Project: Designing guidelines for hip surveillance in children with cerebral palsy at Holland Bloorview
- Dr. Anne Kawamura, MD
- Angie Ip, MD
- Chun Kim, PT
- Shauna Kingsnorth, PhD
- Darcy Fehlings, MD
What was this study about?
Children and youth with cerebral palsy (CP) are at higher risk of having their hip slide or completely come out of joint. This can cause pain and affects caregiving such as getting your child dressed or changing a diaper.
Right now, we do not have a standard way of checking the hips of children with CP at Holland Bloorview. This study will use current research to develop a care pathway so that all children and youth with CP have hip monitoring and can be referred quickly for treatment when it is needed.
What did we do?
We reviewed the evidence for hip monitoring in CP.
We are currently developing the care pathway for hip monitoring and treatment that will be used at Holland Bloorview.
We will need to teach caregivers, physicians, nurses and physiotherapists about our new care pathway so that everyone will know:
- When to do a hip x-ray to check for the hip sliding or being out of joint
- When to refer to the orthopedic clinic or hypertonia clinic
Impact for clients, families and clinical practice
We hope that this care pathway will help us to detect hip problems early in all of our clients with CP and to ensure that they get the treatment they need as soon as possible.
What did we learn?
Our research of the evidence has confirmed the increased incidence of hip problems and highlighted the importance of early detection of hip sliding in children with CP. We identified key guidelines and publications for monitoring hip sliding in CP.
We are working on interpreting this key evidence into a care pathway that will be used at Holland Bloorview by clinicians and families of children with CP.
We submitted a proposal to Research Ethics to study how the pathway will affect clinical care.
The next steps in our project will be to:
- Implement our care pathway. This will involve consultation with physicians, clinicians, as well as family leaders. It will also involve a chart review to assess current practice around hip surveillance and to monitor for change after implementation of our pathway.
- Explore options to make our care pathway and accompanying information available online and accessible to physicians, clinicians, families, and learners.
- Share what we have learned with other centres through the Ontario Association of Children’s Rehabilitation Services.