Physical & Occupational Therapy in Pediatrics最新文献

Aims: The purpose of the study was to explore youth gymnastics coaches' perceptions on inclusive sports participation following an educational module. The study aims to explore implications for occupational therapy professionals' role in inclusive sports.

Methods: A qualitative descriptive approach was utilized with convenience sampling occurring through online platforms. Nine participants completed an educational module on autism spectrum disorder including strategies to promote inclusion in sports and address sensory and motor issues, prior to completing a semi-structured interview. Interviews were transcribed and coded prior to the determination of themes with triangulation and member checking employed.

Results: Thematic analysis resulted in the following themes: (1) occupational engagement in sports benefits both neurodiverse and neurotypical children; (2) sociocultural and physical environments create barriers to autistic youth's participation in sports; and (3) grace and knowledge enhance coaches' ability to promote inclusive occupational participation in sports for autistic youth. Themes were representative of the interconnected occupational components impacting inclusive sports of which occupational therapists are poised to address.

Conclusion: Lack of participation in sports for all children and children with disabilities is a complex system of physical, social, psychological, cultural, and environmental elements. Occupational therapists are equipped to educate youth sports providers and demonstrate leadership in advocating for inclusive sports programs to facilitate equitable sports participation, health, and wellness for children.

Aim: To assess the effectiveness of family-centered care (FCC) interventions on motor and neurobehavior development of very preterm infants.

Method: Randomized and quasi-randomized trials assessing the effect of FCC on motor and neurobehavioral outcomes in very preterm infants (28-32 wk gestation) were included. Five electronic databases and grey literature were searched from January 2010 to August 2022. Two reviewers independently screened the titles/abstracts and full texts, assessed the risk of bias, and extracted data. The Cochrane Risk of Bias 2.0 Tool and GRADE were used for risk and evidence certainty assessments. Meta-analysis or narrative synthesis was performed based on data availability and heterogeneity.

Results: Seventeen trials with 21 publications were included. GRADE showed low to moderate evidence. At 24 months, FCC interventions improved motor development (Mean Difference (MD):5.00, 95% CI: 2.58-7.42), cognitive development (MD: 3.64, 95% CI: 1.15-6.12), and behavior development (MD: -2.40, 95% CI: -4.32, -0.48) compared to control groups. Further, the FCC showed minimal or inconclusive effects on language, communication, and personal social development measured anytime between newborn and 24 months of age.

Conclusions: Early initiated FCC interventions can be a promising approach to improve motor, cognition, and behavioral development in very preterm infants.

Aims: Conduct a systematic review and meta-analysis on the effects of motor intervention on social, communication, and cognitive skills in individuals (0-21 years) with autism spectrum disorder (ASD).

Methods: Seven databases were used to search for randomized control trials (RCT) implementing a motor intervention for children with ASD; and measured social, communication, and cognitive outcomes. Twenty-three RCTs were selected with 66 outcomes and 636 participants (range of mean age: 4.3 - 12.3 years).

Results: Motor interventions had a significant, positive effect on (1) all outcomes combined (i.e. social, communication, and cognitive) (SSMD: 0.41, p = .01), (2) social (SSMD: 0.46, p = .012) and (3) combined social/communication (SSMD: 0.47, p = .01) domains, but not for the motor domain (SSMD: 0.45, p = .25) or cognitive domain alone (SSMD: 0.22, p = .18). In children above age nine, a 1-year increase in age corresponded to a 0.29 decrease in SSMD (less effective).

Conclusions: Motor interventions have a positive impact and should be considered when planning interventions for children with ASD.

Aim: To develop the Physical Literacy Profile Questionnaire (PLP-Quest) for children, adolescents, and young adults with disabilities and to assess its measurement properties.

Method: The PLP-Quest was developed based on the physical literacy framework proposed by the Australian Sports Commission, and following the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria for instrument development. After development, the following PLP-Quest measurement properties were investigated: content validity, structural validity, internal consistency and test-retest reliability.

Results: All PLP-Quest items were considered relevant and comprehensive by 50 caregivers and 50 health professionals. In structural validity analysis, with 109 responses, two items were removed, resulting in a final set of 22 items in PLP-Quests' final version. There was predominance of a single factor in the principal component analysis, confirming unidimensionality. Cronbach's alpha analysis showed that the instrument had good internal consistency (α = 0.93). The analysis of the intraclass correlation coefficient (ICC) showed that the instrument had good test-retest reliability (ICC= 0.92, 95% CI: 0.87-0.96).

