Physical & Occupational Therapy in Pediatrics最新文献

Aim: To compare bimanual coordination in children with bilateral cerebral palsy (BCP) with that of children with typical development (TD) and correlate bimanual coordination with clinical measures of hand function.

Methods: 3-D kinematic data were collected from 14 children with BCP (mean age 13 years 1 month; range 7.3-17.2 years, 5 females) and 14 age-matched children with TD (mean age 13 years 1 month, range 7.0-16.0 years, 7 females) as they opened a drawer with one hand and activated a switch inside it with the other hand at self-paced and as-fast-as-possible speeds. Hand roles varied in each condition. Participants' hand function levels were classified using the Manual Ability Classification System. Unimanual dexterity and bimanual performance were evaluated using the Box and Blocks Test and Both Hands Assessment respectively.

Results: Participants with BCP performed the bimanual task more slowly (p < 0.001) and sequentially, as evidenced by greater time differences between the two hands achieving the end goal (p = 0.01). Faster speeds, particularly when the less affected hand opened the drawer, facilitated time-related measures of bimanual coordination (p < 0.05). Bimanual coordination correlated with all clinical measures of hand function (p < 0.05).

Conclusion: For children with BCP, speed and hand used for each subcomponent of the task influence bimanual coordination. Better bimanual coordination is associated with less impairment of both hands.

Aims: The aims of this study were to: (1) synthesize existing evidence regarding the integration of students with osteogenesis imperfecta (OI) into the school setting, (2) tabulate existing school integration tools for OI, and (3) create an individualized school plan to facilitate school integration.

Methods: Guided by the process of developing evidence-informed guidelines, an international, interprofessional, expert task force was convened. The process entailed: (1) reviewing of the literature, (2) developing recommendations, and (3) creating a clinically meaningful, person-focused plan to facilitate the integration and promotion of school inclusivity. The 13-member task force relied on empirical studies, grey literature, and their experiential knowledge (from clinical, teaching or patient experiences) to devise the plan.

Results: Over a series of eight meetings and five drafts, the Task Force prioritized 14 core items for inclusion. These items consisted of general student information, fracture response protocol, student inclusion recommendations, mobility considerations, transfer considerations, toileting protocol, physical education recommendations, fieldtrip information, transportation considerations, evacuation plan, environmental and scholarly considerations, consent and authorization, and an annual renewal document.

Conclusion: Further research is recommended to pilot the plan, solicit ongoing feedback, implement and evaluate the plan into routine education and health care practices.

Aim: To compare children with and without neurodevelopmental disorders (NDD) in self-rated activity competence, participation, and the associations between activity competence and participation.

Methods: This cross-sectional study included 126 children with NDD and 115 without NDD, aged 6-12 years, who completed interviews with the Perceived Efficacy and Goal Setting System (PEGS) and Picture My Participation (PmP). Independent t-tests or Mann-Whitney U tests examined group differences in the PEGS and PmP scores. Correlation and regression analyses examined associations between the PEGS and PmP scores.

Results: Children with NDD perceived lower physical competence than children without NDD, particularly in self-care (d = 0.80) and leisure (d = 0.66). The two groups did not differ in participation. Both groups demonstrated significant correlations between perceived activity competence and attendance (r = 0.21-0.49) and involvement (r = 0.19-0.53); significantly lower correlations were observed in children with NDD than those without (d = 0.22-0.28). Perceived activity competence significantly influenced attendance (β = 0.365) and involvement (β = 0.391).

Conclusions: Children with NDD perceived less competency than peers without NDD. Children's perceived activity competence is correlated bi-directionally with perceived participation. Clinicians can support competence to promote participation, or by supporting participation, the competence can be enhanced.

Aims: Mother-Child Health Centers in Israel offer comprehensive health-care services, including unique screening programs that serve as important preventive services for families of lower socioeconomic status. This study aimed to explore the service quality regarding family-centered care and professionalism from the perspectives of parents, providers, and observers.

Methods: Eighty-nine Arabic-speaking parents of children (M = 17.4, SD = 11.7) from East Jerusalem completed socio-demographic, self-efficacy, care, and child development questionnaires. Five providers completed demographic-professional and care questionnaires; two occupational therapists completed observation forms.

Results: Most parents reported moderate self-efficacy, and half of the children had suspected/detected developmental delays. Parents rated enabling, partnership and respectful care highly, with low scores for providing information. Observations indicated higher scores for professional referrals and listening to parents, but lower scores for providing adapted-written information. Content analysis revealed two main categories knowledge provision and parent-provider interaction with sub-categories.

Conclusion: This study highlights the value of assessing early intervention services from multiple perspectives, confirming that high-quality interaction between recipients and providers is essential for successful family-centered services, while emphasizing the need for socio-cultural adjustments. Further research involving large samples of providers and diverse at-risk populations, and long-term assessment is recommended to refine and enhance these services.

Aims: Interventions to support function and quality of life among pediatric patients undergoing hematopoietic cell transplant (HCT) are a priority. The purpose of this study was to evaluate the feasibility of a structured, individualized yoga intervention for children/adolescents undergoing HCT.

Methods: Patients ages 8-17 years hospitalized for HCT participated in either phase one (standard of care [SOC] group) or phase two (yoga group) of the study. Feasibility outcomes included recruitment rates, number/intensity of yoga sessions completed, and patient satisfaction. Participants in both groups completed functional outcome and quality of life (QOL) measures.

