Rheumatology

Occupational and Physical Therapy Services in the Rheumatology Clinic

Occupational and physical therapists are part of the interdisciplinary health care team that manages the care of patients seen in the Rheumatology Clinic at Cincinnati Children's Hospital Medical Center. The focus of therapy is to maintain or restore the ability to function in your daily environment.

Therapists assist patients and their families with decreasing the affects of their condition on their physical function. Occupational and physical therapists:

Evaluate the individual
Develop a home exercise program
Provide patient and family education regarding the daily management of their condition with regard to achieving the highest possible level of physical activity

How are occupational and physical therapy different?

Occupational therapists focus on the fingers, hands, wrists, elbows, shoulders and neck. They look at how you use these body parts in daily activities such as handwriting, getting dressed and washing your hair, carrying items and playing sports.

Physical Therapists focus on the feet, ankles, knees, hips, back and neck. They look at how you use these body parts for activities such as walking, playing or participating in sports. They also help you with good posture while sitting at the computer and doing daily activities.

How often would I have to come for therapy visits?

Most therapy visits in the Rheumatology clinic occur on the same day as the visit to the physician. Therapy is family-centered, focusing on teaching patients and families how to perform the exercises, adjust activities and how to reduce pain. At each visit the current physical condition and functional status of the patient are assessed and home exercise programs are modified as needed. There are times when more frequent occpational or physical therapy visits are needed due to specific issues that require more frequent therapy management.

What types of conditions do the therapists in the Rheumatology Clinic work with and how might they help?

Juvenile arthritis: Therapists teach exercises to restore full movement to joints, keep muscles strong and keep the patient moving as much as possible. They teach you how to protect your joints while doing activities. They may provide splints or casts for extra support for short periods of time. Suggestions are also given for the family to share with school staff about helping the child function best at school.
Dermatomyositis: Therapists teach exercises and positioning to prevent affected muscles from becoming very tight. Once the muscles are not as sore, the therapists will begin to work on helping the child strengthen muscles that have become weak.
Scleroderma: Therapists teach stretching and positioning to prevent tightness and loss of movement. They may offer suggestions that are needed to maintain good posture.
Lupus: Therapists teach exercises for joints if they are affected by arthritis. They may also provide ideas for changing activities to help with fatigue or to help with overall physical fitness.
Fibromyalgia: Therapists offer suggestions to adjust current activity level, diet and sleep patterns to decrease pain and increase your ability to participate in daily activities.
Joint Hypermobility Syndromes: Therapists work extensively with these disorders, teaching patients how to protect their loose joints by adjusting their posture and positioning while doing physical activities. Strengthening exercises are gradually increased to allow the muscles to learn to support the joints in better positions. Supportive splints for fingers or shoe inserts for feet may also be provided to help keep loose joints in better positions.
Myofascial Pain: Therapists teach muscle stretches, pain relief techniques and improved posture to these patients. They offer guidelines for increasing activity levels. In some cases, they may provide specific muscle relaxation techniques.
Complex Regional Pain Syndromes: After medical diagnosis, the main treatment of these disorders is therapy. Therapists teach patients techniques that help decrease pain, increase movement and return to normal activities.
Biomechanical Inbalances: Therapists teach muscle stretching and strengthening and adjustments to posture. In some cases shoe inserts or other types of supports are provided.

Are there some special treatments that might require more frequent visits?

Some types of therapy treatment do require more frequent visits to see the physical or occupational therapists. These treatments may include serial casting to help improve:

The position of a tight joint
Splinting adjustments
Myofascial (muscle) techniques
Iontophoresis

When the family lives very far from the medical center, every attempt is made to work with therapy providers in your local area to receive therapy treatments that require frequent visits. The therapists in the clinic would still see you occasionally along with the rheumatology doctor to help plan your overall treatment.