Because there are many different insurance companies with many different plans, it is your responsibility to understand your child's insurance coverage. We recommend that you call your insurance company to assure coverage.

How do I get an appointment?

Call Kathy Grinde, PT, at (763)416-8712 to coordinate your child's entry into the program.

Learn more at Civitan International Research Center.

Torticollis is a condition involving the neck that is often caused when the sternocleidomastoid (one of two muscles arising from the sternum and inner part of the clavicle, also called SCM) muscle is shorter than normal. This often results in a posture where the head tips toward the side of the short muscle, and rotates toward the opposite side.

Why does my child need to use both sides of her body?

It is very important that your baby be able to look about her environment, be able to turn her head and body both sides, use both hands to play and reach for toys, and use both legs to kick and push. A lack of practice and awareness of one side of the body can lead to neglect of that side and ineffective movement with that side of the body. This in turn can lead to long-term asymmetry in body posture and movement.

Children with torticollis often stay in a preferred posture with their head turned in one direction. They may have difficulty looking at people or toys on one side of their body, have difficulty lifting one arm to reach for toys, and have difficulty maintaining a posture with weight on one side of the body. They frequently need help achieving and playing in a variety of postures.

Physical Therapy

Your physical therapist will give you specific home program activities in addition to these general recommendations. The home program will include:

  • stretches
  • active strengthening exercises
  • developmental activities

How to make an appointment