Outpatient rehabilitation for a pediatric patient with developmental delay

A non-ambulatory 27-month-old girl with a history of failure to thrive, metabolic acidosis, and developmental delay was seen for 12 sessions over 7 weeks in a pediatric pro-bono outpatient clinic. Treatment was provided by a student physical therapist under the direct supervision of a licensed physical therapist. The patient was examined using the two-minute walk test to examine ambulatory endurance, 10-meter walk test to determine gait speed, Peabody Developmental Motor Scale 2nd Edition to diagnose developmental delay, Gross Motor Function Measure-66 and Gross Motor Function Classification System – Expanded and Revised to track and predict gross motor function, and Pediatric Evaluation of Disability Inventory to assess the patient’s participation needs at home and in the community. The main goals for this patient were to increase static and dynamic balance, increase ambulatory endurance and speed, increase gross motor function, and improve functional independence at home and in the community. The main interventions used in this episode of care included: treadmill and overground gait training with and without body weight support, balance exercises, and task-specific training, all while utilizing a family-centered approach. The patient made significant improvements in her ambulatory speed and endurance, gross motor function, and functional independence at home and in the community. The patient was referred to neurologist for a second opinion on magnetic resonance imaging results and discharged to continue living at home with home exercise program under the supervision and care of her family after 7 weeks of treatment.