Objective: To describe a multidisciplinary service model designed for children with complex tone and movement disorders

Background: Pediatric tone and movement disorders are diverse and cause significant disability, the assessment and management of movement disorders requires an integrated and multi-disciplinary team approach. Patients with complex disability often require multiple hospital appointments to see physicians and therapists, they are on multiple medications and require education on their medications, therapies, and equipment and care routines. This creates confusion. Families are often overwhelmed with appointments and care duties. Multi-disciplinary clinics can act as a one-stop-shop where the patient is evaluated and managed by an inter-disciplinary team. This leads to better communications and less burden on the families.

Method: In September 2018 a team of physicians and therapists met to initiate a joint clinic, including a pediatric rehabilitation physician, a pediatric neurologist and a pediatric neurosurgeon as well as a senior pediatric physiotherapist and a senior pediatric occupational therapist. A rehabilitation nurse coordinates the clinic. Patients are referred from various clinics including rehabilitation medicine, neurology and Orthopedics.

Results: The clinic is held monthly, four patients are reviewed every month.
A total of 34 patients (23 males) were seen in the clinic; full assessment was undertaken by the team. Eight patients were selected to have a baclofen test dose to help in decision making. Six patients were recommended Selective Dorsal Rhizotomy and four underwent the procedure. Three patients were offered baclofen pumps and two are awaiting funding, two patients were recommended to have deep brain stimulation, one of them underwent the procedure abroad.
Overall; 16 patients were offered intervention following the clinic assessment and five underwent successful procedures. Reviewing the 12 patients whose main reason for attending the facility was movement and tone issues, the mean reduction in their clinic visits after enrollment in the clinic was 50%.

Conclusion: The multidisciplinary movement and tone disorder clinic leads to more streamlined patient selection for surgical procedures and reduces the burden of clinic visits on the patient and family.

References: 1. van Egmond, M.E., Eggink, H., Kuiper, A. et al. Crossing barriers: a multidisciplinary approach to children and adults with young-onset movement disorders. (2018) J Clin Mov Disord 5, 3 2. Bent N, Tennant T, Swift T, Posnett J, Scuffham P, Chamberlain MA, et al. Team approach versus ad hoc health services for young people with physical disabilities: a retrospective cohort study. Lancet. 2002;360:1280–6.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/complex-pediatric-tone-and-movement-disorder-clinic-a-model-for-multi-disciplinary-care-in-qatar/