Physical Medicine & Rehabilitation

University Pediatricians | Michigan

About the Division of Physical Medicine & Rehabilitation

The Division of Physical Medicine and Rehabilitation (PM&R) at the Children's Hospital of Michigan (CHM) specializes in the rehabilitation and medical management of children with special healthcare needs for conditions including but not limited to: cerebral palsy, brain injury, spinal cord injury, and spina bifida/myelomeningocele, neuromuscular disorders, developmental delay and musculoskeletal conditions.

 

Physicians on staff understand how cognitive and physical impairments affect growth and development. They use this knowledge to work with patients and their families to develop individualized treatment plans to restore or improve function and quality of life. Physicians work closely with the team to manage spasticity, swallowing disorders, developmental therapy needs, and bracing and equipment needs. Procedures including neurolytic injection, alcohol blocks, and intrathecal baclofen pumps are used as part of the comprehensive spasticity management program.


Disabilities, illness or injuries treated in both the inpatient and outpatient clinics include:

  • Amputations
  • Arthrogryposis
  • Brachial plexus injury
  • Brain tumors and other childhood cancers
  • Burns
  • Cerebral palsy
  • Cerebral vascular accident
  • Complex regional pain syndrome
  • Gait deviations
  • Muscular dystrophy
  • Neuromuscular disease
  • Orthopedic injuries or disorders
  • Spina bifida
  • Spinal cord injury
  • Spinal muscular atrophy
  • Sports injuries
  • Torticollis
  • Traumatic and non-traumatic brain injury


CHM provides a 12-bed inpatient rehabilitation program certified by the Commission on Accreditation of Rehabilitation Facilities (CARF), demonstrating dedication to accountability and compliance with internationally accepted standards of excellence.


A friendly child-centered atmosphere is provided, dedicated to helping children be comfortable during their outpatient visits. Specialty clinics and programs include: Myelomeningocele/Spinal cord injury clinic, Muscular Dystrophy Clinic, Intrathecal Baclofen Pump Program and Alcohol Block Clinic for treatment of spasticity.

Rehabilitation

The Children's Hospital of Michigan offers a full complement of therapy services in a 12-bed inpatient unit with four convenient outpatient locations for children and adolescents recovering from injury or illness. Therapists are pediatric rehabilitation specialists including team members certified in NDT (Neurodevelopment Treatment) and SIPT (Sensory Integration and Praxis Tests). The rehabilitation centers are kid-friendly and the therapy staff is skilled in working with children in a therapeutic milieu.


The primary focus of the inpatient program is to help each child improve their function and prepare them for return to home, school and the community. Based on the child's needs, the rehabilitation program focuses on mobility, activities of daily living, communication, memory and social interaction. When necessary, adaptive equipment is used to help each child achieve as much function as possible. The interdisciplinary team is experienced in the complexities of pediatric disability and rehabilitation.



The inpatient program admits children with neurological (traumatic and non-traumatic brain injury, spinal cord injury and cerebral vascular accident), congenital and orthopedic conditions. Children with extensive burns and other disabling conditions are also candidates for admission to the unit.

Leadership

Division Chief: Charles B. Pelshaw, MD

Physical Medicine & Rehabilitation Clinical Programs

Physical Medicine and Rehabilitation (PM&R) staff work with many departments within the hospital to generate a rehabilitation plan for our patients. Available services include:

  • Augmentative communication
  • Intrathecal Baclofen intervention
  • Occupational therapy
  • Physical therapy
  • Prosthetics/orthotics
  • Social work
  • Speech pathology

  • Inpatient Rehabilitation Unit:

    Physicians provide inpatient consultations, and the PM&R Division runs the inpatient rehabilitation unit, a 12-bed Commission on Accreditation of Rehabilitation Facilities (CARF), demonstrating dedication to accountability and compliance with internationally accepted standards of excellence in pediatric rehabilitation . The Division works closely with an interprofessional team including physical, occupational, and recreation therapists, speech and language pathologists, rehabilitation nurses, orthotists, prosthetists, psychologists and neuropsychologists, care managers, social workers, and dietitians, and pharmacists to provide comprehensive patient care. They also collaborate with cardiovascular surgery, neurology, neurosurgery, orthopedics, genetics, hematology, oncology, trauma, and pediatrics on a regular basis.

