Rehabilitation services include physical therapy, occupational therapy, and recreational therapy. Children and teens who need these services often start receiving them while they are in the hospital (e.g., for vincristine neuropathy). Then, at discharge, the oncologist will write orders for home services. Various rehabilitation services are available either privately (paid for by insurance, if covered) or through the school system.

Physical therapy

Physical therapy involves using exercise and motion to improve the body’s strength and movement. If an arm or leg is not moving at all, the physical therapist moves the limb through the entire range of motion to prevent the muscles from tightening during recovery. When the arm or leg begins to recover, the physical therapist devises strengthening exercises for the affected limb. Physical therapy uses equipment such as tilt tables, stationary bicycles, and treadmills. Therapy in a pool (also called aquatic therapy) is another form of physical therapy used to strengthen affected limbs.

William’s vincristine neuropathy is pretty bad. He didn’t get much physical therapy for the seven months we were inpatient, nor during the stay for his BMT [bone marrow transplant]. He is getting lots of help now. He has the half boot orthotics and also wears orthotics in his shoes. His arch completely dropped. He has both nerve and strength issues.

Occupational and recreational therapy

Occupational therapy focuses on recovering or maintaining the ability to participate in activities of daily life. For example, occupational therapists help children regain the fine motor skills needed to tie shoes, hold a pencil, eat, and dress themselves. They also evaluate the child’s need for any special equipment to maximize independence, such as an adaptive holder to help the child write with a pencil or a computer if writing by hand is not a realistic goal.

Recreational therapy also works on activities of daily living, as well as on social and cognitive functioning, developing coping skills, and integrating children back into community settings. Examples of methods used by recreational therapists are creative arts (e.g., painting, dance, drama), sports, and leisure activities.

Accessing therapies in school

Rehabilitation helps many children make a full, or near full, recovery. Your child may be able to get rehabilitative services at school, because schools are required to provide educationally relevant therapies (e.g., physical therapy and occupational therapy). For information about therapies provided by schools, see Chapter 20, School.

Our son had some physical therapy as soon as he could tolerate it in the hospital. He was under 3 and eligible for early intervention services (which are available to all children younger than school age who have the potential for delayed development) because of his diagnosis, so we asked for and received some physical therapy from them for a period of time after he was discharged from the hospital.