Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581443
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Pediatric chronic pain and functional neurologic disorders are frequently encountered causes of pediatric morbidity and disability. These medical conditions are complex, with multifactorial etiologies and presentations....Pediatric chronic pain and functional neurologic disorders are frequently encountered causes of pediatric morbidity and disability. These medical conditions are complex, with multifactorial etiologies and presentations. Both have been found to benefit from biopsychosocial approaches in addition to common pharmacologic interventions. The diagnosis and exclusion of other processes is vital to quickly identify appropriate treatment plans. A multidisciplinary team consisting of physicians, therapists, psychologists, and caseworkers must work in conjunction with the family and patient to minimize disability and distress caused by these disorders, with the ultimate goal to increase day-to-day functionality for the patient.
Haas MT, Alejandro RE, Ratnasingam D
… +1 more, Tsao EY
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581442
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Pediatric cancer rehabilitation requires an interdisciplinary approach to manage the physical, cognitive, and psychosocial effects of cancer and its treatments. With survival rates now exceeding 85%, emphasis has shifted...Pediatric cancer rehabilitation requires an interdisciplinary approach to manage the physical, cognitive, and psychosocial effects of cancer and its treatments. With survival rates now exceeding 85%, emphasis has shifted toward addressing long-term impacts, especially among the nearly 15,000 children and adolescents diagnosed with cancer each year. Rehabilitation interventions span the cancer care continuum, from prehabilitation at diagnosis to supportive and palliative care, focusing on optimizing quality of life. Survivorship guidelines stress early detection of treatment-related complications and ongoing care to manage chronic health risks, enhance functional independence, and minimize disabilities for survivors.
Levin J, Alejandro RE, Alvarez G
… +2 more, Cancel D, Wilkey K
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581441
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Pediatric patients diagnosed with a concussion or mild traumatic brain injury experience symptoms such as headache, difficulty concentrating, nausea, and disturbance of balance. Symptoms normally last about 4 weeks thoug...Pediatric patients diagnosed with a concussion or mild traumatic brain injury experience symptoms such as headache, difficulty concentrating, nausea, and disturbance of balance. Symptoms normally last about 4 weeks though recovery can be delayed. A multimodal approach is taken to educate patients and families, treat symptoms, and progress a patient toward return to play and school. Guidelines regarding brain imaging, bloodwork, and management of complicated patients are discussed in detail in this article.
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581440
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The following article is an overview of neonatal brachial plexus palsy, including current literature on early recognition of glenohumeral dysplasia and trends in surgical intervention. Long-term concerns regarding pain,...The following article is an overview of neonatal brachial plexus palsy, including current literature on early recognition of glenohumeral dysplasia and trends in surgical intervention. Long-term concerns regarding pain, function, and quality of life are also discussed.
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581439
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Movement disorders are a group of neurologic diseases characterized by abnormalities in motor function that are not attributable to weakness or spasticity. They are divided into hyperkinetic (involuntary movements) or hy...Movement disorders are a group of neurologic diseases characterized by abnormalities in motor function that are not attributable to weakness or spasticity. They are divided into hyperkinetic (involuntary movements) or hypokinetic (paucity of movement). In this article, we will present common clinical scenarios where physical medicine and rehabilitation specialists are likely to encounter movement disorders. Then, we will discuss pharmacologic interventions, focusing on medications specific to phenomenologies that may be encountered in physical medicine and rehabilitation clinics. Finally, we will provide an overview of deep brain stimulation for refractory movement disorders.
Drakou E, Wright S, Delfiner LD
… +1 more, Cancel D
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581438
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Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) are childhood-onset neuromuscular disorders with substantial morbidity and significant rehabilitation needs. Recent advancements, particularly gene-base...Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA) are childhood-onset neuromuscular disorders with substantial morbidity and significant rehabilitation needs. Recent advancements, particularly gene-based therapies, have significantly altered the disease trajectory for both conditions, necessitating updated care guidelines. This review will delve into the pathogenesis of DMD and SMA, explore the latest disease-modifying treatments available for each, and comprehensively address the multifaceted rehabilitation needs across the spectrum of disease severity. The aim is to provide a comprehensive overview of current best practices to optimize functional outcomes and quality of life for individuals with DMD and SMA.
