Prefac
This is the first edition of Pediatric Rehabilitation that has not been under the leadership of Dr. Gabriella Molnar, who is happily retired and living with her “cowboy” in Oklahoma.
She has passed the torch to me and Dennis Matthews and we have been stimulated by the challenge. For the most part we have kept the basic structure of past editions while making changes that reflect the advancement of pediatric rehabilitation.Our field is changing and so we have streamlined some topics and added new chapters on gait labs, as many of us are actively involved in this exciting adjunct to our practice of medicine. We have added a new chapter on aging with pediatric onset disability that will be of great interest to physiatrists.
Medicine and rehabilitation are changing. Many of us see very few arthritis patients. Our rheumatology colleagues are doing a fantastic job with these children and so the need for rehabilitations has decreased. Leg lengthening, limb salvage procedures, limb reattachment, and improved safety of farm machinery have decreased the number of children who need prosthesis. Genetic testing has altered the referral patterns for children who need electromyography. Bladder continence and bowel irrigation surgeries have changed how we manage patients with spinal cord injuries.
More of us are seeing children with concussions as the literature proves the value of screening and following the children serially. Our options for spasticity management are different and more widely used than in the last edition of this book.
We are constantly challenged by children who are surviving cancers to assist in their rehabilitation. Patients with solid organ transplants benefit from our services. Our patients seem sicker, spend less time on our inpatient units, and are now managed in day programs. The chapter authors have diligently incorporated these issues and many more.
A new feature of this edition is “Pearls and Perils” of caring for different types of patients. These pearls and perils are important take-home points some of the authors have for you.
You will notice that some chapter authors have returned and we have asked them to incorporate new pediatric rehabilitation specialists, as it is our hope that these new coauthors will become the senior authors of future chapters and perhaps editors of future editions.
We are happy to present to you this compiled wisdom of the brightest and most enthusiastic clinicians in our tightly knit group of pediatric rehabilitation specialists.
Michael A. Alexander Dennis J. Matthews
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