New Pediatric Applications for Astym Therapy

New Pediatric Applications for Astym Therapy

Astym Therapy: Secret to Success at Paley Institute

We are all familiar with the many ways Astym therapy has helped a wide variety of orthopedic patients. But did you know that Astym therapy can also help children with neurologic and/or orthopedic conditions?

The Paley Orthopedic and Spine Institute in West Palm Beach, Florida is world renowned for their role in orthopedic surgeries, as well as their innovative therapy treatments. The Paley Institute treats many different orthopedic conditions and patient age groups. However, they are best known for their management of the most disabling of pediatric congenital abnormalities.

We would like to introduce you to their Director of Rehabilitation, Dr. Fran Guardo. MEd, MPT, DPT,BSPTS C-1, Astym cert.

Dr. Guardo has worked in movement science since the early 80’s, first as an Exercise Scientist, then becoming a Physical Therapist in 1999. Since 2009, she has been the Director of Rehabilitation for the Paley Institute. In addition to actively treating patients, she also trains therapists and surgeons, nationally and internationally, in the rehabilitation techniques utilized with their highly specialized population. She is an adjunct professor for Nova Southeastern University and has been performing Astym treatments since 2016.

We asked Dr. Guardo, “As a department manager and physical therapist, how does Astym therapy impact the results that you see in your clinic?

I have found Astym therapy to be one of the most transformational techniques in my career. I have taken the basics that I learned in the course and innovated from there based on anatomical concepts and knowledge.”

As a facility director, Dr. Guardo ensures that all her treating therapists are certified in Astym therapy. When asked about the type of patients that she typically sees in her practice, she responded,

I have treated all ages who are undergoing limb lengthening or post lengthening, Arthrogryposis, Cerebral Palsy, clubfoot, torticollis, scoliosis, kyphosis, hyper lordosis–to name a few.

A common condition seen at the Paley Institute is Arthrogryposis. Babies with this condition are born with multiple joint contractures throughout their trunk, extremities, feet, and hands. Cervical Torticollis is common as well. This little guy’s trunk extensors are so tight that he cannot lie prone with his pelvis on the floor.

Many doctors take a “wait and see” approach when presented with these children. At Paley, however, treatment starts at about 4 weeks of age. In their experience, children born with arthrogryposis who receive successful early intervention will:

  • Minimize the amount and scope of any future, corrective surgeries.
  • Establish better movement patterns, allowing them to achieve their developmental milestones in a timelier manner.
  • Be given more opportunities to interact with their environment, resulting in enhanced cognitive and social development.

At Paley, multiple areas of involvement are treated simultaneously, utilizing the combined services of both OT and PT.

Dr. Guardo ensures that all treating therapists at Paley are certified in Astym therapy. They all agree that following treatment, their patients experience an immediate decrease in pain. This allows these children to be stretched more assertively during their treatment sessions and/or subsequent serial casting. Paley therapists also see that their patients demonstrate an immediate improvement in muscle activity and motor control. For example, children who have previously not shown any quadriceps activation will often kick their leg right after treatment.

We asked Dr. Guardo if children and infants responded differently to Astym therapy, as compared to older patients.

Infants and children have varied responses. They tend to get a flush response when I treat over tight tissue, even if I don’t feel the texture that I feel with adults. The infants rarely ever bruise”.

The Astym therapy education staff has worked closely with these dedicated therapists, and recently presented at their Advanced Rehabilitation Techniques for Limb Lengthening and Deformity Course held at Paley.

In addition to on-site, Paley-specific training sessions, the Astym therapy team has provided Paley with several sets of specialty instruments, which are designed to reach in and around the external devices associated with the treatment of these little superstars.

Astym therapy plays a big role in the treatment success seen at the Paley Institute. But the therapists at Paley are not the only ones getting great results with their pediatric patients. Other Astym certified therapists have achieved outstanding results with their own pediatric patients. Astym therapy has been shown to be helpful in the treatment of children with cerebral palsy. Certified therapists observe that following treatment, their patient’s abnormal resting tone is reduced, which allows these children to be stretched-then splinted-more assertively.

A case study was published in 2016, which documented these findings. It was shown that following Astym treatment, the child’s muscle resting tone was normalized and their gait patterns improved. Specifically, the child ambulated with even stride length and demonstrated diminished genu recurvatum. There was a decrease in the child’s reports of pain when standing and walking. Ultimately, this child was able to discontinue use of their AFO.

If you or any of your colleagues work with pediatric conditions such as torticollis, club feet, leg lengthening procedures or cerebral palsy, think about what a difference Astym therapy can make in the lives of these children. Just imagine the joy in helping a child like this little cutie, as they rapidly progress to the level of functional success that you see here.



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