Results: All participants approached for the study agreed to participate, with 22 in the SOC group and 8 in the yoga group. On average, yoga participants completed 5.3 ± 2.8 sessions, the majority of moderate intensity. Most yoga participants reported the overall program, breathing, and relaxation strategies as helpful (83.3%) and supported their ability to move (66.7%). There were functional gain trends noted from baseline to time point 3 among the yoga group not observed in the SOC group.

Conclusions: Yoga is feasible as a therapeutic intervention for hospitalized pediatric patients undergoing HCT. Functional assessment data, if streamlined, may be a relevant outcome for future yoga interventions.

Aims: This study aimed to evaluate the impact of upper-extremity constraint-induced movement therapy (UE-CIMT) on gross motor skills, postural control, and lower extremity function in children with hemiplegic cerebral palsy (CP).

Methods: The electronic databases PubMed, CINAHL, Scopus, and Ovid were searched for eligible articles using the following keywords: "cerebral palsy," "children," "CIMT," "gross motor skills," "postural control," "balance," and "gait." Quality assessment of eligible studies was performed using the PEDro scale.

Results: Out of 919 identified papers, nine met the inclusion criteria. Findings suggest potential benefits in improving gross motor skills, postural control, and lower extremity function, as shown by measures such as the Gross Motor Function Measure (GMFM), the Peabody Developmental Motor Scales (PDMS-2), and gait parameters. However, methodological heterogeneity limits the strength of evidence.

Conclusion: While CIMT primarily targets UE function, emerging evidence suggests its influence may extend to gross motor skills. This highlights the potential for UE-CIMT to support broader motor improvements beyond the targeted limb. However, the quality of existing evidence is limited due to methodological weaknesses, small sample sizes, and variability in study design. Well-designed trials are needed to validate these findings and contribute to holistic rehabilitation approaches optimizing interventions for children with CP.

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.

Aims: To examine the responsiveness of the Seated Postural & Reaching Control (SP&R-co) test in children with cerebral palsy (CP) classified at levels III to V on the Gross Motor Function Classification System (GMFCS).

Methods: Eleven children received a motor learning-based intervention. Expert and blinded raters scored pre- and post-intervention SP&R-co test videos. Responsiveness was measured with paired t-tests, and effect sizes with Cohen's d. Minimum Clinically Important Differences (MCIDs) were estimated for SP&R-co overall and dimension scores.

Results: The SP&R-co test was responsive to group improvement in sitting-related postural and reaching control (SP&R-co overall = 48.9 points, p < 0.001). It captured increases in the active (change = 2.4 points, p = 0.040), proactive: bimanual (change = 10.5 points, p = 0.001), proactive: unimanual (change = 19.8 points, p < 0.001), and reactive (change = 15.3 points, p = 0.016) dimensions. Most children showed overall score improvements exceeding the MCID value, whereas clinical improvements in dimension scores varied across children with different GMFCS levels.

Conclusions: This preliminary study shows that the SP&R-co test is responsive to clinical changes in postural and reaching control strategies in children with CP who can follow test directions and are classified as GMFCS levels III-V.

Aims: Children with cerebral palsy (CP) have low physical activity (PA) and high sedentary behavior. The aim was to trial a participation-focused behavior-change intervention to increase PA and decrease sedentary behavior.

Methods: Twelve children with CP were recruited (mean age 5 years 6 months ± 1 year 2 months, Gross Motor Function Classification System [GMFCS] levels I = 1, II = 1, III = 1, IV = 4, V = 5); eight with complete post-intervention data (mean 5 years 10 months ± 1 year 4 months, GMFCS I = 1, III = 1, IV = 4, V = 2). Children received 8 weekly sessions targeting individualized PA participation goals in a pre-post feasibility trial. Outcomes included: implementation, effectiveness (Canadian Occupational Performance Measure [COPM]), device-measured PA, goal confidence, quality of life, and barriers to PA participation. Semi-structured interviews explored acceptability and were analyzed thematically.

Results: Implementation was feasible with ≥90% sessions attended and high enjoyment (89.5%). After 8 wk, COPM goal performance (mean difference [MD] = 2.9, 95% CI 0.7, 5.0; p = 0.02), satisfaction with performance (MD = 3.0, 95% CI 1.6, 4.4; p = 0.002), and confidence (MD = 1.4, 95% CI 0.4, 2.5; p = 0.02) significantly increased with no change in other outcomes. All six caregivers interviewed reported the intervention to be acceptable.

Conclusions: Active Start Active Future was feasible to conduct, acceptable and showed preliminary evidence to improve PA in young children with CP.

Aims: To determine inter-rater and test-retest reliability of a video analysis tool (VAT-AAT) for evaluating changes in frequency and duration of verbal social behaviors, non-verbal social behaviors, play behaviors, and negative behaviors of children and young people aged 3-25 years with autism during animal-assisted therapy (AAT).

Methods: Following recruitment and training, 23 occupational therapy students from an Australian metropolitan university rated a simple or complex video-recorded AAT session on two occasions. Expert raters determined acceptable score ranges which were compared with collected data from the raters to determine intraclass correlation coefficients (ICC).

Results: ICCs were 0.84 (simple session) and 0.89 (complex session) for inter-rater reliability and 0.84 (simple session) and 0.89 (complex session) for test-retest reliability. The percentage agreement was similar across level of session complexity and rater experience with children and autism but was lower for participants with less experience with animals (<10% difference in percentage agreement).

Conclusions: The VAT-AAT has good inter-rater and test-retest reliability when used in AAT with children and young people with autism. Session complexity or rater experience with children or autism did not impact on the level of agreement with expert raters. Validity of the tool now needs to be established.