Foreword: pediatric orthopedics in physical therapy.

Management of the child with an orthopedic impairment should be of interest not only to pediatric therapists but to all physical therapists who deal with clients with any type of musculoskeletal disorder. An understanding of normal musculoskelctal development, as provided in the first article of this two-part special series, is critical to the conscientious management of any individual with disease or abnormality of muscles, bones, or joints. Because it is impossible within this special series to provide a comprehensive review of the entire field of pediatric orthopedics, we have chosen to focus on some of the more common orthopedic concerns of children with developmental disabilities, limb deficiencies, juvenile rheumatoid arthritis, and idiopathic scoliosis.

Landmark federal legislation implemented during the past two decades has greatly expanded the role of physical therapists in both assessment and management of infants, children, and adolescents with orthopedic and neurologic disabilities. Both Public Law 94-142 and Public Law 99-457 identify physical therapists as primary team members in providing services to infants, preschoolers, and school-aged children with handicapping conditions. Despite an increase in the number of physical therapists employed in early intervention centers and public school systems, the extent of the service needs and demands cannot be met without assistance from physical therapists in private practice and hospital settings. Thus, it is incumbent on all physical therapists to expand their knowledge base concerning the care and management of children with orthopedic and other disabilities.

The articles in this special series encompass a wide range of topics related to the assessment and management of children with a variety of orthopedic impairments. This issue begins with a review of musculoskeletal development and is followed by articles that discuss the topics of joint mobilization, contemporary physical therapy management of scoliosis and juvenile rheumatoid arthritis, prosthetic management of children with limb deficiencies, physical therapy management of myelodysplasia, and the use of lower-extremity orthoses for children with cerebral palsy and myelomeningocele. The final two articles in this issue review current approaches to gait analysis and the assessment of postural control during adapted seating.

The remaining articles in this series will appear in the january issue of the journal and will include articles on assessment of lower-extremity torsional alignment, the role of weight bearing and standing for children with developmental disabilities, preoperative and postoperative physical therapy for the child with cerebral palsy who is undergoing orthopedic surgery, and physical therapy management prior to and following the Ilizarov limb-lengthening procedure.

As co-editors of this special series, we would like to thank the authors of these papers for their patience, persistence, and superb contributions to updating our knowledge of pediatric orthopedics. We would also like to thank the manuscript reviewers, who included both regular reviewers and guest reviewers. We are pleased to note that both the authors and the reviewers for these invited manuscripts represent a wide range of health professionals, including physical therapists, occupational therapists, orthopedists, pediatricians, orthotists, prosthetists, and kinesiologists, thus providing a truly interdisciplinary focus to this special series on the care and management of the pediatric orthopedic client.

SR Harris, Phd, Pr, FAPTA, is Associate Professor, School of Rehabilitation Medicine, University of British Columbia, T325-2211, Wesbrook Mall, Vancouver, British Columbia, Canada V6T 2B5.

LM Knutson, Phd, PT, PCS, is Lecturer, Physical Therapy Graduate Program, and Senior Physical Therapist, Division of Developmental Disabilities, The University of Iowa, 2600 Steindler Bldg, Iowa City, [A 52242.