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Therapeutic Camps Improve the Self-Esteem and Confidence of Kids with Hand Differences

Therapeutic Camps Improve the Self-Esteem and Confidence of Kids with Hand Differences

by | Jul 9, 2021 | Research & Innovation

Scottish Rite for Children is world-renowned for its patient-centered care for children with orthopedic conditions. Our Center for Excellence in Hand is committed to caring for children with hand and upper limb conditions. The center is focused on providing innovative treatment to help patients live active and independent lives. Occupational Therapist and Certified Hand Therapist Amy Lake, has recently published The impact of therapeutic camp on children with congenital hand differences in the Cogent Psychology.

The goal of this study was to evaluate the efficacy of hand camp by investigating camp participation and outcomes on self-esteem, physical function, activity participation, and peer relationships. Forty patients with a congenital hand difference seen in hand clinic between the ages of 10 and 13 were eligible to attend hand camp. Following hand camp, Peer relationships, upper extremity function, and self-esteem improved immediately. Upper extremity function and self-esteem scores continued to improve significantly throughout the 6-month follow-up period. The authors of the study believe that research related to therapeutic camping experiences is integral when identifying best-practice interventions to increase the quality-of-life outcomes for children with congenital hand differences.

To date, no research has been conducted on the effects of camp participation in the pediatric congenital hand difference (anomaly) population. Another goal of this study was to evaluate the efficacy of a therapeutic hand camp for children with a congenital hand difference. Attendees of the 2015 Tween Camp (ages 10–13 years) completed self-report assessments of self-esteem, function, participation in activities, and relationships with peers. Attendees also completed an assessment to determine if they believed camp objectives were met. This specific camp was chosen for the initial study due to the camp attendees’ ability to complete assessments independently.

Some of the key takeaways from this study are:

  • Participants reported that their upper extremity function had significantly improved from pre-camp to immediate follow-up
  • Participants expressed a significant improvement in their self-esteem from pre-camp to immediate follow-up
  • Following camp, participants indicated improved skills in peer interaction, daily physical activities, willingness to try new things and confidence in explaining their hand difference.

This suggests that following camp, a child is: more apt to participate in extracurricular activities; have higher self-esteem with regard to their hand difference; be more independent in activities of daily living; and manage negative reactions from others regarding the appearance of their hand. This supports the hypothesis of the study, that camp can indeed make a positive impact on children with congenital hand differences.

Because of the success of our hand camps, Scottish Rite for Children has helped start-up hand camps around the globe based on our Hand Camp Model including camps in Florida, Missouri, California, Italy, and England. Coming soon to Australia.

Learn more about hand research.

Sports Medicine and Psychology Experts Work Together – Caring for the Whole Child

Sports Medicine and Psychology Experts Work Together – Caring for the Whole Child

by | Oct 6, 2020 | Research & Innovation

Our Sports Medicine team noticed that a commonly used outpatient depression screening questionnaire was identifying more patients than were actually at risk for concerns for suicide. This created an excessive number of alerts to the clinical team to assess patients that were not at risk, which is called a high false positive rate. The team implemented changes to reduce that rate without missing those patients that were truly at risk and needed further evaluation.

Jane S. Chung, M.D., sports medicine physician, says, “Suicide is now the second leading cause of death among young people 10-24 years of age, and is a serious public health problem in our youth. Often, in the sports medicine setting, these kids who are hurting and struggling internally are the ones coming in to see you for sports-related injuries and other musculoskeletal ailments,” says Chung. “Our team felt it was important to look into this trend in our own outpatient clinics to come up with a strategy to best identify those patients at risk so we can provide early intervention, as early identification and intervention is key in helping these youth at risk.” Success with the effort would allow resources to be properly allocated to the right patients.

Partnering with the Psychology and Research teams, the group developed a new strategy to decrease the high false positive rate in screening questionnaires utilizing a staged process in the electronic medical record. Additionally, patients were given the opportunity to review their responses before submitting, as often young patients can misread or answer a question too quickly on the iPad questionnaires. The clinical staff was then notified of those patients who provided responses that were concerning for suicide risk.

Recently, in March 2020, the team implemented a more pointed suicide screening questionnaire with hopes that future analysis will show continued improvement in identifying those youth at risk. The staged approach effectively identified patients in need of intervention and the false positive rate drastically improved. Researcher, Connor Carpenter says, “Quality improvement projects like this one have a real impact on our patients and our system. When patients get treatment they need and not the treatment they do not, everyone wins.”

