Physical & Occupational Therapy in Pediatrics最新文献

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.

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: 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: To measure the quality of life in children with impaired walking who receive a mobility assistance dog (MAD).

Methods: The parents of ten children who received a MAD completed the cerebral palsy quality of life questionnaire, before receiving their dog and at one, three, and six-month follow-up. Data were analyzed to assess changes for each participant and to the group.

Results: The group showed a positive change in the domains of social well-being and acceptance, feelings about functioning, and emotional well-being and self-esteem after six months. Children with less impairment (GMFCS I-II) showed a change in social-wellbeing and acceptance, feelings about functioning, participation, physical health, and emotional-wellbeing and self-esteem after six months. Children with more impairment (GMFCS III-IV) showed no change at any timepoint measured.

Conclusions: This novel therapeutic area of receiving a MAD demonstrated some positive quality of life changes after six months for a small group of children with impaired walking. These are preliminary findings in a small sample and this intervention would benefit from further study.

Aims: To understand how occupational therapy literature conceptualizes, discusses, describes, implies, and operationalizes self-regulation.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and JBI methodology guided the review. MEDLINE, Embase, CINAHL, PsychInfo and ERIC databases were searched with studies from 2000 - June 2023 deemed eligible. Two reviewers extracted data with results presented in figurative, tabular, and narrative synthesis. Critical appraisal was conducted using the Mixed Methods Appraisal Tool and the Critical Appraisal Skills Programme checklist for systematic reviews. Content analysis of construct descriptions was conducted.

Results: A total 4159 articles were screened for eligibility, and eighty-one assessed at full text. Nine additional studies were retrieved through hand-searching. Sixty-four studies were included and underwent critical appraisal. Content analysis revealed five self-regulation constructs and associated terms in the occupational therapy literature, including self-regulation, executive function, emotion regulation, interoception and social-emotional learning.

Conclusions: Five distinct self-regulation constructs were analyzed in the occupational therapy literature, with various terms used to describe and define these. Self-regulation and executive function were often described as linked constructs. Similarly, lack of congruence between self-regulation measures, identified interventions and the underlying self-regulation construct was identified.

Aims: To summarize evidence on effective knowledge translation (KT) interventions to increase evidence-based practice among pediatric rehabilitation professionals.

Methods: The PRISMA 2020 Checklist was used for search, selection, and data extraction. The Mixed Methods Appraisal Tool assessed quality, while the Cochrane Effective Practice and Organization of Care described KT interventions.

Results: Our search yielded 7233 records; 29 met the inclusion criteria. Two studies used educational materials alone. The remaining 27 studies used multifaceted KT interventions, combining education with local opinion leaders or knowledge brokers (n = 12), continuous quality improvement (n = 11), reminders (n = 6), communities of practice (n = 6), provider performance monitoring (n = 5), audit and feedback (n = 2), information and communication technology (n = 2), clinical practice guideline (n = 1), or routine patient-reported outcome measures (n = 1). Significant improvements in knowledge (n = 10), skills (n = 6), adherence and use (n = 4), perceptions (n = 3), intentions of use (n = 2), confidence level (n = 1), beliefs and attitudes (n = 3), and professional behavior change (n = 2) were reported. Included studies had a moderate to high-risk bias.

Conclusion: Educational and local opinion leaders were common in multifaceted KT interventions, the majority resulting in improved professional knowledge, skills, attitudes and beliefs, and behaviors. Rigorous study designs are needed to confirm these findings.

Aim: This study aimed to develop the Participation Questionnaire for Preschoolers (PQP) and validate its psychometric properties as a disability-specific tool designed to assess participation in preschool-aged children with autism spectrum disorder (ASD).

Methods: This cross-sectional study recruited caregivers of 412 children, including those diagnosed with ASD and those at risk for neurodevelopmental disorders. Participants were recruited from child development facilities, medical institutions, and developmental support websites across Japan. Data from 287 children diagnosed with ASD were analyzed for item reduction, followed by exploratory factor analysis and the calculation of Cronbach's alpha to evaluate internal consistency. Five hypotheses were tested to assess construct validity.

Results: Item reduction resulted in the removal of seven items and the identification of four factors: Friendship and Education, Family Satisfaction, Daily Living and Independence, and Leisure and Community Life. Cronbach's alpha values for these factors ranged from 0.74 to 0.88, indicating acceptable internal consistency. Three of the five hypotheses related to construct validity were supported, aligning with expectations.

Conclusion: The PQP exhibited structural validity, internal consistency, and construct validity. However, further longitudinal studies are needed to validate its measurement properties over time.

Aim: We aimed to describe telehealth used to detect infants at risk of neurodevelopmental delay and assess the assessors' and caregivers' perceptions and costs.

Methods: This was an observational study in which five physical therapists applied the General Movement Assessment, the neurological exam based on the Hammersmith Infant Neurological Examination, and the Alberta Infant Motor Scale via telehealth in 65 infants at risk of neurologic delay during the COVID-19 pandemic. The perceptions of assessors and caregivers were assessed using a questionnaire. We tabulated the family's costs (internet access) and the therapist's expenses (internet access and professional fees).

Results: In general, assessors felt comfortable and reported good quality of teleassessment. They highlighted the significant effort they and caregivers required for synchronous methods, challenges in clearly guiding caregivers on infant positioning, difficulties in adjusting the camera's position, and unstable internet connections. Most assessors expressed a willingness to continue using telehealth. Caregivers displayed high satisfaction, and the costs were minimal.

Conclusion: Teleassessment during the COVID-19 pandemic was feasible, although implementing this method of health service in general clinical practice still requires further scrutiny.

Aim: To compare caregiver-reported current and desired home participation of infants with and without biological risk in the first year of life.

Method: Observational, cross-sectional and comparative study. Caregivers of 48 infants with (mean corrected age = 5.6(±2.3) months) and 32 without (mean corrected age = 5.8(±1.9) months) biological risk completed the Young Children's Participation and Environment Measure home section. Caregivers reported on their infant's current participation (frequency and involvement) in 13 activities within the domains of basic care routines, household chores, interactive and organized play, and socializing with friends and family, as well as their desire for change(s) in their infant's home participation. We compared groups using comparative tests (Bonferroni's correction for multiple comparisons; p < 0.0125).

Results: Infants with biological risk participated less frequently in the domain household chores (U = 383.000; p < 0.001); and were less involved in the domain household chores (U = 407.000; p < 0.001). No significant group differences were found in desire for change.

Conclusion: Results suggest that home participation restriction can be identified for infants with biological risk in one out of four domains, which may allow health professionals to develop strategies to intervene early in the participation of children at risk in this specific area of household chores.