Physical & Occupational Therapy in Pediatrics最新文献

Aims: The aims of this study were to: (1) synthesize existing evidence regarding the integration of students with osteogenesis imperfecta (OI) into the school setting, (2) tabulate existing school integration tools for OI, and (3) create an individualized school plan to facilitate school integration.

Methods: Guided by the process of developing evidence-informed guidelines, an international, interprofessional, expert task force was convened. The process entailed: (1) reviewing of the literature, (2) developing recommendations, and (3) creating a clinically meaningful, person-focused plan to facilitate the integration and promotion of school inclusivity. The 13-member task force relied on empirical studies, grey literature, and their experiential knowledge (from clinical, teaching or patient experiences) to devise the plan.

Results: Over a series of eight meetings and five drafts, the Task Force prioritized 14 core items for inclusion. These items consisted of general student information, fracture response protocol, student inclusion recommendations, mobility considerations, transfer considerations, toileting protocol, physical education recommendations, fieldtrip information, transportation considerations, evacuation plan, environmental and scholarly considerations, consent and authorization, and an annual renewal document.

Conclusion: Further research is recommended to pilot the plan, solicit ongoing feedback, implement and evaluate the plan into routine education and health care practices.

Aims: The aim of this study was to identify and describe methods that physiotherapists use to evaluate the immediate effects of their interventions for infants in hospital with acute respiratory tract infections.

Methods: We constructed an anonymous digital survey to physiotherapists working with infants aged 0-24 months in Sweden. The survey was distributed by e-mail and posted on web pages for seven weeks, which included a reminder.

Results: Replies were obtained from 88 respondents, and 52 completed surveys remained to be analyzed. All 21 counties in Sweden were represented. The most prevalent answer options were as follows: more productive/increased or decreased cough (73%), increased oxygen saturation (35%), changed secretion sounds (33%), reduced work of breathing (20%), and parental report (16%).

Conclusions: The physiotherapists reported to use diverse methods for evaluation of their interventions. However, to a large degree they used subjective measures, which depend on the individual clinician's assessment and interpretation. The evaluation methods vary in psychometric properties and robustness. This study identifies the need for consensus about valid, reliable, and clinically relevant evaluation methods for this patient group.

Aims: Well-designed score reports can support therapists to accurately interpret assessments. We piloted a score report for the Pediatric Evaluation Disability Inventory-Patient Reported Outcome (PEDI-PRO) and evaluated: 1) To what extent can occupational and physical therapists (OT, PT) accurately interpret item-response theory (IRT)-based PEDI-PRO assessment results? 2) What is the perceived clinical utility of the pilot score report?

Methods: Exploratory, sequential mixed methods design. Focus groups with OT and PTs (n = 20) informed the development of the final score report; revisions were made in response to feedback. Next, OTs and PTs (n = 33) reviewed score reports from two fictional clients and answered survey questions about the interpretation of the PEDI-PRO results. Additional questions evaluated clinical utility.

Results: Focus groups: Visual cues supported score interpretation, but therapists requested additional explanations for advanced IRT measurement concepts. Survey: Therapists accurately interpreted foundational IRT concepts (e.g. identifying most/least difficult items, highest scores), but were less accurate when interpreting advanced concepts (e.g. fit, unexpected responses). Therapists anticipated sharing different components of the score report with family members, clinicians, and payers to support their clinical practice.

Conclusions: The pilot PEDI-PRO score report was highly endorsed by therapists, but therapists may need additional training to interpret advanced IRT concepts.

Aim: This scoping review synthesizes literature about occupational therapy parent-mediated interventions (PMIs) that target occupation-based outcomes for children with developmental disabilities (DD).

Methods: A search of PubMed, Web of Science, and CINAHL from 2010 through 2023 was performed resulting in 471 publications. Studies were included if they involved PMIs for participants with DD aged 3-12 years and were published in English. Studies were excluded if the outcomes were not occupation-based. A thematic analysis was conducted following an iterative review of charted data.

