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Little Milestones, Big Impact: Play is Key Part of Physical Therapy

patient with therapist

As the leader in specialty pediatric burn care, Shriners Children’s provides wraparound services at each stage of a child’s recovery from the acute injury to reconstructive surgeries.

A key part of the multi-disciplinary approach to burn treatment is physical therapy, and it starts as soon as the child is admitted to one of Shriners Children’s four burn hospitals.

“Our care plan starts on day one,” said Rehabilitation Manager Kim Tran, who has worked as a physical therapist at Shriners Children’s Ohio for 27 years. “We determine the child’s range of motion and focus on those areas where it may be limited.”

patient with therapist

The physical therapists at Shriners Children's all have a singular focus: getting kids back to pre-burn activities.

Burn patients tend to have difficulty moving because the scar tissue is tighter than regular skin. So a big part of physical therapy is movement and stretching.

“We pride ourselves on having an aggressive approach to physical and occupational therapy, so we get these kids up and moving as much as possible,” Tran said.

This is where physical therapists tap into their creativity.

“We want to incorporate play as much as possible, so we have toys, games and all kinds of tools to add a little fun,” Tran said.

For example, therapists may blow bubbles and ask a child to stretch their arms high to pop them. The team works on gripping and grabbing by pulling and peeling stickers or using small building blocks to a create a castle.

patient playing basketball

Even things like basketball can be an important part of a physical therapy plan.

The method may look a little different based on a child’s medical needs, but Tran said the goal remains the same: getting them back to pre-burn activities.

“If a toddler was crawling before the burn injury, we work to get them back to that point. Or if an older child was attending school, we’re going to get them into the classroom again,” Tran said.

The continuum of care at Shriners Children’s can sometimes span years after the injury.

“What’s unique about children who have a burn injury is the affected skin can’t move with their growth spurts, so they have to come back for reconstructive procedures,” she explained. “We’ll work with them again to help straighten their elbow or leg.”

Every stretch and step adds up to a victory for patients and their therapists.

“The most rewarding part of my job is helping a child through a really traumatic event so they can go back to being a kid,” she said. “Every therapy session has so many little milestones that ultimately lead to good outcomes and that child walking out of the hospital.”

Shriners Children’s provides specialty pediatric burn care at four locations: Shriners Children’s Ohio, Shriners Children’s Boston, Shriners Children’s Texas and Shriners Children’s Northern California.

How Shriners Children's incorporates play into rehabilitation

Shriner Children's Ohio Physical Therapist Kim Tran explains the importance of physical and occupational therapy for children with burns. Read more about our physical, occupational, and recreational therapies.
View Transcript

Jessica Wagner:

Hi everyone. It's Jessica Wagner, marketing and communications coordinator here at Shriners Children's Ohio and today I'm really excited to introduce to you physical therapist Kim Tran. She may look familiar to you. You may have seen her in some of our videos featuring Avery in our occupational and physical therapy gym. So we now are going to take this opportunity to get to know her a little bit better.

Our therapy team is really important to all of our patients, particularly those with burns. In the video you see Avery, she's looking like she's having a lot of fun and she is, but there's a reason behind that. So Kim, let me turn it over to you and explain a little bit of what's going on inside the gym.

Kim Tran:

Sure. So burn patients tend to have difficulty moving and the scar tissue wants to limit how much they move. So with kids especially, we try to incorporate play as much as possible. So if we have to stretch their arms up, we'll blow bubbles and make them pop the bubbles up in the air. Or if they're working on using their hand to grasp things, we will get the little toys out and move Hot Wheel cars all over the place to try to strengthen their hands as well. So it just makes it more fun. It's not always fun, but it does make it more fun.

Jessica Wagner:

That's great and there's the play aspect, but there's also the continuum of care that you guys provide. So you will stay with a patient like Avery or other patients throughout their growing years, is that right?

Kim Tran:

Correct. We see our patients up to 21 years old. Because the scar tissue tends to feel tight and not be as stretchy as regular skin, as our patients go through growth spurts, they have to come back and they may have complaints that maybe their elbow isn't straightening as much as possible 'cause they just grew two inches. So they will come back for reconstructive procedures and we will teach them again how to take care of it and how to make the most out of that procedure so they move the best that they can.

Jessica Wagner:

I think it's so wonderful that as part of your job, you get to stay with these kids as they grow and develop and turn into young adults. Tell me a little bit, what is the favorite part of your job or what you find most rewarding?

Kim Tran:

Easily it's knowing that we can get these patients through one of the most traumatic things that will ever happen in their life and get them returning to what they were doing pre burn. Whether it was going to school, crawling. Anything that they were doing before we get them back to where they were.

So for me, the most rewarding thing is knowing that a patient has been on bedrest for five days and now I'm getting them out of bed and they're going to walk 50 feet. So there's so many milestones on a day to day basis and it makes it very rewarding.

Jessica Wagner:

Yeah. That plays into our current campaign, the Watch Me Campaign of when our patients do reach these milestones and they say, "Watch me do this," and we all celebrate those important milestones in their recovery.

Well Kim Tran, thank you so much for taking a few minutes to talk with me. I'm sure I'll be seeing you again in the gym because it's a really fun place for our kids to build up some of their muscle and recovery and stay loose and lumber and continue on that path. So Kim Tran, thank you so much. For you guys watching you can always get more information about Shriners Children's Ohio on our website, Kim, thank you so much.

Kim Tran:

Thanks for having me.

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