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Project: Developing a hip surveillance pathway for children with cerebral palsy at Holland Bloorview

Centre for Leadership in Child Development


What was this study about?

Children and youth with cerebral palsy (CP) are at higher risk of having their hip slide or completely come out of joint. This can cause pain and affects caregiving such as getting your child dressed or changing a diaper.

Until now, we did not have a standard way of checking the hips of children with CP at Holland Bloorview. This study used current research to develop a pathway so that all children and youth with CP have hip monitoring and can be referred quickly for treatment when it is needed.

What did we do?

  • We reviewed the evidence for hip monitoring in CP.
  • We developed a pathway for hip monitoring and treatment that is currently being used at Holland Bloorview.
  • We have taught caregivers, physicians, nurses and physiotherapists about our new care pathway so that everyone will know:
    • When to do a hip x-ray to check for the hip sliding or being out of joint.
    • When to refer to the orthopedic clinic or hypertonia clinic.

Impact for clients, families and clinical practice

We are evaluating whether this pathway will help us to detect hip problems early in all of our clients with CP and to ensure that they get the treatment they need as soon as possible.

What did we learn?

Our research of the evidence has confirmed the increased incidence of hip problems and highlighted the importance of early detection of hip sliding in children with CP. We identified key guidelines and publications for monitoring hip sliding in CP

Using this evidence along with information from clients, physiotherapists, nurse practitioners physicians, and students, we developed a pathway that is being used at Holland Bloorview by clinicians and families of children with CP. We are currently evaluating how the pathway will affect clinical care.

Next steps

The next steps in our project will be to:

  • Evaluate how the pathway impacts the care of clients with CP. We are consulting with clinicians, as well as family leaders and reviewing charts to learn how the care pathway has been implemented at Holland Bloorview.
  • Explore options to make our pathway and accompanying information available online and accessible to physicians, clinicians, families, and learners.
  • Continue sharing our pathway with other centres through the Ontario Association of Children’s Rehabilitation Services and internationally at the American Academy of Cerebral Palsy and Developmental Medicine Conference