Physical & Occupational Therapy in Pediatrics最新文献

Background: Children with autism spectrum disorders (ASD) can have difficulty adapting to environmental changes and motor-tasks demands.

Objective: to investigate the effectiveness of non-immersive virtual reality (VR) combined with traditional physiotherapy versus traditional physiotherapy alone on static and functional balance in children with ASD, aged from 7 to 12 years.

Methods: Fifty-three children with ASD were randomly assigned to either the VR group, received virtual reality training combined with traditional physical therapy, or the control group, received traditional physical therapy alone. The Biodex balance system and the pediatric balance scale were used to evaluate the balance control before and after the 12-week treatment program.

Results: MANOVA results showed significant improvements in the pediatric balance scale scores for both the VR and control groups compared to the pre-intervention, and that the post-intervention results were significantly lower than the pre-intervention in terms of the overall sway index and all Biodex tested conditions (p < 0.05). However, post-intervention between-group comparisons showed that these significant improvements in all outcome measures were in the favor of the VR group (p < 0.05).

Conclusion: This study suggests that virtual reality training could be an effective adjunct to traditional physical therapy for improving postural control in children with ASD.

Aims: Animal-assisted interventions (AAI) incorporate animals in health, education, or human services to improve participant health and well-being. AAI can decrease stress, increase happiness, and improve motor skills. During the COVID-19 pandemic, virtual AAI programs became more common. Telehealth also became more prevalent in occupational therapy. This study explored the perceptions of occupational therapy (OT) practitioners regarding including animals in telehealth OT pediatric interventions.

Methods: Survey responses were collected from 18 occupational therapists who have included animals in OT pediatric telehealth interventions.

Results: Most participants agreed that incorporating animals into telehealth enhanced the therapeutic experience for their clients, as they perceived the intervention to decrease stress levels, improve mood, and increase social interaction skills. Additionally, three themes emerged from participants' open-ended responses: virtual AAI is versatile, virtual AAI can enhance the telehealth experience, and there are different challenges associated with virtual AAI.

Conclusions: The findings provide clear support for the role of animals in pediatric OT telehealth interventions.

Background: Understanding the occupational experience of typically developing adolescents and their attributions of strengths and difficulties is important for promoting their adaptive occupational participation.

Objectives: To explore the psychometric properties of the Self-Perception of Occupational Experiences for Teens (SPOT) interview, occupational experiences, attributions of strengths and difficulties, and strategies for managing challenges among typically developing adolescents.

Methodology: 83 typically developing adolescents underwent the Self-Perception of Occupational experiences for Teens interview. Descriptive statistics and qualitative content analysis were used to analyze the data.

Results: Acceptable to good internal consistency was found across all SPOT domains and scales and moderate correlations among all scales within the four domains. Descriptive analyses showed high ratings across domains, with social activities reported the most enjoyable and activities of daily living the least difficult. Leisure and social domains were the most frequently reported as strengths, while education was the most difficult. Emerged themes from qualitative analyses were internal attributes, external attributes, and motivation. Connecting with others and personal values were rated as most effective strategies for overcoming challenges.

Conclusions: Aligning interventions with adolescents' attributions and challenges may enhance their motivation and engagement, promoting adaptive participation.

Aims: Well-designed score reports can support therapists to accurately interpret assessments. We piloted a score report for the Pediatric Evaluation Disability Inventory-Patient Reported Outcome (PEDI-PRO) and evaluated: 1) To what extent can occupational and physical therapists (OT, PT) accurately interpret item-response theory (IRT)-based PEDI-PRO assessment results? 2) What is the perceived clinical utility of the pilot score report?

Methods: Exploratory, sequential mixed methods design. Focus groups with OT and PTs (n = 20) informed the development of the final score report; revisions were made in response to feedback. Next, OTs and PTs (n = 33) reviewed score reports from two fictional clients and answered survey questions about the interpretation of the PEDI-PRO results. Additional questions evaluated clinical utility.

Results: Focus groups: Visual cues supported score interpretation, but therapists requested additional explanations for advanced IRT measurement concepts. Survey: Therapists accurately interpreted foundational IRT concepts (e.g. identifying most/least difficult items, highest scores), but were less accurate when interpreting advanced concepts (e.g. fit, unexpected responses). Therapists anticipated sharing different components of the score report with family members, clinicians, and payers to support their clinical practice.

Conclusions: The pilot PEDI-PRO score report was highly endorsed by therapists, but therapists may need additional training to interpret advanced IRT concepts.

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.