Rehabilitation and functional outcomes for thoraco-omphalo-ischiopagus conjoined twins five years after separation: A case report.

This is a case report of a single pair of conjoined twins, not a trial, so it cannot show that any treatment caused the outcomes. The twins received many interventions at different times, including surgery, prehabilitation, inpatient rehabilitation, outpatient therapy, equipment, bracing, orthoses, and prostheses, so the contribution of any single component cannot be separated. Outpatient therapy compliance was not objectively assessed, and outpatient function was not measured with a consistent validated outcome because different sites used different scoring methods. The report says the progression of the twins was not always linear and the exact timing of independent ambulation is not known. The twins had extremely complex anatomy and medical comorbidities, including shared organs, ostomies, vesicostomy, skin flaps, kyphosis, and scoliosis, so findings may not apply to other children.

Do not conclude that separation or any specific therapy caused these gains. This is a case report of a single pair with many combined interventions and no comparison group.