Cerebral palsy multidisciplinary clinic opens downtown

By bringing different specialties together, the team approach improves the care Norton Children’s can provide for children with multiple medical conditions.

A new multidisciplinary cerebral palsy clinic for children who need a higher level of care has opened in the Novak Center for Children’s Health in downtown Louisville. The clinic aims to streamline care, make appointments easier for families and improve outcomes.

“Multidisciplinary clinics allow one patient to be seen by multiple doctors instead of the other way around. It makes it much easier on our patients’ families. Some of them are coming from three to four hours away,” said Christopher Barton, M.D., Norton Children’s Cerebral Palsy Clinic director and a child neurologist with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine.

Dr. Barton runs the clinic with pediatric orthopedist Star L. Nixon, M.D., of Norton Children’s Orthopedics of Louisville; and Catherine P. Schuster, M.D., and Mary Marie E. McClanahan, M.D., pediatric physical medicine and rehabilitation specialists with Norton Children’s Physical Medicine & Rehabilitation. Norton Children’s Orthopedics of Louisville and Norton Children’s Physical Medicine & Rehabilitation are affiliated with the UofL School of Medicine.

According to Dr. Barton, bringing different specialties together in a team approach improves the care Norton Children’s can provide for children with multiple medical conditions.

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“The multidisciplinary approach ensures things don’t get missed,” said Dr. Barton, who is also an assistant professor of child neurology at the University of Louisville School of Medicine. “We’ll come up with an idea that we might not have come up with on our own. That’s what brings better patient outcomes — constant communication.”

Offering the full range of care at one location has an added benefit for children with cerebral palsy, who often have mobility issues, according to Dr. Barton.

In addition to its physicians, the cerebral palsy multidisciplinary clinic also has an orthotist, a social worker and a nurse navigator working with the children and families.

The clinic opened in October 2020, and providers are on-site the third Monday of every month.

Custom therapies for each child

Because spots are limited, Drs. Barton, Nixon, Schuster and McClanahan determine which patients qualify for the clinic. Physicians who have patients they think could benefit from the multidisciplinary approach should refer to one of the clinic’s doctors first for an evaluation.

The clinic treats all cerebral palsy types: ataxic, athetoid, diplegic, dyskinetic, hemiplegic, spastic and quadriplegic. The multidisciplinary team follows each patient, adapting the treatment to the changing needs as the child grows and develops.

According to Dr. Schuster, medical director of pediatric rehabilitation at Norton Children’s Physical Medicine & Rehabilitation, residency program director and associate professor of physical medicine and rehabilitation at the University of Louisville School of Medicine, rehabilitation treatment strategies are designed for each child, based on severity of their condition, the underlying pathology and anticipated function.

“Patients with cerebral palsy require a multidisciplinary approach, and having all these people interested and willing to provide the best care to achieve improved outcomes for our patients is really the most important thing,” Dr. Schuster said.

Treatments offered by the clinic include bimanual training (BIT); constraint-induced movement therapy (CIMT); intrathecal baclofen pump; botulinum toxin injections; splinting and bracing; strengthening; selective dorsal rhizotomy and other neurosurgery; and orthopedic surgery, including soft tissue and tendon lengthening, hip osteotomy, spinal fusion and rhizotomy.

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