Results: Twelve studies met the inclusion criteria reflecting four themes across occupational therapy PMIs, including variation in terminologies, types of PMIs, key components of PMIs, and the overall impact. While the effects of PMIs are difficult to define due to the variability in the samples, interventions, and outcomes, this review suggests general positive impacts of PMIs.

Conclusion: The emerging body of evidence supporting PMIs within the field of occupational therapy suggests they are feasible and have the potential to improve child and parent outcomes when delivered to children with DD. Further research is needed to clarify PMIs' components, unify the identification terminology, and test the efficacy of different types of PMIs for specific populations.

Aim: To compare bimanual coordination in children with bilateral cerebral palsy (BCP) with that of children with typical development (TD) and correlate bimanual coordination with clinical measures of hand function.

Methods: 3-D kinematic data were collected from 14 children with BCP (mean age 13 years 1 month; range 7.3-17.2 years, 5 females) and 14 age-matched children with TD (mean age 13 years 1 month, range 7.0-16.0 years, 7 females) as they opened a drawer with one hand and activated a switch inside it with the other hand at self-paced and as-fast-as-possible speeds. Hand roles varied in each condition. Participants' hand function levels were classified using the Manual Ability Classification System. Unimanual dexterity and bimanual performance were evaluated using the Box and Blocks Test and Both Hands Assessment respectively.

Results: Participants with BCP performed the bimanual task more slowly (p < 0.001) and sequentially, as evidenced by greater time differences between the two hands achieving the end goal (p = 0.01). Faster speeds, particularly when the less affected hand opened the drawer, facilitated time-related measures of bimanual coordination (p < 0.05). Bimanual coordination correlated with all clinical measures of hand function (p < 0.05).

Conclusion: For children with BCP, speed and hand used for each subcomponent of the task influence bimanual coordination. Better bimanual coordination is associated with less impairment of both hands.

Aim: The Test of Gross Motor Development Third Edition (TGMD-3) is used to assess the development of fundamental movement skills in children from 3 to 10 years old. This study aimed to evaluate the intra-rater, inter-rater, and test-retest reliability and to determine the minimal detectable change (MDC) value of the TGMD-3 in children with developmental coordination disorder (DCD).

Methods: The TGMD-3 was administered to 20 children with DCD. The child's fundamental movement skills were recorded using a digital video camera. Reliability was assessed at two occasions by three raters using the generalizability theory.

Results: The TGMD-3 demonstrates good inter-rater reliability for the locomotor skills subscale, the ball skills subscale, and the total score (φ = 0.77 - 0.91), while the intra-rater reliability was even higher (φ = 0.94 - 0.97). Test-retest reliability was also shown to be good (φ = 0.79-0.93). The MDC₉₅ was determined to be 10 points.

Conclusion: This study provides evidence that the TGMD-3 is a reliable test when used to evaluate fundamental movement skills in children with DCD and suggests that an increase of 10 points represents a significant change in the motor function of a child with DCD.

Aims: Interdisciplinary collaboration between health and education professionals is one of the principles of inclusive education. This study aimed to describe the practices and service delivery by pediatric occupational therapists (OTs) in schools in Spain.

Methods: Data came from a convenience sample of pediatric OTs recruited through Spanish professional colleges and associations for a web-based survey, mixed-method research study. Thirty-five respondents were excluded because they didn't meet the eligibility criteria. Ninety-two responses were obtained for data analysis. Twenty-nine OTs (31.5%) work in schools (school-OTs), and sixty-three participants (68.5%) don't work there but collaborate with schools (non-school OTs).

Results: Participants support students with and without a medical diagnosis. Services provided by OTs external to the educational system are mainly funded by families or only partially covered. Findings show that most participants use standardized assessments and apply several intervention approaches. They believe there are barriers to the collaboration and implementation of occupational therapy services in schools.

Conclusions: This preliminary study shows a need for changes in Spain's State and Regional Education legislation and provides recommendations to improve school service delivery. Pediatric OTs are encouraged to reflect on and identify opportunities for changes to enhance school-based occupational therapy practice in Spain.