From the Guidelines
I strongly recommend referring the 9-year-old patient with M92.6 for physical therapy to focus on early intervention, prevention of severe joint contractures, and restoration of range of motion, strength, mobility, and pain relief. The referral should specify a treatment plan that incorporates age-appropriate activities to maintain the child's engagement and compliance with the program. According to the clinical practice guideline and expert consensus recommendations for rehabilitation among children with cancer: a systematic review 1, the treatment plan should include:
- Focus on early intervention and prevention of severe joint contractures and deconditioning
- Restoration of range of motion, strength, mobility, and pain relief
- Orthotics and assistive devices as needed
- Bracing and splinting as needed
- Management of fatigue and musculoskeletal symptoms through gradually increasing exercise regimen, activity pacing, cognitive behavioral strategies, and sometimes medication. Physical therapy sessions should be scheduled 2-3 times weekly for 6-8 weeks initially, with a reassessment at that point to determine if continued therapy is needed 1. Home exercises should also be prescribed to complement in-clinic sessions. This referral is justified because juvenile osteochondrosis conditions respond well to conservative management through physical therapy, which can help reduce pain, improve function, prevent deformity, and potentially avoid the need for more invasive interventions.
From the Research
M92.6 Referral to 9 y/o for Physical Therapy
- The provided studies do not directly address the referral of a 9-year-old for physical therapy for a specific condition, such as M92.6.
- However, some studies discuss the role of physiotherapists in prescribing physical activity and exercise to people with musculoskeletal pain 2.
- Other studies explore the effectiveness of different rehabilitation approaches, such as Dynamic Neuromuscular Stabilization (DNS) training for chronic ankle instability 3, and the promotion of physical activity after stroke 4.
- Additionally, research has been conducted on the comparison of direct access physical therapy with referred physical therapy episodes of care, showing that direct access may lead to improved patient outcomes and decreased costs 5.
- The use of telerehabilitation in physical therapy has also been studied, with some reviews suggesting that it can be comparable to in-person rehabilitation or better than no rehabilitation for certain conditions 6.
- It is essential to note that the specific condition, M92.6, is not mentioned in the provided studies, and therefore, the evidence may not be directly applicable to this particular scenario.