Interpretation: Preliminary assessments of the measurement properties of the PLP-Quest indicate that this instrument has the potential to assess physical literacy in children, adolescents, and young adults with disabilities.

Aims: To compare perceptions of family-centered behaviors and children's occupational performance between occupational therapy interns in Taiwan who received a family-centered teaching (FACT) model and those who received a conventional family approach.

Methods: A two-group quasi-experimental design was employed. Participants included 49 interns, 44 caregivers, and 45 children with disabilities under 6 years old. The FACT model consisting of didactic lessons and hands-on practice was developed to strengthen interns' competencies in identifying parental concerns related to children's goals, writing goals using GAS format, and collaborating with caregivers in implementation of interventions. The interns' perceptions of their family-centered behaviors were measured using the Chinese version of the "Measure of Processes of Care-Service Provider" (C-MPOC-SP). Children's occupational performance was rated using the "Canadian Occupational Performance Measure" (COPM).

Results: Interns who received the FACT model demonstrated a significant increase in the Showing Interpersonal Sensitivity and Treating People Respectfully scales of C-MPOC-SP compared to the comparison group. The ratings of caregivers who received the FACT model increased significantly for children's performance, but not for satisfaction with performance.

Conclusions: The family-centered teaching model implemented in the internship increased interns' perception toward more family-centeredness and children's occupational performance.

Aims: To investigate the association between static balance and motor imagery (MI) abilities in preschool children with probable developmental coordination disorder (pDCD).

Methods: The participants were 28 children aged 3-6 years, attending a child development support center. They were categorized into the pDCD and control groups based on their Movement Assessment Battery for Children-Second Edition score. Static balance ability was measured using a gravity sway meter to compare performance under eyes-opened and eyes-closed standing conditions. MI ability was assessed using the N-type test.

Results: Compared with the controls (static balance; n = 10, MI; n = 14), children with pDCD (static balance; n = 13, MI; n = 14) showed significantly greater center of pressure (COP) displacement in eyes-closed standing condition and lower scores on the N-type test. A significant negative correlation (-0.59) was observed between MI ability and COP displacement during eyes-closed standing condition in the pDCD group, indicating that the poorer MI ability accompanied the worse static balance ability in this population.

Conclusions: Preschool children with pDCD have poor static balance ability with their eyes closed, which may be related to their MI ability. These findings emphasize the importance of the early detection of pDCD and suggest that symptoms may be alleviated by understanding the condition and providing appropriate support.

Aim: This study assesses real-world bimanual performance improvements following Hand-Arm Bimanual Intensive Therapy (HABIT) using an objective tool (accelerometers) and to identify demographic and clinical predictors of these gains in children with unilateral cerebral palsy (UCP).

Methods: Forty children with UCP (mean age: 10.7 ± 3.24 years) participated in 30 h of HABIT. Bilateral wrist-worn accelerometers measured bimanual performance using use ratio, bilateral magnitude, and median acceleration. Self-perceived performance was measured using the Canadian Occupational Performance Measure (COPM), and upper extremity (UE) capacity with Jebsen-Taylor Hand Function Test (JTHFT), Nine-Hole Peg Test (NHPT), and Box and Block Test (BBT). Predictors such as age, sex, affected side, severity levels, and baseline capacity were analyzed.

Results: Use ratio (p = .02) and median acceleration (p = .04) showed improvements, indicating enhanced real-world performance. Gains were observed in COPM (performance and satisfaction, p = .001) and UE capacity (JTHFT: p = .001, NHPT: p = .02, and BBT: p = .01). Age, baseline NHPT and JTHFT scores explained 40.7% of the variance in use ratio, while NHPT accounted for 11.5% of the variance in median acceleration.

Conclusion: HABIT enhances real-world bimanual performance in children with UCP. Older age and more impaired baseline dexterity are significant predictors of greater therapeutic gains, offering potential strategy to maximize real-world functional gains.

Introduction: Non-nutritive sucking (NNS) is commonly employed to assist in the development of preterm infants facing feeding challenges. The effectiveness of NNS interventions on sucking performance (suction and expression/compression component of sucking) in this population has not yet to be systematically explored.

