Clinical services
About Clinical services
Children are referred to Physiotherapy at the Royal Children's Hospital with a wide variety of physical problems within three broad clinical areas: musculoskeletal, cardio-respiratory and neurosciences. Therapists in all areas may provide patients and families with home exercise programs and education. They will also liaise with other appropriate health professionals and are likely to be involved in the transition back to home and school.
Musculo-skeletal Team
The Musculoskeletal Team are involved in the assessment and management of a range of orthopaedic conditions including:
Inpatients and Outpatients
- Fractures, soft tissue or sporting injuries.
- Post operative programs following orthopaedic surgery, including Single Event Multi-Level Surgery for children with cerebral palsy.
- Spinal surgery including scoliosis management.
- Complex conditions present from birth or the result of accident, illness or disease.
- Children born with limb deficiencies or following limb amputations.
- Management of juvenile idiopathic arthritis and related conditions.
- Children dealing with chronic pain.
- Treatment of burns including scar management.
- Management of obstetric brachial plexus injuries.
- Assessment and treatment of children with plagiocephaly and/or torticollis.
Outpatient Clinics
Physiotherapists from the Musculoskeletal Team attend the following outpatient clinics:
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Deformational Plagiocephaly Clinic
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Burns Clinic
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Orthopaedic Cerebral Palsy Clinic
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Obstetric Brachial Plexus Palsy (Erb's Palsy) Clinic
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Limb Deficiency Clinic
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Limb Reconstruction Clinic
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Wheelchair Clinic (shared with Neurosciences Team)
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Spina Bifida Clinic
Hydrotherapy
The Royal Children’s Hospital Physiotherapy Department provides a hydrotherapy service which currently takes place at Ascot Vale Leisure Centre. Referrals are currently accepted from within the hospital.
Musculoskeletal Links
Deformational Plagiocephaly - (misshapen head)
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Information for Parents
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Information for Health Care Professionals
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Ordering of brochure 'How to protect the head shape of your baby' - Australian Physiotherapy Association (National Office) ph: (03) 9092 0888Sids and Kids - http://www.sidsandkids.org
Spina Bifida
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Spina Bifida Foundation of Victoria - http://www.sbfv.org.au
Obstetric Brachial Plexus Palsy (Erb's Palsy)
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Information for Parents
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RCH Brachial Plexus Palsy Booklet
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Burns and Physiotherapy
Cerebral Palsy
Limb Deficiency
Limb Reconstruction
General orthopaedic conditions
Cardio-Respiratory Team
The Cardio-respiratory Physiotherapy team comprises of a specialist group of therapists who are skilled to treat patients with cardio-respiratory conditions.
Commonly treated patients include:
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Patients with Cystic Fibrosis.
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Patients with other long term respiratory issues.
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Patients with Neuromuscular conditions including weakness of the respiratory muscles.
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Patients in the Paediatric Intensive Care Unit.
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Patients who have undergone surgery for heart problems or abdominal problems.
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Patient who have undergone a heart, lung, liver or kidney transplant.
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Patients who require equipment to help with their breathing, clearing of secretions or cough.
Patients are most commonly seen when admitted to hospital but are also often seen in the outpatient clinic setting, including the Cystic Fibrosis clinic.
Cardio-Respiratory Links:
Heart Kids - http://www.heartkids.org.au/
Team Life — Transplant
Muscular Dystrophy
Spinal Muscular Atrophy
Neurosciences Team
The Neurosciences Physiotherapy team provides services to the following patient populations:
In-patients:
- Developmental medicine: children with long term complex conditions such as cerebral palsy, who are admitted due to respiratory illness.
- Neonatal Unit: children admitted to the neonatal unit with diagnoses of congenital or acquired brain injury, congenital syndromes or developmental needs, requiring assistance with positioning and range of movement, leading onto actively encouraging growth and skill development.
- Neurology: children admitted with strokes, demyelinating conditions or neuropathology affecting their function, who require input for safety for discharge from a mobility and equipment perspective.
- Neuro—oncology: children with diagnosed brain tumours, who require input for safety for discharge from a mobility and equipment perspective.
- Neurosurgery: children who have an acquired brain injury who require input for safety for discharge from a mobility and equipment perspective.
- General Medicine: children with complex conditions who are admitted with respiratory illness, or children with neurological conditions who are admitted with functional difficulties who require input for safety for discharge from a mobility and equipment perspective.
Outpatients
The Physiotherapy Department is primarily an inpatient service. We provide a limited service to the outpatient population and are involved in the following outpatient clinics.
- Complex Movement Disorders Clinic: a monthly assessment clinic where the Physiotherapist aids in the evaluation of intervention required to implement movement disorders management for dystonia and spasticity. This includes Intrathecal baclofen trials, spasticity management and spasticity surgical options.
- Neurodevelopmental Assessment (Team 1): a weekly specialized clinic for babies and children with complex developmental needs. The physiotherapist is involved in a multidisciplinary clinic that identifies the ongoing therapy and medical needs of the child to promote their development and skill acquisition. These children are then referred to the most appropriate community service.
- Wheelchair clinic: a weekly specialized wheelchair assessment clinic where children from the community attend with their community therapists to confirm prescription and funding of wheelchairs through the Victorian Aids and Equipment program.
- Neurosmuscular Disorders clinic: a weekly multidisciplinary clinic where the physiotherapist is involved with long term monitoring of children with Neuromuscular disorders to ensure access to community therapies and equipment.
- Long term effects clinic: a monthly multidisciplinary clinic where the physiotherapist is involved in long term monitoring of children with previous Neuro-oncology issues to identify any functional issues over time, or to help identify new issues, and ensure access to community therapies and equipment.
Early Intervention Outpatients
Children under the age of five should be referred in the first instance to a local community Early Intervention service such as Specialist Children’s Services. If when contacting this service you are advised of a long waiting list then you should also forward a referral to the Royal Children’s Hospital Physiotherapy Department.
We will provide a limited interim service to the ‘at risk’ population in this age group until their local service starts. Our priority service will be to children with a developmental delay or children with a specific diagnosis under the age of two years. A limited service will be provided to children aged between two and five years of age.
School aged children
School aged children without a firm diagnosis and with complex needs needing an expert assessment may be reviewed initially at the Royal Children’s Hospital and ongoing therapy transferred to a community provider as appropriate.
We are unable to offer an ongoing outpatient service to school aged children, including those with the following conditions: cerebral palsy, toe walking, developmental co-ordination disorders and neuromuscular disorders.
These children are eligible for services with community providers with funding accessible through the Medicare Plus system or Program for Students with Disabilities. Service providers can be sought through Yooralla, SCOPE and The Australian Physiotherapy Association website.
Children with Neuromuscular disorders should be directed to the Neuromuscular Clinic that operates through the Neurology Department at the Royal Children’s Hospital.
Brunswick Special Development School
Physiotherapists from RCH Neuro Team provide a service to Brunswick SDS twice weekly. The physiotherapist acts as a consultant to assess the children’s physical needs, provide appropriate equipment and work with children, parents, teachers and support staff to implement interventions on a daily basis. Physiotherapy programs complement the child’s educational goals.
Brunswick SDS website
Neurosciences Links:
Yooralla - www.yooralla.com.au
Scope Victoria - www.scopevic.org.au
Australian Physiotherapy Association - www.physiotherapy.asn.au
