Clinical growth was experienced this year especially in outpatient clinics and in particular in interdisciplinary collaborations. 52% of the outpatient activity of the division occurred in the Pediatric Rehabilitation Clinics and 48% was provided in the clinics of other divisions. Rehabilitation services are provided in the Muscular Dystrophy Association (Drs. McMahon & Michaud, Co-Directors) and Stroke Clinics (Dr. Vargus-Adams) in Neurology, in the Cerebral Palsy (Dr. Vargus-Adams) and Myelomeningocele (Dr. McMahon) Clinics in Developmental Disabilities, in the Brachial Plexus (Dr. Michaud, Co-Director) and Limb Reconstruction (Dr. Michaud) Clinics in Orthopaedics, and in the Wheelchair and Adaptive Seating Evaluation Clinic (Drs. Michaud, McMahon) in the Dept. of Occupational & Physical Therapy. Consultations are also provided as needed for children with disabilities for the International Adoption (Dr. Michaud) and Lysosomal Disorders (Dr. Michaud) Centers. Planning occurred this year to provide rehabilitation services in the future Multidisciplinary Spine Center (Dr. Kinnett) in Orthopaedics and to expand rehabilitation services in the Neuro-oncology Clinic (Dr. Pruitt) in Oncology.
The focus of research in the division is on pediatric traumatic brain injury (TBI). TBI is the #1 cause of acquired disability in childhood. It is the #1 diagnosis resulting in admission for inpatient pediatric rehabilitation in the US and at Cincinnati Children's. Dr. Wade is currently involved in 3 federally-funded studies investigating child and family outcomes, parent-child interaction, and models of family intervention following pediatric TBI. The 1st study funded by the NICHD examines the effects of TBI on young children and their families, with emphasis on the relationship between social environmental factors and child recovery and subsequent development. The 2nd study, also funded by NICHD, examined the efficacy of an online family problem-solving intervention to improve caregiver and child function after TBI. With the randomized trial recently concluded, overall findings reflect significantly less distress, depression, and anxiety between baseline and 6-mo. follow-up among parents whose family received the online intervention versus those receiving usual care. The 3rd study, "A Trial of Two Online Interventions for Child Brain Injury", funded by the CDC, compares the successful on-line intervention from the previous study to an online discussion group in a multi-site randomized trial. When completed in Oct. 2006, this project should shed light on the characteristics of families who benefit from each of the interventions. Mary McMahon, MD, is completing a 4-year pilot study funded by NICHD and NINDS that will provide data on appropriate outcome measures of children in a minimally conscious state and on the pharmacokinetics of amantadine in children. Results will be useful in designing future studies of the impact of pharmacologic intervention on neurologic and functional outcomes after pediatric TBI. Together, these projects reflect the division's commitment to research that improves quality of life outcomes for children and their families.
Pediatric PM&R faculty provide training for residents in the largest combined residency program in this subspecialty in the country. We strive to foster future leaders and academicians in this field. This year's graduates were Stacy Suskauer, MD, who entered a research fellowship in brain injury rehabilitation in the Dept. of PM&R at Johns Hopkins University, and Amy Houtrow, MD, MPH, who accepted a position as Assistant Professor in the Dept. of Pediatrics and Medical Director of Pediatric Rehabilitation at the Children's Hospital, University of California at San Francisco. The physician faculty provides a regional course bi-annually in collaboration with faculty in pediatric physiatry from Columbus Children's /OSU and Riley Children's/IU. In May, we offered the 4th Pediatric Rehabilitation Course for residents in PM&R training programs of the University of Cincinnati, Ohio State University, Indiana University, University of Kentucky, and University of Louisville, at Cincinnati Children's.
Professional highlights include 100% faculty presentation at the Annual Assembly of the AAPM&R in Phoenix, Arizona. The number of presentations in pediatric PM&R was higher from Cincinnati Children's than from any other institution and Dr. Wade's study on family intervention after TBI was nominated for best research presented at the meeting. Dr. McMahon is the pediatric representative on the Program Planning Committee for the AAPM&R, Dr. Kinnett is on the Life-Span Care Committee for the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM), and Dr. Vargus-Adams is on the Program Committee for the AACPDM. Dr. McMahon began serving as an Oral Board Examiner for the American Board of PM&R. Dr. Michaud is serving as a member of the Function, Integration and Rehabilitation Sciences Subcommittee for the NIH's National Center for Medical Rehabilitation Research.
