New clinical decision tool to assist physical therapists with joint mobilization application to the pediatric population

ABSTRACT

Joint mobilizations are well-established and extensively researched treatment modality for adults. However, it remains largely unexplored in the pediatric population. Physical therapists hesitate to perform joint mobilization on children because of lack of knowledge, concern for the developing skeletal system, and the paucity of research on the topic. The aim of this article is to present a decision tool created for a continuing education course with the purpose to instruct pediatric therapists in the safe and effective use of joint mobilizations in children. It is based on the pediatric paradigm of developmental and functional assessment to best address the concerns and preferences of physical therapists (PTs). To advance research in pediatric joint mobilization, PTs should listen to the concerns of pediatric therapists and respond to those concerns with effective, evidence-supported training. This decision tree will serve as a resource for the education of pediatric therapists in the safe and effective use of joint mobilizations.

KEYWORDS:

• Red flags
• manual therapy
• children
• pain
• multimodal care

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This project was not supported by grant funding

Notes on contributors

Virginia K. Henderson

Virginia K. Henderson PT, DPT is a pediatric physical therapist in the department of orthopedics and sports medicine at Texas Children’s Hospital. She completed her Master of Physical Therapy at The University of Texas Health Science Center in San Antonio, and her transitional Doctorate of Physical Therapy at Texas Women’s University. She completed her manual therapy fellowship with The Manual Therapy Institute. Dr. Henderson is currently an ScD student at Texas Tech University Health Sciences Center and is studying the application of joint mobilization in the pediatric population.

Jean-Michel Brismée

Jean-Michel Brismée PT, ScD is professor in the Doctor of Science and Doctor of Philosophy programs in Rehabilitation Science at Texas Tech University Health Sciences Center in Lubbock, Texas, and teaches orthopaedic manual therapy related continuing education courses with the International Academy of Orthopaedic Medicine (IAOM-US).