CHEERS (Paediatric Rheumatology)

Our Paediatric Rheumatology service is involved in the diagnosis and management of the following conditions (as stipulated within the NHS England service specification for Paediatric Rheumatology).

The paediatric rheumatology physiotherapy and occupational therapy team at Addenbrooke’s Hospital treats patients with inflammatory musculoskeletal conditions.

The role of the OT in treating young people with inflammatory and non-inflammatory conditions is very diverse, ranging from:

• Assessing the child’s ability to perform day-to-day tasks and routines and suggesting alternative ways to carry out tasks
• Offering practical support and advice on assistive gadgets/aids for example pencil grips, writing slopes, bath boards
• Offering advice on pain management and techniques to improve sleep and energy levels
• Acting as a liaison between the family, health and social care teams and school about current needs
• Setting patient centred goals to maintain their engagement in therapy and to motivate them to return to full function.

How will Occupational therapy help?

The OT can help by suggesting:

• Hand/wrist exercises to strengthen or stretch specific muscles
• Activity modification by suggesting different ways to do an activity for example, adopting a more supported seating posture, taking regular rest breaks and getting the correct pen grip with or without the help of a pencil/pen grip aid
• Splinting - splints are sometimes used:

When joints are very painful and the pain and stiffness are having an effect on their ability to carry out certain tasks

To stabilise a joint if there is deviation or subluxation (i.e. misalignment/dislocation)

To stretch out soft tissues which have tightened and caused loss of movement to e.g. a finger joint

• Teaching relaxation techniques and techniques to increase sleep and energy levels
• Pain management advice techniques to help to reduce pain and stiffness in their hands and wrists
• Providing information to school to support a child attending and participating in lessons and extracurricular activities during their school day
• Pacing/energy conservation: when a child is working towards a specific goal or trying to increase their muscle strength and endurance it’s important they pace themselves

We are dedicated to high quality medical research in the knowledge that this is the principle way that improvements in care and in outcomes can be achieved. Children and young people who come into our service will be given the opportunity, where eligible, to take part in open research studies (in Norwich and / or Cambridge).