Pediatric Physical Therapy最新文献

Purpose/hypothesis: Systematically review current evidence on the content of physical therapy (PT) examination and evaluation to inform the update to the 2020 Developmental Coordination Disorder (DCD) Clinical Practice Guideline (CPG).

Methods: Eight databases were searched for studies that informed the content of PT examination and evaluation, including psychometric properties of tests and measures used in the PT management of DCD. Methodological quality and certainty of evidence were assessed.

Results: Three systematic reviews and 30 cohort studies were included. Two findings impacting the 2020 DCD CPG are: (1) very low- to high-quality evidence supports cultural adaptations and cutoff scores for DCD-specific questionnaires, and (2) very low-quality evidence supports 4 outcome measures that are responsive to change with intervention.

Conclusion: Newer evidence reaffirms 4 of 5 recommendations on examination of the 2020 DCD CPG and adds evidence that could increase the recommendation strength of 2 action statements from best practice to moderate.

Purpose: Investigate the effect of structured neonatal physical therapy program (SNP) on neurodevelopmental outcomes of moderate and late preterm (MLP) infants.

Methods: Sixty MLP infants were randomly allocated to usual care (UC) or SNP. A previous publication reported the effect of neonatal component of SNP at hospital discharge. This paper examined SNP's effect on motor, cognitive and language outcomes at 3 and 6 months using a 2-way mixed design ANOVA.

Results: Both groups were similar at baseline for motor scores. Infants receiving SNP significantly outperformed UC at all subsequent time points. At 3 and 6 months, SNP significantly outscored UC in cognitive and language outcomes.

Conclusion: SNP is effective in improving neurodevelopmental outcomes of MLP infants. However, caution is suggested in interpreting its effect on cognition and language as we lacked baseline scores to compare the longitudinal trajectory.

Purpose: This study explored whether the type of torticollis, amount of tummy time or container time, participant age at examination, and Alberta Infant Motor Scales score influence the length of physical therapy care for infants with torticollis.

Methods: Data for 149 participants were extracted from medical records for infants with torticollis who received care between November 2018 and November 2021.

Results: Statistically significant correlations were found between length of care (LOC) and torticollis type, age at examination, active range of motion rotation deficit, and passive range of motion rotation deficit. A multiple regression model predicted LOC from age at examination in days, as well as passive and active rotation deficits.

Conclusion: Higher passive and active rotation deficits lead to longer LOC. However, longer lengths of care were associated with younger ages at examination, different from earlier studies.

Purpose: To determine responsiveness of the Activity Measure for Post-Acute Care (AM-PAC) "6 Clicks" Basic Mobility Short Form (BMSF) and Basic Mobility Short Form - Low Function (BMSF-LF) for children in the acute care setting.

Methods: Fifty-one children admitted to a large pediatric, acute care hospital participated in this retrospective study. The BMSF and BMSF-LF were administered by physical therapists during each admission at least 2 times. The standardized response mean (SRM) for the BMSF and BMSF-LF were calculated to determine responsiveness.

Results: Moderate effect sizes were found for both the BMSF (SRM = .71) and the BMSF-LF (SRM = .76).

Conclusions: The AM-PAC BMSF and BMSF-LF have acceptable responsiveness to determine functional change in pediatric acute care setting.

Purpose: This case report assesses the outcomes of a 6-week modified intensive program for a 4-year-old boy with cerebral palsy (CP), Gross Motor Function Classification System Level IV.

Summary of key points: The modified intensive program included the practice of developmental gross motor skills, standing/gait training in adaptive equipment, constraint-induced movement therapy, and whole body vibration.

Conclusions: The child improved in 4 of the 5 outcomes, including timed sitting balance and modified versions of the 5 Times Sit-to-Stand Test and 9-Hole Peg Test. His ability to assist with transfers, sit independently, and use both hands for play and self-help skills also improved.

Recommendations for clinical practice: This case report adds to the body of evidence supporting the use of intensive program models of physical therapy for children with CP and highlights the need for additional research in this emerging area of clinical practice.

Purpose: The purpose of this study is to report on therapeutic scoliosis-specific exercises (PSSE) for a child with spinal muscular atrophy (SMA) who had spinal fusion.

Methods: PSSE were recommended after scoliosis was diagnosed and exercises focused on posture and improving strength preoperatively and restoring function postoperatively.

Results: Gross motor function remained stable before spinal fusion, briefly decreased after the procedure, and then stabilized post-surgery. Distance walked on the 6-minute walk test decreased post-surgery but improved after the addition of PSSE to the Standard of Care.

Conclusions: Including PSSE as an adjunct to traditional interventions may be beneficial for children with SMA. Evidence supports incorporating PSSE to improve posture preoperatively in idiopathic scoliosis. Its use postoperatively and in children with SMA is not well studied. Controlled studies are needed to understand the impact of pre- and post-op PSSE in children with SMA.