Stroke is one of the top ten causes of childhood death globally, and more than half of survivors live with lifelong disabilities. A new Australian guideline, the first for stroke rehabilitation in children, recommends a multidisciplinary team of health professionals, including physiotherapists, to guide and support children with stroke and their families.
Australian Physiotherapy Association (APA) member Cate Clancy was one of the physiotherapy contributors to The Subacute Rehabilitation of Childhood Stroke clinical guideline, whose clinical advisory group included physiotherapists, neuropsychologists, speech and occupational therapists, music therapists, education consultants, social workers, clinical psychologists and doctors.
Cate, who works in the Victorian Paediatric Rehabilitation Service at Monash Children’s Hospital, said that the guidelines were important for all hospital and community-based health professionals to ensure best practice care of children with stroke, particularly as the lifelong burden of stroke can be much larger for children than adult sufferers.
“The key difference between stroke rehabilitation in children and adults is that adult rehabilitation focuses on regaining previously held skills while children need to be taught new skills that they didn’t get a chance to develop before their stroke. Physios work closely with them to develop their functional movement skills.”
“Somewhere between 100 and 300 children suffer a stroke each year in Australia, and more than half of those occur in children under the age of five.”
“By providing health practitioners across the country with this best practice guide, children with stroke will have the best possible chance to rehabilitate to their full potential and reduce the longer term physical, emotional and economic effects of their stroke.”
Stroke affects the physical function, communication abilities, learning and social behaviours of sufferers. The earlier rehabilitation commences, the quicker progress towards long term beneficial outcomes can be seen. The guide recommends that rehabilitation treatment be delivered by a team of health practitioners, with physiotherapists playing an integral role in getting children moving, minimising their level of disability and maximising their participation in activities appropriate for their age.
Cate says physios also play a large role in educating families, carers and school staff in how best to support children as they transition from hospital back to home and school.
“Families and carers are critical in supporting children with stroke to help them optimise their recovery and gain maximum independence and participation. Goals for rehabilitation are determined jointly with the child, family and health professionals to identify the next area of progress in physical function, social activities or communication. Parents and carers will ideally be actively involved in therapy sessions to carryover the rehab strategies into the child’s daily life and keep their motivation up for ongoing improvement and recovery.”
The guideline was produced by Murdoch Children’s Research Institute and the Victorian Paediatric Rehabilitation Service, made possible by the Victorian Stroke Clinical Network and endorsed by the Stroke Foundation.
Cate Clancy is available for further comment.
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