Physical & Occupational Therapy in Pediatrics最新文献

Purpose: Children with cerebral palsy (CP) experience higher rates of sleep disturbances. Power mobility may affect sleep health due to the cognitive activity associated with mobility. This study aims to establish proof-of-concept to examine the effect of a power mobility intervention on the sleep health of young children with CP.

Methods: Toddlers (12-36 months old) with CP completed a 12-week intervention and used the Explorer Mini. Caregivers reported the total number of days and the total duration in minutes of device use. Caregivers also evaluated changes in their child's sleep health.

Results: Spearman's correlations indicated moderate correlations between overall sleep score and Explorer Mini use. Mann-Whitney U tests indicated moderate effect sizes on Explorer Mini use between stable/worse sleep and better sleep groups.

Conclusion: Future work should expand upon this study and examine whether an association exists between power mobility use and sleep health using fully powered statistical analyses.

Aims: To investigate how effective is robot-assisted therapy vs. comparison intervention (no intervention, placebo or a conventional intervention) in improving affected upper limb outcomes (any related to the upper limb function, such as muscle strength, motor coordination, tones, reach, and grasp) in children with cerebral palsy (CP).

Methods: Searches of this systematic review with meta-analysis were conducted on Cochrane, LILACS, MEDLINE, PEDro, and Scielo databases. Studies with children with CP, which delivered robot-assisted therapy on upper limb were included.

Results: Four studies were included. The meta-analysis was performed for all Quality of Upper Extremities Skills Test subscales and muscle tone. Robot-assisted therapy, compared with conventional therapy, improved dissociated movements by 4,3 points (95%CI 0.9 to 7.6, I²=0%, p = 0.01), grasp by 5,7 points (95%CI 3.0 to 8.3, I²=0%, p < 0.001), and weight bearing by 8,7 points (95%CI 2.2 to 15.2, I²=0%, p = 0.008). The quality of evidence for all measures was rated as moderate.

Conclusion: Overall, robot-assisted therapy appears to be effective in improving dissociated movements, grasp, and weight-bearing, but not for muscle tone and protective extension in children with CP. However, these results need to be interpreted cautiously.

Aims: To assess test-retest reliability and concurrent validity of the 1-min sit-to-stand test (1-minSTST) in children and adolescents who are overweight or obese.

Methods: Thirty-nine overweight and obese children and adolescents were included. The 1-minSTST was administered twice with a one-hour break. Concurrent validity was evaluated by assessing correlations between 1-minSTST repetitions and six-minute walk test (6MWT) distances. The cardiorespiratory measures (blood pressure, heart rate, oxygen saturation, respiratory rate, dyspnea, and perceived fatigue) were recorded before and after each test.

Results: Test-retest reliability was excellent (ICC: 0.90, 95% confidence interval 0.90-0.97). There was no relationship between scores on the 1-minSTST and 6MWT (r = -0.06, p = 0.71). No statistically significant correlation was found between scores on each test and change in cardiorespiratory responses, except for respiratory rate (r = 0.43, p = 0.006). Change in cardiorespiratory responses was similar when performing each test (p > 0.05).

Conclusion: While the 1-minSTST seems promising, it is not significantly related to the 6MWT, indicating they may assess different dimensions of fitness in this population. Further investigations are needed to determine the clinical implications of 1-minSTST outcomes in pediatric population.

Aims: Given that play is shaped by cultural contexts, a culturally adapted tool is essential for evaluating playfulness-the essence of play. This study aimed to examine the psychometric properties of the Persian version of the Test of Playfulness (ToP).

Methods: Participants included 225 children (146 boys, 79 girls; mean age = 57.3 ± 12.76 months) with typical development, autism spectrum disorder, and attention-deficit/hyperactivity disorder. The full sample was used for factor analysis, internal consistency, item analysis, and concurrent validity. Subsamples were used for rater reliability, discriminant validity, and developmental construct validity.

Results: Exploratory factor analysis identified one factor for the extent and intensity scales, and two for the skillfulness scale. Rater reliability was excellent (ICC = 0.80-0.99). Internal consistency was good to excellent (α = 0.80-0.93). High correlations with the Children's Movement Motivation Questionnaire supported concurrent validity (r = 0.72-0.77). All scales significantly differentiated among groups, confirming discriminant validity. Only the skillfulness scale showed significant differences across age groups, supporting developmental validity.

Conclusion: The Persian ToP demonstrated acceptable reliability and validity, supporting its potential utility in clinical and research contexts. Limitations included virtual data collection challenges, sampling bias from snowball recruitment, and the narrow age range.