Aims: To review the literature on the effects of NNS on sucking performance in preterm infants.

Methods: A comprehensive search was conducted across five databases, encompassing publications from the inception of these databases until July 2024. The studies included only randomized controlled trials (RCTs) involving preterm infants born before 37 wk with feeding problems, who were tube-fed. The experimental group received exclusive NNS intervention, while the control group received routine care or no intervention. Data extraction focused on one primary outcome (sucking performance) and two secondary outcomes (physiological characteristics and weight gain at discharge). The quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) scale, while the Cochrane risk-of-bias tool for randomized trials was employed to evaluate the risk of bias. The findings were summarized using a narrative synthesis approach.

Results: Nine RCTs involving a total of 575 preterm infants were incorporated. The methodological quality scores of the included studies ranged from 5 to 8. Compared to standard care, the use of NNS had positive influences on the Lower Anchors and Tethers for Children (LATCH) scale, aspects of sucking parameters (the percentage of milk taken and number of sucks per burst), and physiological characteristics. However, NNS produced variable results on the Preterm Infant Breastfeeding Behavior Scale (PIBBS), weight gain at discharge, and four sucking parameters-volume of milk intake at the first 5 min, rate of milk transfer, overall milk intake, and feeding time. Notably, insignificant association was found between NNS and other sucking parameters, including overall frequency, suction amplitude, and expression amplitude.

Conclusions: The effectiveness of NNS intervention on sucking performance, weight at discharge yielded inconsistent results. However, the existing evidence that elucidated the impact mechanism of NNS and its effects on sucking performance was constrained. Additional trials characterized by robust methodological quality should be employed to further elucidate and clarify the potential impact mechanism of NNS on sucking performance.

Aims: Children in foster care (CFC) have prevalent developmental health needs. Comprehensive health assessments (CHA) that include development evaluation are recommended for CFC. The impact of adding occupational therapy (OT) to multidisciplinary CHA teams is unknown. We aimed to describe findings from OT evaluations performed as part of CHA for CFC and determine if OT evaluation influences developmental health recommendations.

Methods: Retrospective study at a clinic for CFC that included 335 children with OT evaluation during their CHA and 217 without OT evaluation due to limited availability. OTs performed developmental components of CHA using observation and standardized testing. We used descriptive statistics, and chi-square and Fisher's exact tests to compare developmental health recommendations between patients with and without OT assessment.

Results: Median age was 8.3 years (range 0, 19). At least one aspect of development was delayed in 230/335 (69%) children evaluated by OT. OTs provided strategies to strengthen development to 74% of evaluated youth. Children seen by OT received significantly more developmental referrals compared to controls (38% versus 58%, p<.001).

Conclusions: Our findings suggest rehabilitation specialists such as OTs can enhance detection of developmental needs and provide strategies to strengthen development when included in CHA for CFC.

Aims: To assess the reliability of the Alberta Infant Motor Scale (AIMS) when conducted via recorded telehealth sessions by novice and expert raters.

Methods: Ten assessors (six novice, four expert) independently rated recorded telehealth assessments of 23 neurodevelopmentally high-risk infants twice. Inter- and intra-rater reliability of subscale scores, total score and percentile rankings were determined.

Results: AIMS total score inter-rater reliability was excellent across all raters (ICC = 0.92-0.96). Inter-rater-reliability across prone, supine and sitting subscale scores was excellent (ICC = 0.90-0.96) but variable for standing subscale (ICC = 0.06-0.65). Novice total score intra-rater reliability was variable (ICC = 0.45-0.94); expert reliability was excellent (ICC = 0.93-1.00). Recording to real-time telehealth assessment had excellent intra-rater reliability (ICC = 0.96). Time taken to complete the assessment was comparable to a face-to-face assessment (mean: 14.9 min). Novices paused/replayed each video more than experts (2.2 compared to 1.0 in Time 1; and 1.0 compared to 0.5 in Time 2).

Conclusions: The AIMS assessment is reliable when undertaken via telehealth consultation. Time taken to complete the assessment is comparable to a face-to-face assessment. Novice inter-rater reliability was similar to experts. Training and the ability to pause/review infant motor performance may explain the accuracy achieved.