Background/Purpose: The development of targeted biologic therapy for rheumatic diseases, has led to improved patient outcomes and a change in the role of physical (PT) and occupational therapy (OT).. The purpose of this study was to assess the current role of PTs and OTs nationally and internationally in the pediatric rheumatology population.

Methods: An internet survey was sent to pediatric PTs and OTs through 3 listservs: American Physical Therapy Association pediatric section listerv, rehab directors listserv, and pediatric rheumatology bulletin board list serve. Email links were also sent directly to colleagues working in the field. Demographic information was collected. The survey identified the presence of therapies in rheumatology clinics, diagnoses seen, treatments used, and changing PT and OT patient needs and clinical practice with the advent of biologic therapy.

Results: Eighty-five therapists (58 PT/ 27 OT) from more than 40 hospitals and 2 outpatient clinics completed the survey. The majority of respondents were from the US, with others from Canada, Australia and Germany. Sixty percent of respondents had over 10 years of experience. Thirty-eight percent had PT and OT presence in the rheumatology clinic. Thirty-eight percent saw children with rheumatic diagnoses 1-2x/month and 18% saw them >2x/week. Treatment sessions were evenly distributed between stretching (20%), active ROM (21%), strengthening (21%) and building endurance (19%). Twelve percent provided casting or splinting for contractures. Forty-eight percent noted a decreased need for PT and OT services since the advent of biologics. Facilitating patient involvement in community activities was specifically identified by 48% of respondents.

Discussion: While the advent of biologics has resulted in less need for traditional PT and OT services, there continues to be an important role in providing these therapies. In addition, PT and OT clinical practice may require an increased focus on getting children with rheumatic diseases involved in community sports and activities. PT and OT are in a unique position to identify underlying issues that may present as barriers to full participation in sports or other community activities, as well as provide guidance for safe participation in these activities.

Conclusion: Since the introduction of biologics, the role of PTs and OTs in the pediatric rheumatologic population has evolved to not only include traditional therapies but also the facilitation of wellness and participation in sports and community activites.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/current-practices-and-new-directions-in-occupational-and-physical-therapy-for-children-with-rheumatic-diseases-in-the-biologic-era/