Physical & Occupational Therapy in Pediatrics最新文献

Aim: This study examined the discriminative validity of the Evaluation in Ayres Sensory Integration^® (EASI), a standardized, performance-based assessment of sensory integration functions that underlie children's participation in daily life.

Methods: The sample comprised 120 children aged 6-12 years, including 60 children with known or suspected sensory integration difficulties (SID) and 60 typically developing (TD) peers. All participants were administered the EASI. Group differences were analyzed using chi-square tests, Fisher's exact tests, and independent samples t tests. Receiver Operating Characteristic (ROC) analyses were conducted to evaluate the discriminative validity of individual EASI subtests.

Results: Children in the SID group performed significantly below their TD peers across all EASI subtests (p < .001). ROC analyses yielded area under the curve (AUC) values ranging from 0.669 to 0.902, indicating weak to excellent discriminative validity. Subtests assessing praxis and postural control demonstrated the strongest discriminative accuracy, whereas several subtests showed weaker but statistically significant discrimination.

Conclusions: These findings support the EASI as an effective assessment for distinguishing children with sensory integration difficulties from typically developing peers. Although discriminative strength varied across subtests, the overall battery demonstrated strong discriminative capacity, supporting profile-based interpretation and clinical utility within the Ayres Sensory Integration^® framework.

Aims: Timely access to occupational therapy (OT) services for preschoolers remains a challenge, contributing to social health inequities. This study explored the implementation of an OT service co-developed with community organizations and childcare settings and grounded in proportionate universalism and public health principle's.

Methods: A descriptive interpretative qualitative approach was used to document the first year of implementation of a pilot community-based OT service for preschoolers. Findings from interviews with partners, including pedagogical coordinator in childcare centers and community organizations (n = 6), educators (n = 3), parents (n = 3), and the occupational therapist involved in the project (n = 1), were analyzed using the Strengths-Weaknesses-Opportunities-Threats (SWOT) framework and interpreted through the Consolidated Framework for Implementation Research (CFIR).

Results: Key facilitators included strong collaborations, open-mindedness, knowledge and interpersonal skills, tiered organizational model, and personalized services tailored to each partner's needs. Barriers reported were limited follow-up by the OT, shortage of human resources, and limited availability of staff, which negatively influenced the ability to meet regularly and implement strategies.

Conclusions: Findings highlight the value of multi-tiered services and intersectoral partnership for improving access to early childhood rehabilitation services. More studies would help to have a better understanding of the effects of collaborative and multi-tiered services in preschool settings.

Aims: The effects of interventions using digital games in the rehabilitation of children with motor disorders have been well-documented. This study examined the immediate effects of games and verbal encouragement from others on lower limb activity and psychological enjoyment during lower limb motor tasks in children with motor disorders.

Methods: Participants's sample included 14 children, aged 4-13 years, with motor disorders, including cerebral palsy and developmental coordination disorder. The motor task was a 30-s foot-stomping activity. Participants first completed the task under a baseline condition with no stimuli, followed by a game condition in which they performed foot-stomping while engaging in a game. Finally, a game plus verbal encouragement condition was introduced.

Results: The results revealed that game use increased lower limb activity and enhanced enjoyment levels. The additional effect of verbal encouragement was observed only in the enjoyment levels. The percentage increase in lower limb activity due to game use was negatively correlated with age and positively correlated with the level of motor impairment.

Conclusions: In the rehabilitation of children with motor disorders, incorporating digital games into motor tasks and adding positive engagement from others can increase lower limb activity and enjoyment during challenging motor tasks.

Aim: To evaluate the relationship between postural control, quality of upper limb skills, and functional independence in children with cerebral palsy (CP).

Methods: This cross-sectional study included 36 children (aged 3-8 years; GMFCS I-V and MACS I-V) with CP. Postural control was assessed using the Early Clinical Assessment of Balance (ECAB), upper limb (UL) skills by Quality of Upper Extremity Skills Test (QUEST), and functional independence through Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT, DA domain). Spearman's correlation and multiple linear regression were used for analysis (α  =  0.05).