This study, “Effective Administration of Mental Health Screening Tools Affects Appropriate Allocation of Resources and Improves Clinician Ability to Identify Those at Risk for Suicide,” was shared as a medical poster at the 2020 virtual annual meeting of the American Academy of Pediatrics.

Learn more about mental health in young athletes in a previous article.

Limb Reconstruction Meeting Brings Experts from Around the World to Dallas

Limb Reconstruction Meeting Brings Experts from Around the World to Dallas

by | Feb 7, 2020 | Research & Innovation

Scottish Rite Hospital is honored to host the second annual Controversies in Pediatric Limb Reconstruction (CPLR). This two-day seminar brings together leaders in the field to collaborate and discuss the latest treatment techniques for pediatric patients with limb deformities, limb loss, musculoskeletal infection and severe length discrepancies. 

In conjunction with the Limb Lengthening and Reconstruction Society (LLRS) and the Pediatric Orthopaedic Society of North America (POSNA), the program includes lectures, panel discussions and case studies presented by hospital staff and international guests. Co-directed by pediatric orthopedic surgeon David A. Podeszwa, M.D., and researcher Mikhail Samchukov, M.D., CPLR serves as a unique opportunity to bring together experts from various backgrounds who provide care to this specific patient population.

As a leader in this specialty, the Center for Excellence in Limb Lengthening team travels the world to teach others about the devices used to treat conditions associated with limb deformities. CPLR cultivates local and international collaboration right here in Dallas, TX. 

“We are excited to host this prestigious event,” says Podeszwa. “We have the opportunity to collaborate with some of the best from around the world, right here in our hospital, to advance the care provided to these patients. CPLR gives attendees a focused and comprehensive program where they are able to learn, debate and discuss the latest treatment techniques – with the hopes that they take that knowledge and apply it at their respective institutions worldwide.”

Learn more about our Center for Excellence in Limb Lengthening.  

Scottish Rite Hospital Hosts Prestigious Hand Conference

Scottish Rite Hospital Hosts Prestigious Hand Conference

by | Oct 11, 2019 | Research & Innovation

Scottish Rite Hospital’s Charles E. Seay, Jr. Center for Excellence in Hand Disorders is committed to caring for children with hand and upper limb conditions. The center is focused on providing innovative treatment to help patients live active and independent lives. In addition, the hospital’s hand team has become the leader in training hand surgeons from across the globe.

This week, the hospital is hosting the Marybeth Ezaki/Peter Carter Visiting Professorship. Established in 2017, this two-day conference brings together pediatric upper extremity surgeons, as well as other orthopedic surgeons, to discuss the latest treatment techniques in caring for children with complex hand conditions. The visiting professorship is in honor of Marybeth Ezaki and Peter Carter, both former staff hand surgeons who provided world-renowned care and innovation during their time at the hospital.

The hospital is welcoming Steve E.R. Hovius, M.D. – a certified plastic and hand surgeon from Radboud University Medical Centre Nijmegen and at the Xpert Clinic Hand and Wrist Centre Rotterdam. He brings decades of experience, serving as the head of the department of Plastic and Reconstructive Surgery and Hand Surgery at the Erasmus University Medical Centre Rotterdam. The meeting also includes presentations and discussions from hospital staff.

Director of the hand center and co-director for this program Scott Oishi, M.D., FACS, is proud to host such a prestigious group. “Treating pediatric hand conditions can be tricky,” says Oishi. “It requires a specialized team who is dedicated to learning and advancing their techniques. This program is unique in that it brings together hand specialists, both near and far, to discuss the care and treatment of a pediatric hand patient and collaborate on current research.”

Learn more about the hospital’s Center for Excellence in Hand Disorders.

Hospital Doctors Lead the Research and Education in Children with Clubfeet

Hospital Doctors Lead the Research and Education in Children with Clubfeet

by | May 31, 2019 | Research & Innovation

At Scottish Rite Hospital, we are dedicated to providing world-renowned patient care. Our team of experts are able to do so through their steadfast commitment to advancing treatment through research and education. The hospital’s physicians and clinical staff are known worldwide for the research conducted in our Center for Excellence in Foot.

Clubfoot is one of the most common pediatric foot conditions that our experts treat. Through research, our team can study this patient population to better understand the condition and develop innovative treatment plans. With voluntary participation from patients, the team is able to review outcomes after treatment and assess how a child with clubfeet is functioning.

Recently, the hospital published two articles on their latest clubfoot research. Below is what our team is learning:

Functional Outcomes of Patient with Clubfeet at 10-year Follow-up
This research was led by Assistant Chief of Staff Lori A. Karol, M.D., Movement Science Manager Kelly Jeans, M.S., and other staff from the Movement Science Lab.

