Short-Term Powered Mobility Intervention is Associated With Improvements in Development and Participation for Young Children with Cerebral Palsy: A Randomized Clinical Trial.

IF 3.5 4区 医学 Q1 ORTHOPEDICS Physical Therapy Pub Date : 2024-10-25 DOI:10.1093/ptj/pzae152
Heather A Feldner, Samuel W Logan, Sango Otieno, Anna Fragomeni, Carissa Kono, Katie Riordan, Bethany Sloane, Lisa K Kenyon
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Abstract

Objective: The objective of this study was to evaluate the effects of 2 short-term powered mobility interventions across developmental domains, participation, and perceptions of intervention implementation for young children with cerebral palsy and their families.

Methods: This randomized, crossover clinical trial compared 2 powered mobility interventions: the Explorer Mini (Permobil AB, Timra, Sweden) and an adapted ride-on toy car. Analyses included 24 children aged 12 to 36 months, recruited from 3 sites. Each device was trialed in the home for an 8-week period for a total of 16 weeks. Three in-person study visits took place at baseline, crossover, and study completion, and 2 additional virtual check-ins were conducted for each device trial period. Outcome measures included all domains of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4); Child Engagement in Daily Life (CEDL) participation questionnaire; and t3 perceptual implementation measures: Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Analyses included descriptive statistics, 2 by 3 group × time analysis of variance, and post hoc t tests as warranted.

Results: Statistically significant mean improvements were observed in all domains of the Bayley-4 and in the self-care subscale of the CEDL regardless of device order. Caregivers ranked both devices as acceptable and feasible to implement, although the Explorer Mini was ranked slightly more favorably than the adapted ride-on toy car, with a device order effect being observed.

Conclusion: Short-term powered mobility intervention may advance multiple domains of development and participation for young children with cerebral palsy. Caregivers rated 2 different powered mobility devices favorably as part of their child's early intervention strategies.

Impact: This study enhances the quality of evidence available to clinicians and families to support decision-making about powered mobility intervention for young children with motor disabilities, especially those who may be reluctant to begin powered mobility due to stigma or concern for motor skill development.

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短期助力移动干预可改善脑瘫幼儿的发育和参与能力:随机临床试验
研究目的本研究的目的是评估两种短期电动移动干预措施对脑瘫幼儿及其家庭在发展领域、参与度以及对干预措施实施的看法等方面的影响:这项随机、交叉临床试验比较了两种电动移位干预措施:迷你探索者(Permobil AB,瑞典蒂姆拉)和改装的乘骑玩具车。分析对象包括从 3 个地点招募的 24 名 12 到 36 个月大的儿童。每种装置在家中试用 8 周,共 16 周。在基线期、交叉期和研究完成期进行了三次面对面的研究访问,并在每个设备试用期进行了两次额外的虚拟检查。结果测量包括贝利婴幼儿发展量表第四版(Bayley-4)的所有领域、儿童参与日常生活(CEDL)参与度问卷以及 t3 感知实施测量:干预可接受性测量、干预适宜性测量和干预可行性测量。分析包括描述性统计、2×3 组×时间方差分析以及必要的事后 t 检验:结果:无论装置顺序如何,Bayley-4 的所有领域和 CEDL 的自理能力分量表的平均值均有明显改善。护理人员认为这两种装置都是可以接受且可行的,但迷你探索者的评价略高于经过改装的乘骑玩具车,同时还观察到了装置顺序效应:结论:短期助力移动干预可促进脑瘫幼儿在多个领域的发展和参与。作为儿童早期干预策略的一部分,照护者对两种不同的电动代步设备给予了好评:本研究提高了临床医生和家庭可用证据的质量,为运动障碍幼儿的助力移动干预决策提供了支持,尤其是那些可能因耻辱感或对运动技能发展的担忧而不愿意开始助力移动的幼儿。
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来源期刊
Physical Therapy
Physical Therapy Multiple-
CiteScore
7.10
自引率
0.00%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
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