Pediatric Physical Therapy最新文献

Purpose: To introduce a clinical reasoning tool that helps clinicians and families collaboratively identify intervention components in pediatric rehabilitation.

Key points: This special communication presents the F-words Lens Tool, designed to integrate the F-words for Child Development framework with the Rehabilitation Treatment Specification System to enhance clinical reasoning in pediatric rehabilitation. The tool supports families and clinicians in selecting and evaluating intervention components based on the child's goals.

Recommendations: Clinicians should use the F-words Lens Tool to ensure interventions align with the child's functional goals and actively involve families in the clinical reasoning process.

Purpose: Determine the safety and effectiveness of hybrid serial casting (fiberglass and soft casting tape) to increase ankle dorsiflexion passive range of motion (ADF PROM) in children with idiopathic toe walking (ITW).

Methods: A retrospective cohort study of 65 children with ITW undergoing ankle hybrid serial casting was completed. Casts were applied weekly until age-based ADF PROM was achieved.

Results: Children were casted an average of 3.8 weeks on the left leg and 3.1 weeks on the right. ADF PROM significantly improved from -0.3° (SD: 7.1) to 18.0° (SD: 5.6) on the left and 0.2° (SD: 8.7) to 18.4° (SD: 5.3) on the right. 5.0% of casts were removed early. Skin irritation caused a 1-week pause in casting in 6.2% of children.

Conclusion: Hybrid serial casting may be a safe and effective method to improve ADF PROM for ITW and offers the advantage of removal without a cast saw.

Purpose: This study evaluated the accuracy of the Activity Measure for Post-Acute Care "6-Clicks" Inpatient Basic Mobility Short Form (AM-PAC BMSF) in predicting discharge outcomes in a pediatric acute care setting and identifying a cutoff score for outpatient physical therapy referrals.

Methods: A retrospective analysis included initial AM-PAC BMSF scores from 2014 children aged 4 to 17 years hospitalized for more than 72 hours. Receiver operating characteristic curve analysis assessed the tool's sensitivity and specificity in predicting postdischarge physical therapy referrals.

Results: Children referred to outpatient physical therapy had significantly lower initial AM-PAC BMSF scores. A raw score of 17 to 18 (49% impairment) was the optimal cutoff score for predicting outpatient physical therapy referrals.

Conclusions: The AM-PAC BMSF, completed at the initial evaluation, can moderately predict the need for outpatient physical therapy following pediatric acute care discharge. A cutoff score of 18 may support more proactive and targeted discharge planning.

Purpose: To evaluate the effectiveness of hydrotherapy (HT) on pain and function in children with juvenile idiopathic arthritis (JIA).

Methods: Eligible studies were randomized clinical trials published in English, which recruited children with JIA and had 2 groups with 1 receiving HT alone and the other receiving a comparison/control intervention. Risk of bias was assessed using the Cochrane Risk of Bias 2. Overall quality of evidence was assessed with the Grading of Recommendations Assessments, Development, and Evaluation. Meta-analyses were performed for outcomes when possible.

Results: Meta-analyses comparing HT to standard care demonstrated statistically significant effects on pain and VO 2 max favoring HT. No significant differences were found for function (CHAQ), peak knee extensor torque, or 6-minute walk test. The overall level of evidence ranged from very low to moderate.

Conclusions: Hydrotherapy improved VO 2 max and reduced pain in individuals with JIA compared to standard care.