Physical & Occupational Therapy in Pediatrics最新文献

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 explore how physical therapists, children with motor disabilities, caregivers, educational personnel, and physicians in Israel describe and characterize school-based physical therapy.

Method: We conducted a qualitative study including focus groups: four with children aged 4-21 with motor disabilities and four with caregivers of children in the same age-group. Participants (n = 38) were recruited from special education schools. Additionally, we conducted 25 interviews with physical therapists, educational personnel, pediatric orthopedists, and neurologists. The collected data were transcribed and reflexive-thematically analyzed. We ensured the study's trustworthiness using the constant comparison method, peer debriefing, reflexivity, and audits.

Results: Two themes were developed. The first, physical therapy in the lives of children with motor disabilities, refers to physical therapy in general. The second, something different refers to school-based physical therapy and includes sub-themes regarding physiotherapists' scope of practice, relationships, and sense of strangeness in school-based settings.

Conclusion: School-based physical therapy provides potential opportunities for close relationships and expanded practice in the child's environment. However, the estrangement and ambiguity of the physical therapists' role in a non-medical environment may push professionals to limit themselves to narrower, familiar practices. In such cases, the students do not benefit from what school-based physical therapy can offer.

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: Handwriting is crucial for academic success, influenced by sensorimotor and socioeconomic factors. Therapists, in collaboration with educators, play a key role in its support. The first objective is to investigate the association between SES and handwriting skills and to identify related factors associated with SES. The second objective is to investigate the direct and mediating roles of sensory-motor parameters in handwriting skills.

Methods: Sixty-three children were divided into High-SES and Low-SES groups based on family income and parental education level. Handwriting skill was evaluated based on legibility and speed. Proprioception, grip strength, lateral pinch strength, and tip pinch strength were assessed.

Results: The High-SES group demonstrated significantly faster handwriting speed and better proprioception, while motor parameters showed no significant differences between groups. Proprioception was found to mediate 15% of the association between SES and handwriting speed. Proprioception and lateral grip strength predicted faster handwriting speed, while grip strength predicted slower handwriting across participants.

Conclusion: Study results indicate that improving proprioception is one of the key factors in supporting handwriting performance in students with low SES. Activities aimed at enhancing proprioception and lateral grip strength can be used to improve handwriting in all children, regardless of SES differences.

Aims: This pilot study aimed to assess the dual-task performance and balance ability in children and adolescents with Juvenile Myoclonic Epilepsy (JME). Additionally, it sought to investigate the impact of dual-task conditions on functional performance and explore relationship between balance ability and dual-task performance.

Methods: Ten children and adolescents with JME (mean age 16.90 ± 1.20 years) were evaluated. Static and dynamic balance were assessed using the Balance Master System, with modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and Limit of Stability tests measuring static and dynamic balance, respectively. The mCTSIB and TUG tests were performed under single- and dual-task (motor-motor, cognitive-motor) conditions.

Results: No significant differences were found in mCTSIB test between single-task and dual-task conditions (p > 0.05). However, TUG completion time increased under cognitive-motor dual-task conditions (p < 0.05). There was no significant correlation between balance and dual-task performance (p > 0.05).

Conclusions: This exploratory pilot study, conducted without a control group, suggests that children with JME may face difficulties with tasks requiring both cognitive and motor functions, as cognitive-motor dual tasks significantly increased task completion time. Lower scores in certain balance measures suggest a potential risk of balance impairment. These findings underscore the importance of integrating both cognitive-motor dual-task and balance assessments into rehabilitation programs for children with JME.

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: 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.

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: This study aimed to estimate the extent to which dual-task-based balance exercise vs. single-task-based balance exercise (I) vs. no training (C) affects single-limb static and dynamic balance performance (O) in children with a history of ankle sprain (P). This study aimed to assess the impact of dual-task-based balance exercises on enhancing single-limb static and dynamic balance performance in children with a previous ankle sprain history.

Methods: In this quasi-experimental study, 66 male children (mean age = 9.34 ± 0.88 years) with a history of ankle sprains were recruited from sports clubs and assigned to one of three groups: (1) balance training with a dual task (22 participants; 12 sessions); (2) balance training with a single task (22 participants; 12 sessions); or (3) a control group (no training; 22 participants). Static balance (Stork test) and dynamic balance (Y balance test) were assessed before and after the intervention.

Results: Results indicated that static balance in male children during dual-task training outperformed single-task training and the control group (p < .05). Single-task training also surpassed the control group (p < .05). In dynamic balance, both dual-task and single-task balance training groups performed better than the control group (p < .05), with no significant difference between the two training methods (p > .05).

Conclusion: These findings suggest that balance exercises, particularly those incorporating cognitive dual tasks, can enhance the balance performance of male children with a previous ankle sprain history. Coaches and physiotherapists working with such male children are encouraged to incorporate the dual-task model into their training regimens.