McCoy AR, Singerman L, Anand N
… +1 more, Kanallakan A
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581437
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Spina bifida (SB) is the most common neural tube defect. Myelomeningocele is the most common and severe form of SB, leading to a variety of sequelae especially with complications in the central nervous, lower urinary, ga...Spina bifida (SB) is the most common neural tube defect. Myelomeningocele is the most common and severe form of SB, leading to a variety of sequelae especially with complications in the central nervous, lower urinary, gastrointestinal, and musculoskeletal systems. The care of children with SB is not only medically complex but requires coordination across various medical specialties and disciplines. This article provides a broad overview of different aspects of management for children with SB.
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581436
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Pediatric spinal cord injury (SCI) is a rare but devastating group of processes affecting children and their families. Following an initial event, many secondary health conditions (SHC) predictably develop and change ove...Pediatric spinal cord injury (SCI) is a rare but devastating group of processes affecting children and their families. Following an initial event, many secondary health conditions (SHC) predictably develop and change over time that require management. We discuss many of these SHC in the context of pediatric SCI. The transitions to home, school, and adulthood play critical roles in wellness for this population and are uniquely discussed in this review of care following pediatric SCI.
Shoval HA, Cheng J, Bundonis J
… +2 more, Hornung RK, Plata E
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581435
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Transitioning to adulthood requires a shift from child-centered to adult-centered care, focusing on educational, medical, and community support for individuals with disabilities. Key elements include school-based transit...Transitioning to adulthood requires a shift from child-centered to adult-centered care, focusing on educational, medical, and community support for individuals with disabilities. Key elements include school-based transition utilizing the Individualized Education Plans, vocational training, and effective health care transitions prioritizing continuity of care and patient autonomy. The importance of mobility and physical activity is highlighted, particularly through adaptive sports, which enhance health and quality of life. Community involvement, social support, and mental and spiritual health are essential for fostering independence and self-esteem. There are critical financial and legal considerations, including guardianship, and resources are provided.
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581434
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Every child has the right to grow, develop, play, and learn within an environment that maximizes their highest functional potential. This article explores current technologies and considerations for pediatric mobility an...Every child has the right to grow, develop, play, and learn within an environment that maximizes their highest functional potential. This article explores current technologies and considerations for pediatric mobility and positioning. Contemporary concepts within the International Classification of Functioning, Disability, and Health are discussed to support optimal function and participation across home, school, and community settings for children who have mobility delays or restrictions. Individualized self-initiated mobility and positioning options are urgently needed to provide children who have mobility delays or restrictions with the same age-appropriate experiences as their typically developing peers.
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581433
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In young children, hypertonia results from early brain insults leading to upper motor neuron lesions, which cause changes in muscle tone and pathology. These changes contribute to contractures and deformities that impair...In young children, hypertonia results from early brain insults leading to upper motor neuron lesions, which cause changes in muscle tone and pathology. These changes contribute to contractures and deformities that impair activity and participation. The management of hypertonia requires a multifaceted approach, combining phyisical and occupational therapy and pharmacologic interventions. However, limited clinical studies exist for pharmacologic treatments in children aged under 3 years, leaving clinicians to rely on experience when prescribing off-label medications. This article reviews the pharmacologic interventions for hypertonia, with an emphasis on evidence-based dosing recommendations in pediatric patients and new innovations for the management of pediatric hypertonia.
Abasi U, Allen A, Candelario-Velazquez C
… +2 more, Ranade S, Cancel D
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581432
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Neuromuscular disorders caused by abnormal interaction between nerves and muscles can be, in etiology, central or peripheral, congenital or acquired. Hip and spine manifestations of these disorders may be addressed throu...Neuromuscular disorders caused by abnormal interaction between nerves and muscles can be, in etiology, central or peripheral, congenital or acquired. Hip and spine manifestations of these disorders may be addressed through physiatry or orthopedic management. We discuss neuromuscular disorders with hip and spine sequelae, focusing on orthopedic management.
