Author: JJA
A 2 and ? year old girl with spastic hemiplegia (Affecting one side of her body) was brought to her local DEC for a telemedicine visit. The purpose of this visit was to assess the result of a botulinum toxin (Botox?) injection to her calf muscles done the month before at a distant medical center. The videoconference participants included the treating doctor at the medical center and the child, her mother and the DEC?s physical therapist who had worked with the child before.
The mother reported that her daughter?s affected ankle had become looser following the injection, but sometimes it was difficult to stretch the ankle because her daughter would not cooperate. The PT agreed.
The doctor watched the child walk and noticed that she was not walking up on her toes as much since the injections, but when the local PT tried to demonstrate her ankle range of motion by stretching the girl?s leg, she became upset and would not stay still.
Trying to redirect the child, the doctor asked her to come up to the TV and give him a ?high five?. Interested, the girl stopped squirming, got up off the floor, walked over to the computer monitor, and slapped the picture of the doctor?s hand on the screen.
The doctor then asked the girl if she had watched ?American Idol? on television the previous night. When she nodded and smiled, the doctor and the physical therapist knew they might now have a way to complete the range of motion assessment.
The doctor told the girl that they were going to pretend she was on TV. The physical therapist brought out a blue therapy mat that became a ?stage?.
The doctor told the girl that they were going to pretend that she was on American Idol and she could perform on ?TV? while she was being stretched. The girl readily agreed to lie down on the therapy mat and allow the PT to perform a full range of motion exam while she watched herself on the video screen.
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