Guidance for paediatric physiotherapists managing children with acquired brain injury

Children and young people that sustain an acquired brain injury (ABI) represent a complex and heterogeneous patient population(1). Physiotherapy is considered to be a mainstay of neurorehabilitation for this patient group, commencing in the acute setting, continuing through to return home and participation within the community(2). To date, no guidance has been published which is specifically designed for physiotherapists working with children and young people following ABI. Given the Association of Chartered Physiotherapists’ (APCP) recent online publication of other guidance documents, namely guidance for managing neuromuscular disorders(3) and childhood onset spinal cord injuries(4) (available online via the APCP website), it was felt that a subgroup of the APCP’s neuro-disability group would be well placed to develop a guidance document for childhood ABI.

The sub-group of the neuro-disability group consist of four paediatric physiotherapists all specialising in neurorehabilitation. We are currently in the process of developing an evidence-based guidance document for paediatric physiotherapists working with children and young people with ABI. The guidance will be divided into a range of sections (see below for more details) and will contain information targeted at both the foundation level (band 5-6) as well as the advanced level (experienced band 6 and above) physiotherapists in keeping with other guidance documents(3,4).

 The comprehensive guidance document has been designed to provide an introduction to ABI, prior to focusing on individual sections in greater detail. These sections include intervention within intensive care; rehabilitation in the acute setting; transition from hospital to home; and proactive community-based rehabilitation. There is also a section for special considerations which includes areas such as unrecognised and mild traumatic brain injury, brain tumours and epilepsy surgery.

 Due to the comprehensiveness of the guidance document, it was felt necessary to seek peer-review from a range of physiotherapists also specialising in this field.  The initial peer-review process was completed in June 2018 which offered a range of useful perspectives and insights.

 On the whole, the peer-review process demonstrated that the guidance document includes an appropriate range of information, it is deemed suitable to divide the document into foundation and advanced level content and it is anticipated to be a useful resource for physiotherapists working clinically. Suggestions have been fed back and these were gratefully received, these will now be incorporated into the final document.

 Overall, neurorehabilitation following childhood ABI is a complex and multi-faceted clinical area with physiotherapy intervention being crucial throughout the patient journey. With the development of this guidance document, the APCP Neuro-disability group hopes to make current evidence and best practice accessible to all physiotherapists working with children and young people with ABI.  

 

References

  1. McKinlay A, Linden M, DePompei R Aaro Jonsson C, Anderson V, Braga L, Castelli E, de Koning P, Hawley CA, Hermans E, Kristiansen I, Madden A, Rumney P, Savage R and Wicks B. Service provision for children and young people with acquired brain injury: Practice recommendations. Brain Injury, 2016: 30(13-14): 1656-1664.
  2. 2013/14 NHS standard contract for paediatric neurosciences: neurorehabilitation
  3. Guidance for Paediatric Physiotherapists Managing Neuromuscular Disorders
  4. Guidance for Paediatric Physiotherapists – Managing Childhood Onset Spinal Cord Injuries

Alison Fletcher, Claire Tripathi, Elizabeth Wright and David Young - a subgroup of the APCP Neuro-Disability Special Committee