Direct Access Physiotherapy in the Pediatric Emergency Department

Study Overview
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Brief Summary
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The goal of this clinical trial is to compare two methods of managing low acuity musculoskeletal complaints in children and adolescents ages 6 to 17.99 years in the pediatric emergency department. The main question it aims to answer is whether delivering care in two methods is feasible. Participants will receive care while in the emergency department and will be followed for a period of 1-month post-presentation.

Official Title
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Improving Access to Quality Care for Children and Adolescents Presenting to the Pediatric Emergency Department With Musculoskeletal Problems: a Pilot Randomized Control Trial

Conditions
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Musculoskeletal Pain, Musculoskeletal Diseases or Conditions

Intervention / Treatment
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* Other: Interdisciplinary management
* Other: usual care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 6.00-17.99 years of age present to the Montreal Children's Hospital Emergency Department with a suspected MSK complaint, traumatic or not are given a triage score of 3 (urgent), 4 (less urgent), or 5 (nonurgent) according to the Canadian Triage and Acuity Scale (CTAS) are able to communicate in French or English Exclusion Criteria: present with a major MSK condition requiring urgent care (e.g., open fracture, open wound) a red flag (e.g. progressive neurological disorder, infectious symptoms) a co-morbid unstable condition.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Interdisciplinary<br>Interdisciplinary model for management of low acuity msk complaint | Other: Interdisciplinary management<br>* assessment and treatment in an interdisciplinary model<br>|
| Active Comparator: Usual care<br>usual care | Other: usual care<br>* assessment and treatment in usual care model<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of consent | rate of consented patients related to patients approached rate of randomization, feasibility of administration of outcomes | through study completion an average of 4 weeks post-enrolment | 
| Completed outcome measures | proportion of participants who complete all outcome measures | through study completion an average of 4 weeks post-enrolment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity on faces rating scale | Pain intensity on faces rating scale, scale from 0 to 10, with 10 being a worse score | through study completion an average of 4 weeks post-enrolment | 
| Pain interference with function PROMIS scale | PROMIS Pediatric Pain Interference - Short Form 8a, 8 items scores from 1-5 with 5 being a worse outcome | through study completion an average of 4 weeks post-enrolment |