Physical Medicine and Rehabilitation

Pediatric physiatrist Dr. Nadine Trainer has more than 25 years of experience in physical medicine and rehabilitation.  As Medical Director for Children’s Hospital’s rehabilitation services, she provides clinical oversight of outpatient, inpatient and Home Health rehab services.

Physiatry focuses on treating all aspects of a child’s development and establishing a treatment plan that incorporates physical, occupational and speech therapy goals. Patients often have a developmental disability, problems with fine or oral motor skills, or complaints of muscular pain or discomfort.

Children today increasingly survive chronic and acute illnesses, leading to a growing population of children who need the unique elements of physiatry care. Along with providing inpatient consultation, assessment and care planning services, Dr. Trainer manages a seating/wheelchair clinic, working with specialists in physical therapy and medical equipment to design individual plans for wheelchairs, bath chairs and other devices to improve independence and function.

Dr. Trainer also manages the Children’s Hospital developmental follow-up clinic which monitors the health and development of children birth to two years old at high risk for developmental delays. 

Rehabilitation staff members treat 50-75 patients each weekday at the outpatient Rehab Center located in West Knoxville and see all Children’s Hospital inpatients who need rehab care. Evaluation and treatment services are child and family-focused, multidisciplinary and comprehensive.

Physical therapy focuses on development of skills needed to functionally move in the environment, such as walking or using a wheelchair. The Rehab Center’s therapeutic pool offers a setting for practicing physical therapy skills through aquatic rehabilitation.  Physical therapists also cast custom shoe inserts and fabricate splints to assist in reaching therapy goals. They plan an important role in the Healthy Ways and Rx: Fitness programs, as well as rheumatology, cystic fibrosis and hematology/oncology clinics.

Occupational therapists focus on fine motor skills and improving a child’s daily living activities through therapy. Services are provided in therapy rooms, the pool and the sensory integration room, which is equipped with specialized equipment to help children process sensory input.

Speech therapy services include oral motor development and feeding, development of receptive and expressive communication skills and access to technology that assists a patient during therapy. Speech therapy sessions also may be held in the pool to improve a child’s breath capacity, vocalization and volume. Speech therapists participate in the cleft lip and palate clinic and work with radiology staff to perform modified barium swallow studies.

Rehab social workers address family needs, including resource coordination, education, behavior management, interpretive services and advocacy. Social workers also work with families to help them access public school services required for achievement of educational goals.

Good nutrition is critical to each child’s health and development. Nutrition services are an integral aspect of comprehensive rehab services and support occupational, physical and speech therapy goals.