  • Myelomeningocele/Spinal cord injury clinic:

    The Myelomeningocele Care Center at the Children's Hospital of Michigan DMC is the only program of its kind in Metropolitan Detroit. It has provided multidisciplinary care to children with spina bifida, spinal cord birth defects, spinal cord injuries, spinal cord tumors and infections for more than 30 years. The center offers a one-stop medical care solution for children with multiple neurosurgical, urologic, orthopedic and rehabilitative health-related issues.


    Additional clinic support services include nutrition, wound, ostomy, continence nursing, psychology, physical therapy, occupational therapy and social work as well as orthotic and equipment needs. Myelomeningocele Care Center staff take a family-centered care approach to treatment, because family has the greatest influence on child health and development. A family-centered discussion of the child takes place during annual multidisciplinary evaluations.

  • Muscular Dystrophy Clinic:

    The Division works in conjunction with the Neurology Department at the Children’s Hospital of Michigan which is nationally known for research, diagnosis and treatment of muscular diseases in children including muscular dystrophy, Charcot-Marie-Tooth disease and spinal muscular atrophy. Patients have access to innovative treatments and medications through clinical trials. Working in conjunction with the Muscular Dystrophy Association, the Children’s Hospital of Michigan offers a multidisciplinary muscular dystrophy clinic in Detroit. Team members include a PM&R physician, neurologist, pulmonologist, physical therapist, occupational therapist, respiratory therapist, social worker, orthotist and equipment vendor.

  • Intrathecal Baclofen Pump Program:

    The Division works with the Neurosurgery group in the placement and management of intrathecal baclofen ( ITB) pump for treatment of severe spasticity. The Children’s Hospital of Michigan has the largest pediatric pump population in Metro Detroit. Patients have a pump trial done to see if they are a candidate for the ITB pump. If they are, they are sent to Neurosurgery for evaluation and subsequent pump placement. They are then either admitted for inpatient rehabilitation following placement for aggressive pump management or return for frequent visits to maximize the pump's ability to control the spasticity.

  • Alcohol Block Clinic:

    The Alcohol Block Clinic is a clinic specifically designed as an adjunct way to treat spasticity. It is believed to be the only one in the Metro Detroit area where patients are placed under anesthesia to obtain spasticity control of the obturator nerve. In conjunction, botox injections can also be performed in smaller muscle groups at the same time under anesthesia- thus eliminating the trauma to the child of receiving additional injections while awake.

  • Spasticity Clinic

    We have a Multidisciplinary Spasticity clinic that patients are referred from both PM&R clinics and from outside providers specifically if they have failed oral spasticity/ botulinum injections.  Patients are seen by PM&R physician  and /or PM&R Physician Assistant, Neurosurgeon, Physical and Occupational therapist and are evaluated for Intrathecal baclofen pumps and rhizotomy.  Recommendations are made by the team to the family on which procedure the patient qualifies for. 

Faculty

Faculty


Advanced Practice Providers

  • Melisa Concepcion, PA-C
  • Debra Hsieh, CNP

Want to learn more about our distinguished specialists? Click the button below to be taken to our Faculty Directory.

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Education

Learn more about the residency program and fellowships offered in affiliation with the Children's Hospital of Michigan.

Research

Recent Faculty Publications

  • Charles Pelshaw, MD

    • Journal of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach -1 (2020) 1–7 1 *(case report on GBS) DOI 10.3233/PRM-180562 

  • Christina Santia, DO

    • Co-author of "Paradoxical Reaction to Increased Doses of Intrathecal Baclofen in a Patient with Leigh Syndrome” which has been accepted in the Journal of Pediatric Rehabilitation Medicine.

Recent Faculty Abstracts/Presentations (National)

  • Charles Pelshaw, MD

    • Marupudi NI, Ayoubi L, Concepcion M, Pelshaw C, Erlandson E. Short-term Functional Outcomes of Infra-Conus Mini-Laminotomy for Selective Dorsal Rhizotomy: A Surgical and Rehabilitative Perspective. 43rd Annual Meeting of the American Society of Pediatric Neurosurgeons (ASPN), Nassau, Bahamas, Jan 26-31, 2020.