World Physiotherapy Day 2020

September 8 marks World Physiotherapy Day and it is an opportunity to recognise the dedication our physiotherapists have to making a difference in injured and sick kids’ lives.

Throughout 2020, our clinicians have faced additional and unique challenges in caring for patients and families during the COVID-19 pandemic. Physiotherapy teams across the Network remained agile and continued to assess and treat patients, by adapting to altered working conditions and accessing technology, the team were able to achieve their number one goal; to keep children moving.

Stephanie Duvenage, Physiotherapist at The Children’s Hospital at Westmead, explains that despite the challenges faced this year, the physiotherapy team have continued to work with each patient to set goals based on what they want to achieve, whether it’s participating in sport or engaging with other peers.

“The biggest challenge for us during this period has been integrating Telehealth. Our physios had to learn to change our communication style because doing sessions over Telehealth is very different to having an in-person session. We had to really take the time to describe the action and help the parent understand for them to facilitate the action on their end. It has been a learning curve but the whole team has adapted really well,” said Ms. Duvenage.

For Stephanie, gaining a child’s trust is the most important thing and the rewarding part of her job is knowing her part in a child’s recovery journey can have a large and long lasting impact for the patient.

“I was working with an oncology patient for a year and he got so weak and was mainly mobilising in a wheelchair. I called his mum to see how he was going and I could hear him in the background, ‘Is that Steffi? Is that Steffi?’ and mum mentioned he wanted to speak to me. His mum put him on the phone and he was so excited to tell me that he walked all the way to the park. Apparently he had been waiting to tell me this for two weeks.

“We physios like to think that we bring life to each day rather than adding days to someone’s life,” said Ms Duvenage.

Oliver was admitted to Sydney Children’s Hospital, Randwick (SCH) in March and shares his health journey where physiotherapy played an integral part in his recovery.

Oliver’s story

Like any mother, Sindy often thinks of her children’s future, trying to navigate the best path for them to succeed. Then one unsuspecting day while at work, she received a concerning phone call from her 15 year-old son Oliver, and her world came to a standstill. “I need to go to the hospital”, she could hear the pain and fear in his voice. She froze.

Lethargy, high fevers and abdominal pain were the start of a rapid decline in Oliver’s health. He needed to be transferred from his local hospital to SCH for specialist care, where tests showed signs of significant inflammation and fluid in his abdomen and lungs, he also developed anaemia, low platelets, an enlarged spleen and kidney impairment.

Oliver underwent extensive investigations to establish a diagnosis including a bone marrow aspirate, CT scans, genetic testing, and frequent blood tests to monitor his inflammation and organ dysfunction.

“For some time, there was uncertainty surrounding his condition. I told Oliver that he will be okay but not knowing myself if he would be. We had to take day by day,” said Sindy.

He was eventually diagnosed with an extremely rare and life threatening condition called TAFRO, short for thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly. A disorder of immune regulation where the immune system turns on excessively and doesn’t know how to turn off, which left him in extreme pain, bedridden and too weak to move.

Treated with multiple immunosuppressants and critically ill, his long stay in ICU left him extremely physically weak, so the physiotherapy team adopted an early mobilisation approach to try to fast track his recovery, beginning in the intensive care unit.

“There is a growing emphasis placed on the benefits of early mobilisation for patients in the intensive care setting, where a common detrimental effect of bed rest and critical illness results in physical deconditioning. We needed to assist Oliver to start moving as early as possible to prevent this and restore his muscle function and build strength,” said Sky Fosbrooke, Senior Rehab Physiotherapist, Sydney Children’s Hospital, Randwick.

Usually an energetic and happy teenager who takes daily bike rides with friends, he was now undergoing daily rehabilitation sessions using the supine bike, an over-the-bed motorised bike that can function with minimal movement and keeps up the momentum until the patient is able to cycle actively.

With the care and guidance of his physiotherapy team, Oliver set tangible goals with the aim to walk again.

“Oliver’s positive attitude made our work much easier. Each time we would tick off a goal, we would set a new one. His sheer determination saw him grow stronger, progress from the supine bike to an upright one and to twice daily rehabilitation gym sessions,” said Sky.

After a four month stay during a heightened period of the pandemic, Oliver is walking again and back home with his family. He has now set personal goals, and with the continued support of his physiotherapy team with ongoing treatment, he is optimistic he will one day return to school and get his learner license just like his friends.