Results: Strong positive correlations were found between ECAB and QUEST (ρ  =  0.823, p < 0.001), ECAB and PEDI-CAT (ρ  =  0.781, p < 0.01), and QUEST and PEDI-CAT (ρ  =  0.872, p < 0.001). Regression models explained 69.3% of the variance in PEDI-CAT and 73.6% in QUEST scores. Multiple linear regression was significant only for the MACS to predict the functional independence (PEDI-CAT) and upper limb skills (QUEST).

Conclusion: Postural control significantly correlates with both the UL skills and functional independence in children with CP.

Aim: To evaluate the feasibility and effectiveness of a collaborative telehealth intervention on engaging families in the intervention process, achievement of individualized goals, time spent practicing goal activities, and participant experiences.

Methods: Twenty-one children/adolescents with physical disabilities (mean age 10.6 ± 4.1 years) and their parents collaborated with a physical therapist on an eight-week individualized intervention to achieve three goals for performance of activities during daily routines using WhatsApp.

Results: Mean ratings for Performance and Satisfaction with performance on the Canadian Occupational Performance Measure and mean Goal Attainment Scale T-scores increased between baseline, post-intervention, and 12-week follow-up (p < 0.001). Participants reported the intervention was more practical than usual care, they practiced their goals during the intervention, continued to practice in the 12 wk until follow-up, and the intervention empowered them to plan new personal goals in the future and ask for help when needed. An average of 9.2 ± 4.5 h was spent practicing the activities for the three goals.

Conclusions: The collaborative process facilitated family engagement in the intervention and may have potential to build family capacity and children's self-determination. Further research is needed to determine whether the findings are replicable when the intervention is incorporated into students' education programs.

Trial registration: Registered July 2024 at clinicaltrials.gov (NCT06514287).

Aim: The aim of the study was to examine children's lived experiences of the therapeutic relationship with their occupational therapist.

Methods: A hermeneutic phenomenological design was used. Fourteen children aged 2 to 10 were recruited through occupational therapists at various sites within a healthcare institution in Quebec (Canada). Individual art-based interviews were conducted with children. A hermeneutic phenomenological analysis was used to identify themes emerging from their experiences.

Results: Children's experiences of the therapeutic relationship reflected four main themes. First, trust-building emerged as central, with children highly attuned to nonverbal cues such as empathic gaze and active listening. Second, children highlighted the importance of feeling genuinely heard and understood in their therapeutic journey. Third, the learning process, with its progress and challenges, was shaped by the therapist's responsiveness. Finally, a shared understanding of therapeutic activities fostered a strong connection, especially when the activities held personal meaning for the children and reflected their own goals.

Conclusions: This study showed that children value being heard, understood, supported, and engaged in meaningful therapy activities that reflect their goals and interests. Their experiences emphasize the importance of recognizing children as active participants and integrating their voices into the co-construction of therapeutic relationships.

Aims: This cohort study aimed to evaluate the test-retest reliability, responsiveness, and interpretability of the Participation Questionnaire for Preschoolers (PQP), a tool for assessing participation in preschool children with autism spectrum disorder (ASD).

Methods: Caregivers of children with ASD aged 51-75 months completed online surveys at four time points over six months. Test-retest reliability was examined using intraclass correlation coefficients (ICCs) for 275 participants. Responsiveness was examined by analyzing correlations between changes in PQP scores and the Strengths and Difficulties Questionnaire and the Family Outcomes Survey based on four predefined hypotheses. To assess interpretability, the Global Rating of Change (GRC) Scale was used as an anchor to analyze receiver operating characteristic curves and estimate minimal important change (MIC).