Summary

Our team analyzed outcomes of patients’ feet who received either the Ponseti serial casting (a form of treatment that places a cast from the thigh to the toes after gentle stretching of the foot) or French physiotherapy (daily stretching, exercise and massage, and taping to slowing move the foot to the correct position), and those who later required subsequent surgery. The Movement Science Lab recorded gait analysis, ankle strength, daily step activity and parent-reported outcomes of patients 10 years after receiving treatment.

What We Learned

  1. Children with clubfeet have less range of motion, movement and power in their ankle in comparison to children with normal feet.
  2. There are minimal differences in gait, parent-reported outcomes and daily activity between feet treated with Ponseti casting or physical therapy.
  3. Feet that did not receive surgery had better ankle power and muscle strength than feet requiring invasive joint surgery.

Clinical Significance

This study supports our efforts to minimize invasive joint surgery when treating a patient with clubfoot. Functional studies such as this continue to help our doctors in developing treatment plans for patients diagnosed with clubfoot.

Read the full article

Non-operative Treatment Outcomes for Patient with Non-Idiopathic Clubfeet
This research was led by Chief Medical Officer B. Stephens “Steve” Richards, M.D., and nurse practitioner Shawne Faulks, M.S.N., R.N., C.N.S.

Summary

Our doctors regularly diagnose and begin treating clubfoot during infancy. Since much of the non-operative treatment takes place before developmental milestones, some patients who were initially thought to have “idiopathic” (no known cause) clubfoot may develop other conditions throughout development rendering a “non-idiopathic” diagnosis. Little is known about the treatment outcomes of this population. Therefore, the purpose of this research is to better understand the clinical outcomes of patients who were later found to have non-idiopathic clubfoot, and how their outcomes compare to patients who have idiopathic clubfoot.

What We Learned

  1. Nearly 1 in 10 infants with idiopathic clubfoot were found to later have non-idiopathic clubfoot due to other orthopedic, neurological or developmental disorders.
  2. Non-idiopathic patients can be expected to respond favorably to non-operative treatment.
  3. Patients later found to be non-idiopathic had a greater chance for clubfoot recurrence that required surgery.

Clinical Significance

This study demonstrates the importance of developmental assessments during a child’s clinical visit. Pediatric orthopedic specialists should be proactive in evaluating more than just clubfeet or other orthopedic disorders during follow-up exams.

Read the full article

Learn more about the research in our Center for Excellence in Foot.

McIntosh and Tulchin-Francis Receive the Women Who STEAM Award

McIntosh and Tulchin-Francis Receive the Women Who STEAM Award

by | May 3, 2019 | Research & Innovation

At Scottish Rite Hospital, our team of experts are recognized nationally and internationally for their dedication to advancing the care for children with orthopedic conditions. This week, two of the hospital’s very own received a unique honor.

Pediatric orthopedic surgeon Amy L. McIntosh, M.D., and Division Director of Movement Science Kirsten Tulchin-Francis, Ph.D., were selected as Women Who STEAM by the Dallas Chapter of The Links, Incorporated. The STEAM award acknowledges outstanding women from diverse backgrounds in the areas of science, technology, engineering, arts and math. McIntosh, Tulchin-Francis and the other six women honored, have made remarkable contributions in their respective fields, while also teaching, mentoring and serving within the community and workplace.

McIntosh and Tulchin-Francis are leaders and innovators at the hospital. Both understand the importance of educating the next generation, especially young women who may be interested in the sciences. Together, they organize and host the Dallas Perry Outreach Program and Medical Student Outreach Program through The Perry Initiative – an organization that encourages young women to pursue careers in orthopedic surgery and engineering. They have the opportunity to share their story to this group and showcase what it is like to be a female working in this industry. “The greatest honor is to have the opportunity to influence young girls,” says Tulchin-Francis. “Being able to show them what I do and letting them take what they are learning in the classroom and see how it can be applied in real life is a victory in itself.”

The Links, Incorporated is an international, not-for-profit corporation established in 1946 that consists of over 15,000 professional women of color located throughout the world. The 2019 inaugural Women Who STEAM Award luncheon was hosted by the corporation’s Dallas chapter. They recognize the tremendous value in actively supporting the growth and development of young girls to create a positive future for the community. The chapter established the Women Who STEAM Award to create a pipeline to success for all girls of color, specifically in the STEAM fields.

(Photos courtesy of Reflections HP Photography, ReflectionsHD.com)