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581431
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Aerodigestive disorders affect the upper airway, respiratory and gastrointestinal system. These disorders are often related and pose a diagnostic and therapeutic challenge for patients with neuromuscular disorders. Ideal...Aerodigestive disorders affect the upper airway, respiratory and gastrointestinal system. These disorders are often related and pose a diagnostic and therapeutic challenge for patients with neuromuscular disorders. Ideally, this patient population should have a multidisciplinary team that includes a gastroenterologist, otolaryngologist, pulmonologist, and speech therapist to both diagnose and treat these aerodigestive conditions. Over time, these disorders can cause significant morbidity and mortality, but early treatment can improve quality of life.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210370
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Adolescent females with disabilities face unique challenges relating to sexual health and education. In this article, we will explore the important concepts and special considerations for adolescent females with disabili...Adolescent females with disabilities face unique challenges relating to sexual health and education. In this article, we will explore the important concepts and special considerations for adolescent females with disabilities with the hope of helping physiatrists better understand and serve this population.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210369
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Parkinson's disease, multiple sclerosis, and Alzheimer's disease are 3 prevalent neurodegenerative diseases. Beyond disparate disease incidences between men and women, additional sex-related differences exist. Disease pr...Parkinson's disease, multiple sclerosis, and Alzheimer's disease are 3 prevalent neurodegenerative diseases. Beyond disparate disease incidences between men and women, additional sex-related differences exist. Disease presentation, natural course, treatment considerations, genetic factors, hormonal factors, health care utilization patterns, and outcomes can vary between men and women in general. These disease processes represent examples of well-defined discrepancies between men and women afflicted. Other neurodegenerative conditions, such as motor neuron disorders, progressive supranuclear palsy, and multisystem atrophy, have shown to have a slight predilection toward men compared to women, yet have not been as extensively studied.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210368
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The coronavirus disease 2019 (COVID-19) pandemic has given rise to long COVID, a prolonged manifestation of severe acute respiratory syndrome coronavirus 2 infection, which presents with varied symptoms and conditions la...The coronavirus disease 2019 (COVID-19) pandemic has given rise to long COVID, a prolonged manifestation of severe acute respiratory syndrome coronavirus 2 infection, which presents with varied symptoms and conditions lasting beyond expected acute illness. Despite efforts, diagnostic and treatment approaches remain insufficient, particularly for women who experience higher prevalence rates. Rehabilitation professionals have played a crucial role during the pandemic. Individualized rehabilitation plans, encompassing various therapies and interdisciplinary collaborations, are essential. Addressing disparities and biological sex differences is paramount, requiring increased research, understanding, and advocacy for effective rehabilitative care tailored to all individuals affected by long COVID.
Schoenlank C, Thomas A, Bakshiyev R
… +1 more, Chen S
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210367
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Osteoporosis is the most common metabolic bone disease across the world resulting from compromised bone microstructure and decreased bone mineral density. It primarily impacts postmenopausal women over 50 years placing t...Osteoporosis is the most common metabolic bone disease across the world resulting from compromised bone microstructure and decreased bone mineral density. It primarily impacts postmenopausal women over 50 years placing them at heightened risk for fractures. The pathophysiology involves an imbalance in bone resorption and production. Nonpharmacologic approaches can bolster a treatment plan, namely with alterations in nutrition and exercise. The first clinical indication of osteoporosis is typically a fracture, which is mostly found to be a vertebral compression fracture. Osteoporosis is a highly treatable and preventable condition that can result in high morbidity and mortality if not adequately addressed.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210366
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This article discusses rheumatologic conditions in women including rheumatoid arthritis, lupus, Sjogren's syndrome, inflammatory myopathies, systemic sclerosis, and polymyalgia rheumatica. These conditions, often affecti...This article discusses rheumatologic conditions in women including rheumatoid arthritis, lupus, Sjogren's syndrome, inflammatory myopathies, systemic sclerosis, and polymyalgia rheumatica. These conditions, often affecting muscles, joints, and other organ systems, require early diagnosis and multidisciplinary management. Treatment includes medications, braces, therapy services, education, and lifestyle modifications including energy conservation techniques. These conditions can also impact pregnancy and require close monitoring and careful disease control. It also highlights the benefits of pulmonary rehabilitation that can be helpful for patients with chronic respiratory disease secondary to their rheumatologic conditions.