Dynamic postural control provides functioning, independence, and quality of life.

Objective: to estimate the extent to which dynamic postural control (O) is affected in children with ASD (P/E) in comparison to their typically developing peers (C), summarizing the findings and answering the following research question: How is the postural control of children with ASD affected when facing dynamic tasks?

Methods: The search was conducted using the following databases: PubMed, Web of Science, SCOPUS, EMBASE. Studies addressing the postural control involving dynamic stability in children and adolescents with ASD and their typical peers were selected.

Results: Thirteen studies, published between 2005 and 2024, eight of which presented good methodological quality and five, fair ones, fulfilled the inclusion/exclusion criteria. We determined that dynamic postural control in ASD is affected by neuromotor deficits, such as reduced postural stability. Increased vulnerability to changes in body alignment and center of pressure results in compensatory movements to maintain posture.

Conclusion: Children with ASD present impaired dynamic postural control, reduced stability, greater vulnerability to changes in body alignment, and the use of specific compensatory mechanisms to keep posture and avoid falls. Further studies should address the impact of sensory information, age, cognition, and support level on dynamic postural control.

Aims: Postoperative mobilization in neonates is a critical component of the enhanced recovery pathway. We aimed to explore physical therapy (PT) and occupational therapy (OT) utilization in neonatal intensive care unit (NICU) patients and hypothesized that neonates with major abdominal surgery will experience increased barriers to receiving therapies compared to nonoperative neonates.

Methods: We retrospectively analyzed neonates admitted to our institution from January 2020 to December 2021. We compared therapy type/timing and clinical outcomes between operative and nonoperative neonates.

Results: We assessed 210 neonates (92 operative, 118 nonoperative). Operative neonates had lower median [Q1, Q3] gestational age (GA) at birth and birthweight. Operative neonates experienced significantly greater median [Q1, Q3] time from admission to first PT/OT session. Time from index operation to first therapy session was 25 days for PT and 22 days for OT. Number of active and missed PT/OT sessions were not significantly different between groups after accounting for length of stay (LOS). Operative neonates more frequently missed PT/OT sessions due to out-of-unit procedures or imaging.

Conclusion: Our data highlight a need for mitigation of barriers to mobilization among operative neonates, particularly in the first few weeks after surgery. Prospective studies are needed to explore the impact of earlier postoperative therapy among operative neonates.

Aim: To synthesize the existing literature on neonatal therapy interventions and evaluate their impact on oral feeding outcomes among preterm infants in the neonatal intensive care unit.

Methods: A systematic literature search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Physiotherapy Evidence Database (PEDro) databases for studies published from 2014 to 2023. Included studies were clinical trials evaluating neonatal therapy interventions delivered by neonatal therapists or caregivers trained by therapists, focusing on oral feeding outcomes for infants born at <37 week gestation. Primary outcomes were time to full oral feeding (FOF) and feeding quality. Secondary outcomes were weight gain and length of stay (LOS). Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

Results: Fourteen studies were included, identifying three categories of neonatal therapy interventions: oral motor stimulation, swallowing exercises, and sensory-based interventions. Most interventions began between 27 and 33 week postmenstrual age. Interventions generally resulted in improved oral feeding outcomes, notably faster achievement of FOF and improved feeding quality. Results for LOS and weight gain varied. Multidomain interventions demonstrated superior outcomes compared to single-domain approaches.

Conclusion: Neonatal therapy interventions can start early and improve oral feeding outcomes in preterm infants, particularly when using multi-domain approaches.

Aim: Children with spina bifida demonstrate impairments in walking; however, little is known about gross motor skill development and its association with lower limb muscle strength. This study aims to investigate the relationship between lower limb strength and gross motor skills in children with spina bifida.

Methods: Lower limb strength and level of lesion were determined by manual muscle test (MMT). Eighteen key gross motor skill items from the Gross Motor Function Measure (GMFM) were assessed, and level of ambulation classified according to a modified Hoffer's classification. Spearman's correlations were used to establish a relationship between muscle strength, level of lesion and gross motor skills.

Results: Participants included 42 children with spina bifida aged 4-16 years (median 8.1 years). Strong positive correlations were demonstrated between lower limb muscles and key gross motor items. While quadriceps strength demonstrates a relationship with supported weight bearing activities, hip extension, and abduction strength demonstrate strong relationships with independent standing, walking, and more complex gross motor skills.

Conclusion: Understanding the relationship between lower limb strength and motor skill attainment may assist in educating parents on functional potential and guiding goal setting for physiotherapy interventions.