Specialist Clinics

This clinic is for every child on the Physiotherapy caseload with a known physical disability. Your child/young person will be offered an appointment in this clinic on an annual basis. To help minimise appointments and to support co-ordinating your child/young person's care, members of the multi-disciplinary team will be invited to join the appointment. Within this clinic a number of physical assessments will be completed to allow us to create a comprehensive report. This will also include relevant goals and up to date recommendations. This clinic is usually held at the Child Development Centre and so parents/carers are expected to attend. ​

 

Your child/young person will be offered an appointment in this clinic when surgical options are being considered. This clinic is run jointly with a Physiotherapsit, Community Paediatrician and Paediatric Orthopaedic Surgeons from Peterborough City Hospital and Addenbrookes Hospital to ensure a multi-disciplinary approach. It is an opportunity to assess your child/young person and discuss the need, benefits, risks and long term goals for surgical intervention.

The appointment will take place at the Child Development Centre and each appointment is approximately 45 minutes long. 

What happens at the clinic

At your appointment we will discuss your child’s current function and mobility level, pain, strengths, areas of concerns and your expectations following surgery. We will complete a physical assessment, including observation your child's gait (if possible), joint range review and muscle strength testing. 

If relevant, your child may have been for an x-ray prior to this appointment. We will review this and discuss the findings with you and your child/young person.  We will together make recommendations and agree with you a plan going forwards. If surgery is recommended, we will discuss your child's upcoming journey including hospital admission, stay, discharge and post-operative rehabiliation. 

We are aware that there will be a lot of information given to you and your child/young person within this appointment and it can be difficult to make decisions around surgery. You will, of course, be given time to consider what has been discussed and can access the Physiotherapy team if you think of questions at a later stage or want to talk through the options again. 

What happens after the appointment

Following the appointment you will receive a clinic letter covering what was discussed, details of the assessment and the proposed plans. If surgery was recommended and agreed then further information inviting you for a pre-operative assessment will come directly from the Orthopaedic team at Peterborough City Hospital. 

If you require to speak with the Orthopaedic team directly, you can call the switchboard at the hopsital on 01733 678 000 and ask to be put through to them. 

This clinic gives opportunity to review your child/young person's muscle tone and discuss options to manage this and enhance their function. The clinic is run jointly by a Consultant Paediatrician specialising in neuro-disability and a member of the Physiotherapy team. If relevant, other members of your child's multi-disciplinary team may also attend the appointment. 

Treatment options include: 

• Medication
• Botulinum toxin injections
• Referral for an orthopaedic option to explore surgical options

Information about Botulinum Toxin

If Botulinum toxin injections is identified as the appropriate treatment for your child, you will recieve an appointment to have this at Peterborough City Hospital. 

Following your child/young person's injections they may require serial casting. This will be discussed with you during your child/young person's assessment appointment. Your child/young person will then be offered up to 6 therapy treatment sessions to optimise the outcome. Your child/young person will be invited back for a review 4 months after the injections. 

What are Lycra garments ?

Lycra, also known as Dynamic Elastomeric Fabric Orthosis (DEFO), Dynamic Textile Orthosis (DTO) or Sensory Dynamic Orthosis (SDO), refers to specially designed and often custom-made garments. These garments are worn by individuals to support them with the physical effects typically associated with underlying neurological disorders. They are made from special fabrics that combine strength and flexibility, ensuring comfort for individuals throughout the day. Panels and reinforcements can be incorporated onto the garments to enhance proprioception to specific body areas, leading to increased body awareness. This can reduce muscle imbalance, improve posture, and support with the management of abnormal muscle tone. Lycra therefore can positively impact an individual's quality of movements and independence and as a result can enhance their ability to engage in daily activities.

Lycra garments are usually bespoke made come in many shapes and sizes.

• Full body suits - these can come with long or short sleeves and full or short legs.
• Top – this can come with long sleeves, short sleeves or as a vest. 
• Bottoms – this can come as full leggings or as shorts
• Gloves – this can come with different finger lengths. 
• Sock
• Gauntlet
• Arm sleeve

Is Lycra suitable for my child? If so, how will my child be referred ?

Your child's Physiotherapist and/or Occupational Therapist will assess if Lycra is suitable during treatment sessions. They then will discuss potential benefits and can arrange a bespoke garment measurement if needed.

What happens during a Lycra Clinic Appointment?

During the initial Lycra appointment, a physical examination will assess your child’s posture and function whilst therapeutic and functional goals are set. Measurements will be taken using a soft tape measure. Your child may be required to undress during this appointment depending on the garment required as measurements cannot be taken over the top of clothes. Your therapist/s will then decide on additional panelling required whilst you and your child decide on the all-important colour. Measurements and specifications are sent off to produce your child’s bespoke garment.

Your child will have a follow up appointment (usually within 8 weeks) to fit the garment. You will be shown how to put on and remove the Lycra garment, and a wearing regime will be discussed.  Your child’s therapist will monitor the effectiveness of the lycra. Return visits to this clinic are needed only when a new garment is required due to growth.

How many hours a day should they be worn?  

Your child’s therapist will provide you with specific wearing advice during the Lycra fitting appointment. Wearing of any new garment should be increased gradually with the aim for it be worn throughout the day. It is advised you wear them daily, so treatment is maximally effective. Compliance is essential as non-compliance can reduce treatment effectiveness.  

Where can I find more information ?

DM Orthotics

Allard UK

Jobskin

This clinic is run on a 3-4 monthly basis and is designed to review children with a confirmed neuromuscular diagnosis. It is a joint clinic with the Consultant Paediatrician, Neuromuscular Advisor and Physiotherapist. Within this clinic the child/young person's progress and management will be reviewed, relevant assessments completed and goal sets. It offers opportunity for you as parents, as well as your child/young person to discuss any concerns and ask questions. 

Useful links:​

• Muscular Dystrophy Website 
• Spinal Muscular Astrophy (SMA) UK Website 
• Duchenne UK Website

For children to lead a healthy lifestyle they need to move as much as possible. It is recommended that children are active for at least 60 minutes per day to help keep their hearts healthy and bones strong- and if they have additional needs, this is just as important. ​

There are several inclusive sports clubs and activities that are available in the local and surrounding areas of Peterborough. Please see the links below to some of these:

• Vivacity – Vivacity offer a wide range of inclusive activities in Peterborough such as adaptive cycling, boccia and sensory swim lessons. You can sign up to these sessions through their website.

• Gymnastics & Trampolining
• Climbing 
• Sailing - Peterborough Sailability
• Horse Riding - Riding for the Disabled Association (New Pasture Riding School, Thorney)
• Horse Riding - (Lynch Farm, Orton) 
• Safari Play - Soft Play
• Inflatanation - Disability Friendly Sessions
• British Blind Sport
• Cerebral Palsy Sport UK – Frame Running
• Sense UK – A range of virtual activities

Please Note that your therapist may recommend swimming or hydrotherapy for your child/young person. This is not a service that is provided by the NHS however may still be identified as beneficial for your child/young person. For some it may be suitable to attend any local swimming pool within the area, whereas for others a specialist hydrotherapy pool may be required. Your therapist will be able to advise you where you may be able to access this however please be aware that hydrotherapy pools within Peterborough are limited with availability and there is a cost to access them. This is not funded by the NHS despite being a recommendation.