For children with cerebral palsy (CP) and related conditions in the southeastern U.S., finding an interdisciplinary clinic that coordinates care, provides appropriate reactive medicine, and helps them look ahead to new challenges can be difficult. The clinic at Lenox Baker Children’s Hospital—Duke’s wheelchair-accessible, neuromuscular therapeutic campus—offers a unique care model that lends itself to caring for up to 500 families.
"We’ve created a comprehensive model that children with neuromuscular conditions really benefit from,” says Christopher D. Lunsford, MD, a pediatric physiatrist, and director of Duke Pediatric Rehabilitation Medicine. Lunsford and clinic co-director Joan M. Jasian, MD, a Duke pediatric neurologist, work to personally coordinate appointments and provide extra services for patients with CP and related conditions. These include pediatric specialists from physical rehabilitation, developmental neurology, physical therapy, speech pathology, nutrition, social work, and orthopaedics.
This year, the program will also add an additional pediatric physiatrist, Ankit Patel, MD, whose expertise in managing CP and related conditions for patients ages 15 and older complements Lunsford’s patient age range of 0 to 21. By having access to all of these specialists in a single day of appointments is not only more convenient for patients and their families, but also more collaborative for Duke specialists.
“When a child tells one of us that they’d like to try something, or the family expresses that they’d like to find better care options for a specific functional problem, our team comes together in real time to discuss those ideas with the patient and family and make a plan to move it forward,” says Lunsford.
Some of these options may be part of Lunsford’s ongoing research trials on wearable rehabilitation technologies. His most recent work involves more quickly identifying falls in the hospital, virtual reality (VR)-assisted occupational therapy, and a VR headset that supports patients’ redevelopment of fine motor and hand function rehabilitation after a stroke.
The clinic also provides treatment options for patients with hypertonia affecting motor function who may benefit from botulinium toxin injection, with or without anesthesia. “If your patient is not sure which anesthesia option they’ll need, it may be helpful to refer to a clinic like ours where we can administer the injection in a way that is most comfortable for the patient.”
In addition to helping patients in the clinic, Lunsford and his team emphasize the support needed between appointments: educating parents and family members, addressing questions and concerns, and connecting them with specialists in their own communities when necessary.
“Although it can be hard to predict what each individual case is going to need, telehealth helps a lot with this piece, and our approach for supporting patients in between appointments helps us to connect them to appropriate therapists as soon as we can,” he explains. The Duke team has also helped mentor therapists in patients’ communities outside of the Triangle who may not be as experienced working with children with certain types of neuromuscular conditions, he adds.
To refer a patient, log in to Duke MedLink or call 800-633-3853.