Pediatric Physical Therapy最新文献

Purpose: Cerebral palsy (CP) is a condition that often presents with altered muscle tone affecting function. The purpose of this case report is to describe the clinical application of transcutaneous electrical nerve stimulation (TENS) to manage the impact of muscle tone during gait in 2 children with CP.

Summary of key points: Two children with CP, who are gait, received TENS to manage spasticity and dystonia. Gait was analyzed using a two-dimensional gait analysis with and without TENS. Results demonstrated medium and large minimally clinically important differences in velocity, cadence, and stride length with TENS.

Conclusion: Using TENS parameters may be a modality to manage tone and improve gait for children with CP. A larger study is needed to determine the effects of TENS.

Recommendations for clinical practice: Clinicians may use TENS on spastic or dystonic muscles as an intervention to improve gait for children with CP.

Purpose: To determine the level of burnout and investigate the relationship between effort-reward imbalance and burnout among early intervention (EI) physical therapists.

Method: Study participants included EI physical therapists from 1 state within the United States. Participants completed an online survey that included demographic questions, the Oldenburg Burnout Inventory, and the Effort-Reward Imbalance Scale. Linear regression examined the relationship between effort-reward imbalance and burnout.

Results: A total of 127 participants were included. Effort, reward, and overcommitment explained 49% ( R2  = .490) of the variance in exhaustion ( F4,118  = 28.38; P < .001) and 29.7% of the variance in disengagement ( F4,118  = 12.48; P < .001) components of burnout.

Conclusion: Physical therapists practicing in EI report high levels of emotional exhaustion, disengagement, and burnout. The results suggest that strategies to manage job demands, rewards, and overcommitment may help EI organizations decrease burnout among EI physical therapists.

Purpose: The purpose of this study was to examine the perceived role and contributions of physical therapists in health promotion (HP) practices within school-based settings.

Methods: A survey was sent to US pediatric physical therapists through a variety of means.

Results: Related to HP in their educational program, 71% indicated content was provided across the curriculum, with 55% reporting gaps in content; 53% reported they are minimally involved in HP efforts, while 41% were not involved at all. Participants perceived role in HP included supporting participation, encouraging an active lifestyle, and providing resources to families. Barriers included time, administrative support, and role as a contract employee.

Conclusions: Results suggest that SBPTs are minimally involved in HP largely due to time. Status as contract employees appears to limit engagement. Participants viewed their role in HP as related to improving participation.

Dynamic Movement Intervention (DMI) and Cuevas Medek Exercises (CME) are promoted as innovative neurorehabilitation methods for children with neurological disabilities, yet both rely on outdated reflex-hierarchical models rather than contemporary motor learning principles. A review of the literature reveals that CME, despite 5 decades of use, is supported only by a few case reports and 2 small, biased comparative studies. DMI, introduced in 2021, has no published empirical evidence beyond a single conference abstract. Thus, both interventions remain at Sackett Level 5-no evidence. The ethical implications are substantial. Families often pay thousands for intensive, noncovered therapies that may displace meaningful participation in education and social life. Therapists have a professional responsibility to avoid legitimizing unproven practices and to prioritize interventions supported by robust evidence. Pediatric rehabilitation should shift toward child-led, functional, and task-specific approaches grounded in modern motor learning science, with professional bodies and insurers withholding endorsement of nonevidence-based methods.

Purpose: In accordance with the International Society of Scoliosis Orthopedics and Rehabilitation Treatment (SOSORT), conservative management, including exercise therapy, should be the first step to treat adolescent idiopathic scoliosis (AIS). For moderate scoliosis, bracing is often indicated in conjunction with exercise therapy to reduce curve progression. Surgical intervention is typically reserved for severe cases (Cobb angle > 45°-50°). While previous research has examined Physical therapy students' knowledge of AIS, limited research has focused on the knowledge and practices of practicing physical therapists. This study aimed to address this gap by assessing Brazilian physical therapists' knowledge and management of AIS.

Methods: This is a cross-sectional study, and we used an internet-based survey with questions about knowledge and management of AIS. We analyzed the responses in relation to the best available evidence on this topic. We recruited Brazilian registered physical therapists from different regions in Brazil. Participants' demographics and survey responses were analyzed using descriptive and inferential statistics.

Results: A total of 65 Brazilian physical therapists from the 5 regions of the country participated in the study. Physical therapists with specific training to treat scoliosis (STTS) were more assertive compared to physical therapists without STTS in indicating brace in AIS with angles between 26° and 45° ( P = .008) and in not indicating surgical evaluation between 26° and 46° Cobb angle ( P = .002).

Conclusion: Brazilian physical therapists generally possess a good understanding of evidence-based AIS treatment approaches, aligning with SOSORT recommendations. Physical therapists with STTS demonstrated superior knowledge and practice patterns, suggesting that STTS is essential for optimal AIS management.