Lindsay and Eric Payne have three children—4-year-old twins and almost 2-year-old Jax. The couple’s twins were textbook examples of toddlers reaching age-appropriate milestones, like walking at 12 months. So when Jax didn’t begin crawling until 11½ months, the Paynes tried not to fret. They understand that all children develop at their own pace. But Jax’s crawl was peculiar. He mostly used his hands and would drag his right foot. He became speedy and proficient using this odd technique and therefore didn’t demonstrate any desire to walk. When Jax still showed no interest in walking at 16 months, the Payne’s pediatrician suggested they visit Fairview Southdale’s outpatient pediatric rehabilitation clinic in Edina.
The outpatient rehab clinic moved into a new facility in 2013, a space designed from the ground up specifically to meet the needs of rehab patients. Services include general physical therapy, occupational therapy and speech-language pathology, and also a range of specialty services for children with developmental delays, children on the autism spectrum and those with feeding and sensory issues, among others. Outpatient rehab services for adults and pediatric speech therapy have been available in Edina for the past 10 years, and pediatric-specific rehab, serving infants through 18-year-olds, has been offered for the past two years.
Jax didn’t have any developmental delays. But his unusual crawling pattern resulted in a weakened right side, making walking more of a challenge for him. During the Paynes’ initial rehab visit, physical therapist Lindsay Hayes performed a few standard tests to determine Jax’s areas of weakness and where to focus their efforts.
Hayes enjoys her profession; it combines her love of children with her interests in teaching, psychology and anatomy. She prefers the one-on-one interaction of physical therapy rather than teaching in a classroom setting. “It’s nice to be able to spend a lot of time with patients,” Hayes says.
Jax’s weekly 45-minute clinic visits consisted of a variety of activities aimed at strengthening his calves, thighs and abdominal muscles. “We had no idea Fairview offered pediatric physical therapy,” says Lindsay Payne. “The staff is delightful and knowledgeable. They made [therapy] fun for Jax.”
Hayes would hold items low to the ground or place items on a countertop to facilitate motions that would strengthen Jax’s legs. Jax began walking after three weeks of therapy. But at first, it was a kind of a “Frankenstein hula walk,” says Payne. So Hayes would have Jax jump on a small trampoline and step between the rungs of a ladder lying on the floor. She would roll an exercise ball down a hallway and have Jax chase after it and push it back. She’d work with him on stairs, holding his favored leg, compelling him to utilize and continue to strengthen his right side.
All along, Hayes followed Jax’s lead and based each therapy session on where he wanted to play in the therapy room. “A child can’t be given a list of exercises to work on at home,” Hayes says. She understands that kids need fun activities to motivate their participation in the process. She teaches parents how to incorporate household objects such as couch cushions and pillows into activities that can help strengthen areas of weakness and lead to changes in function.
Pediatric rehab services can also be helpful for children with genetic conditions that contribute to delay of gross motor skills or children with orthopedic conditions caused by a sports injury. Hayes notes that the educational campaign to encourage parents to put infants to sleep on their backs has resulted in some increased incidences of flattening of the head and/or torticollis, a tightening of the neck muscles. “We still want infants to sleep on their backs,” Hayes says, “But we also want them to spend more awake time on their tummies, and some kids don’t like tummy time.” Physical therapists like Hayes can teach parents activities to help children with torticollis turn their head and provide ideas to help them tolerate tummy time at home. “As with all physical therapy, participation at home is a must,” Hayes says.
Conditions like torticollis typically resolve well, often within a few weeks or a few months. Kids like Jax, who have more initial limitations, are usually finished with therapy sessions after a few months. Patients with more significant delays may also see other specialists for up to six months or more to work on skills and keep up with peers.
Jax’s parents and physical therapist are pleased with his progress. “He’s doing much better,” says Hayes. “We’ll continue to work on a few skills until he masters running and climbing stairs.”
In 2014, Fairview’s outpatient rehab clinic was ranked in the 99th percentile nationally for overall patient satisfaction, something the team is very proud of, as outstanding clinic outcomes, exceptional patient experience and low cost of care continue to be a primary focus.