Results: ICCs ranged from 0.80 to 0.92 for individual subscales and reached 0.93 for the total score. Three of four hypotheses for responsiveness were supported. However, the correlation between the GRC Scale and changes in PQP scores was below 0.3, preventing MIC calculation.

Conclusion: Although the MIC could not be calculated, the PQP's strong test-retest reliability and responsiveness provide a foundation for future research.

Aim: This exploratory study examined evidence for emerging humility and appreciation of the benefits of listening, as shown in students' reflections on their use of listening stances.

Methods: 135 Occupational Therapy, Physical Therapy, Speech-Language Pathology and Audiology students completed a written reflection on their experience practicing a self-selected listening stance (receptive, exploratory, consensus-oriented, or action-oriented listening). A chi-square analysis examined the number of students' humility-related comments as a function of students' discipline and chosen listening stance. Types of benefits arising from listening practice were determined by extracting and grouping quotes in students' reflections.

Results: More Occupational Therapy students chose to practice exploratory listening than expected by chance and they made more humility-related comments when choosing this stance, whereas more Physical Therapy students chose to practice action-oriented listening and they made more humility-related comments when choosing this stance. There was evidence for various positive benefits, including deeper understanding for the self, deeper sharing by the other person, and more meaningful and productive conversations.

Conclusions: This study provides important findings regarding the preparation of healthcare students for clinical practice. There was preliminary evidence of associations between clinical listening practice and emerging humility, as well as greater awareness of the benefits of listening.

Aims: This pilot study provides preliminary insights into pediatric physical therapist (PT) current use and perceived value of telerehabilitation services, identifying key barriers and benefits associated with its implementation.

Methods: An electronic survey was sent to pediatric physical therapy clinical sites from three universities. Multiple-choice and open-ended questions focused on PT use and perception of telerehabilitation, patient characteristics, interventions and assessments utilized, and perceived barriers and benefits.

Results: Data from 68 surveys were analyzed. Pediatric PTs reported an average of 15.5 years (SD = 10.5) of practice experience. Since the conclusion of the COVID-19 pandemic, 42 participants (61.8%) indicated they have continued to provide telerehabilitation services. There was a small-to-moderate positive association between value of delivering telehealth and the frequency of delivering pediatric physical therapy via telehealth (r_s=0.29, p = 0.015). Perceived barriers included socioeconomic, child/caregiver engagement, child characteristics, administrative barriers, and limited hands-on care/reduced clinical effectiveness. Perceived benefits included increased access to services, family empowerment, opportunity for home programming, opportunity for continued services, and family involvement/engagement.

Conclusions: Study findings in this small sample support the perceived value of telerehabilitation as a pediatric physical therapy service delivery model and highlight the ongoing need for its continued use.

Aims: Person-level engagement, though well studied in counseling, mental health, and adult rehabilitation, is also critical in pediatric rehabilitation, yet it remains underexplored in motor learning interventions for children with unilateral spastic cerebral palsy (USCP). This study investigated how individual characteristics, including age and mastery motivation, influenced person-level engagement and examined how engagement affected motor outcomes.

Methods: A retrospective analysis was conducted involving 49 children with USCP aged 6-17 years who participated in either constraint-induced movement therapy (CIMT) or hand-arm bimanual intensive therapy (HABIT). Engagement was assessed through video coding and behavioral questionnaires, while hand function was evaluated using three standardized tests.

Results: Findings indicated that age was significantly related to engagement. Engagement measures correlated with improvements in hand capacity as measured by the Jebsen-Taylor Hand Function Test, but not with performance on the Assisting Hand Assessment.

Conclusion: The results highlighted the relationship between age and engagement, emphasizing the importance of age-appropriate intervention strategies. Engagement played a role in improvements observed on capacity-based hand function tests, suggesting that engagement during therapeutic camps may be more critical for capacity-based than for performance-based motor activities. These insights support the design of targeted, age-appropriate interventions that optimize therapeutic outcomes for children with USCP.