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Original report

E-survey of current international physiotherapy practice for children with ataxia following surgical resection of posterior fossa tumour

Helen Hartley, Bernie Carter, Lisa Bunn, Barry Pizer, Steven Lane, Ram Kumar, Elizabeth Cassidy
Physiotherapy Department, Alder Hey Children´s NHS Foundation Trust, L12 2AP Liverpool, United Kingdom
DOI: 10.2340/20030711-1000020

Abstract

Objective: To determine current international practice regarding physiotherapy input for children with ataxia following surgery for posterior fossa tumour.
Design: An e-survey covering the following domains: participant demographics, treatment/intervention, virtual training, intensity/timing of treatment, and aims and outcomes of physiotherapy management.
Participants: Physiotherapists involved in the management of children with ataxia following surgical resection of posterior fossa tumour. Participants were contacted via 6 key groups; Paediatric Oncology Physiotherapy Network (POPs), Association of Paediatric Chartered Physiotherapists (APCP), European Paediatric Neurology Society (EPNS), International Society of Paediatric Oncology (SIOP)-Europe Brain Tumour Group, Posterior Fossa Society (PFS), and Pediatric Oncology Special Interest Group (SIG) (American Physical Therapy Association).
Results: A total of 96 physiotherapists participated: UK (n=53), rest of Europe (n=23), USA/Canada (n=10), and Australia/NZ (n=10). The most common physiotherapy interventions used were balance exercises, gait re-education and proximal control activities. The most frequently used adjuncts to treatment were mobility aids and orthotics. Challenges reported regarding physiotherapy treatment were: reduced availability of physiotherapy input following discharge from the acute setting, lack of evidence, impact of adjuvant oncology treatment, and psychosocial impact.
Conclusion: This e-survey provides an initial scoping review of international physiotherapy practice in this area. It establishes a foundation for future research on improving rehabilitation of ataxia in this population.

Lay Abstract

The aim of this study was to determine how physio-therapists in different countries currently treat children with balance/coordination problems following surgery for a brain tumour. An e-survey, with questions on type of physiotherapy treatment, intensity and timing of treatment, and aims and outcomes of physiotherapy management, was sent to special interest groups, which included physiotherapists with expertise in this area. A total of 96 physiotherapists participated in the survey. The most common physiotherapy treatments used were balance exercises and gait re-education. Mobility aids and orthotics (e.g. splints) were also commonly used. Physiotherapists reported challenges to treatment, including lack of availability of physiotherapy following discharge from hospital, lack of evidence to guide treatment, and impact of oncology treatment (e.g. chemotherapy/radiotherapy) on the child´s rehabilitation. In conclusion, there is little evidence in this area. The results of this survey provide an initial basis to understand the challenges of treatment and to plan future research.

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