Sample physical therapy prescriptions for nonoperative musculoskeletal trauma in children and adolescents

Phase of healing/rehabilitation

Sample prescription

Inflammatory

Goals:

- Protection of injured structures

- Relative rest

- Decreased swelling and inflammation (ice, elevation, compression)

- Maintenance of cardiovascular fitness

Diagnosis: Grade 2 ankle sprain

Passive support/air cast.

Lace up brace/air cast. Evaluate for/fit assistive device (crutch, roll-about).

Ice, compression, elevation, local modalities as indicated for edema reduction and restoration of ROM.

Cycling, aquatics, upper extremity ergometer.

Reparative

Goals:

- Protection of injured structures

- Range of motion, joint mobility, and flexibility

- Reestablish proprioception

- Maintenance of cardiovascular fitness

- Progression from voluntary muscle firing patterns to strength, endurance, and power

Diagnosis: Grade 2 ankle sprain

Manual therapy, progressive resistive exercise, balance training, and lace-up ankle brace for ROM, flexibility, and proprioception.

Progressive weight bearing exercise as tolerated.

Transition from reparative to maturation

Goals:

- Maintenance of cardiovascular fitness

- Range of motion and flexibility

- Normalize proprioception

- Increased strength, endurance, power, speed and agility. Progress to sport-specific skills.

Diagnosis: Grade 2 ankle sprain

Functional exercise progression, closed chain strengthening, agility drills as tolerated.

Maturation

Goals:

- As above for "Transition from reparative to maturation"

Diagnosis: Grade 2 ankle sprain

Sports specific speed, agility, plyometric training.

ROM: range of motion.

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