Pediatric Physical Therapy最新文献

Purpose: To evaluate the validity and reliability of the Arch Height Index (AHI) in assessing the medial longitudinal arch (MLA) structure in children with spastic diplegic cerebral palsy (CP).

Methods: Twenty children with spastic diplegic cerebral palsy (CP), aged 5-18 years, were assessed. AHI measurements were taken in sitting and standing positions. Arch flexibility index (AFI) was calculated. Reliability was analyzed using intraclass correlation coefficients (ICC), and validity was evaluated by correlating AHI with clinical parameters.

Results: AHI measurements showed high interobserver reliability. AHI was significantly correlated with calcaneal pitch, navicular index, and Meary's angle. A lower AHI was associated with decreased gross motor function, greater hip adductor spasticity, and ankle eversion range of motion.

Conclusions: The AHI is a valid and reliable tool for assessing MLA in children with spastic diplegic CP. Lower arch height is associated with greater functional impairments.

Objective: To analyze and compare the effects of 2 aquatic exercise protocols on the gait of children with cerebral palsy (CP), aged 6 to 8 years.

Methods: A randomized, controlled, and blind clinical trial, carried out with 16 children with CP classified to Gross Motor Function Classification System (GMFCS) II and III bilateral spastic, divided into a group of aquatic balance exercises group (BG) and a group of aquatic trunk exercises group (TG). The following assessments were completed before and after the intervention: 6-Minute Walk Test (6MWT), Trunk Control Measurement Scale, Pediatric Balance Scale, Timed Up and Go, Dynamic Gait Index, and Child Health Questionnaire-Parent form 50.

Results: BG was superior to TG in 6MWT after the intervention. Improvement was observed in most outcomes in both groups.

Conclusion: The protocols demonstrated positive effects on the outcomes analyzed, and BG performed better in the distance covered in 6MWT.

Purpose: Intensive pediatric physical therapy (PT) programs are increasingly common yet lack a clear definition. This study aimed to examine current practice patterns of intensive pediatric PT in the United States.

Methods: A survey was developed and administered using the FITT (frequency, intensity, time, type) model and Knowledge to Action Cycle for pediatric physical therapists providing intensive PT. Survey respondents included pediatric physical therapists providing intensive physical therapy in outpatient, non-acute settings. Data analysis used descriptive statistics and cluster analysis.

Results: Eighty pediatric physical therapists reported intensive programs involved children aged 4-6 years with cerebral palsy (90%), neuromuscular (78%), and neuromotor (44%) disorders. Greatest dose often-always ranged from 2-5 visits per week, ≤60-120 minute sessions over 3-8 weeks. Top interventions included locomotor training (80%), task-specific training (78%), and progressive resistive exercise (76%). Two clusters were identified based on therapist organization and dose.

Conclusions: This first study of intensive pediatric PT revealed marked variability, underscoring the need for a standardized definition to improve clinical care.

Purpose: To assess the concurrent validity of 2 wearable sensors, GENEActiv (GA) and MonBaby (MB), for tracking tummy time in full-term and preterm infants at home.

Methods: Nineteen full-term infants and 13 infants born preterm, aged 3 to 6 months, wore GA and MB sensors during caregivervideo-recorded active play at home over 3 days. Prone (tummy time) durations detected by each sensor were compared to video for validation.

Results: Both GA and MB sensors demonstrated excellent (κ = 0.86) and substantial (κ = 0.78) second-by-second agreement with video, respectively, for tracking tummy time. For cumulative tummy time, the GA showed higher accuracy with video (GA =60 minutes, video =58 minutes, difference =2 minutes) compared to MB (MB =43 minutes, video =47 minutes, difference =4 minutes). No differences in accuracy were found between the 2 sensors.

Conclusion: Wearable sensors can accurately track tummy time at home and can support adherence to movement guidelines in infants. Establishing caregiver feasibility is crucial for broader use.

Purpose: This case report presents the successful management of an adolescent with headache, dizziness, vertigo, and unsteadiness using the International Classification of Headache Disorders, 3rd edition (ICHD-3) and International Classification of Vestibular Disorders (ICVD) diagnostic criteria to screen for vestibular migraine of childhood (VMC) and rule out other conditions with similar symptoms. The physical therapist (PT) (1) used the diagnostic criteria from the ICHD-3 and the ICVD to determine the etiology, (2) taught protective lifestyle behaviors to reduce migraine symptoms, and (3) modified 2 physical therapy clinical practice guidelines to direct treatment.

Key points: The intervention prioritized adopting protective lifestyle behaviors to manage migraine symptoms before introducing exercises targeting vestibular and exertional intolerance symptoms.

Conclusion and recommendations for clinical practice: The diagnostic criteria helped inform the PT that the symptoms were consistent with VMC, which guided the intervention. Protective lifestyle behaviors and physical therapy strategies proved effective with symptom management.

Purpose: To explore the long-term impacts of an intensive physical therapy program, as perceived by caregivers and children.

Methods: Semi-structured interviews were completed with 7 caregivers and 1 child. The data from these interviews were analyzed by an interdisciplinary coding team comprised of 3 physical therapists and 2 psychologists. Rapid qualitative inquiry (RQI) was used, which relies on intensive teamwork, iterative data analysis, and triangulation from multiple sources to get insiders' perspectives.

Results: Interviewees had positive experiences in the Intensity Program which they believed led to long-term and positive impacts in physical, psychological, and social functioning. Even though the program was challenging, and certain parts of it could be improved, interviewees were pleased with it.

Conclusions: Interviewees perceived that the benefits of intensive physical therapy may persist for over a year following the completion of such a program. Perceived benefits of participating in an intensive program seem to outweigh the challenges.