PURPOSE: The aims of this study are to: (1) identify standardized pediatric outcome measures (OMs) currently taught in professional physical therapist (PT) education; (2) identify standardized pediatric OMs currently use...PURPOSE: The aims of this study are to: (1) identify standardized pediatric outcome measures (OMs) currently taught in professional physical therapist (PT) education; (2) identify standardized pediatric OMs currently used in PT practice; and (3) compare similarities and differences in standardized pediatric OMs taught in professional PT education and those used in PT clinical practice. METHODS: This study used an explanatory, sequential mixed methods design with quantitative data from a descriptive, cross-sectional electronic survey to inform 4 qualitative focus group interviews. Quantitative data were analyzed using a 2-proportion Z-test and descriptive statistics. Qualitative data were analyzed using direct content analysis. RESULTS: Quantitative and qualitative data were integrated, revealing significant differences between standardized pediatric OMs taught in entry-level PT programs and those used in professional practice. CONCLUSIONS: Improved alignment of standardized pediatric OMs used by both faculty and clinicians could better equip learners for clinical practice.
PURPOSE: To evaluate the potential of a task-specific training model to improve sitting through tailored trunk support and incrementally challenging reaching. METHODS: A single-subject AB design with follow-up was conduc...PURPOSE: To evaluate the potential of a task-specific training model to improve sitting through tailored trunk support and incrementally challenging reaching. METHODS: A single-subject AB design with follow-up was conducted with a 20-month-old child with severe postural impairments due to 16p11.2 deletion syndrome and multiple comorbidities. Phase A included 6 baseline assessments during 2 weeks, followed by 15 intervention sessions (Phase B) during 5 weeks, and 4 post-intervention assessments during follow-up. Outcomes included the Segmental Assessment of Trunk Control (SATCo) and the Gross Motor Function Measure (GMFM) sitting dimension. Visual analysis, the 2 standard deviation band method, and C-statistics evaluated change. RESULTS: SATCo and GMFM scores were stable during baseline but had significant trend changes from baseline to intervention and follow-up phases. Independent sitting skills emerged after the intervention. CONCLUSIONS: Task-specific training tailored to the child's ability by systematically progressing trunk support and reaching practice may promote long-lasting sitting function.
OBJECTIVE: To analyze and compare the effects of 2 aquatic exercise protocols on the gait of children with cerebral palsy (CP), aged 6 to 8 years. METHODS: A randomized, controlled, and blind clinical trial, carried out...OBJECTIVE: To analyze and compare the effects of 2 aquatic exercise protocols on the gait of children with cerebral palsy (CP), aged 6 to 8 years. METHODS: A randomized, controlled, and blind clinical trial, carried out with 16 children with CP classified to Gross Motor Function Classification System (GMFCS) II and III bilateral spastic, divided into a group of aquatic balance exercises group (BG) and a group of aquatic trunk exercises group (TG). The following assessments were completed before and after the intervention: 6-Minute Walk Test (6MWT), Trunk Control Measurement Scale, Pediatric Balance Scale, Timed Up and Go, Dynamic Gait Index, and Child Health Questionnaire-Parent form 50. RESULTS: BG was superior to TG in 6MWT after the intervention. Improvement was observed in most outcomes in both groups. CONCLUSION: The protocols demonstrated positive effects on the outcomes analyzed, and BG performed better in the distance covered in 6MWT.
PURPOSE: To evaluate the validity and reliability of the Arch Height Index (AHI) in assessing the medial longitudinal arch (MLA) structure in children with spastic diplegic cerebral palsy (CP). METHODS: Twenty children w...PURPOSE: To evaluate the validity and reliability of the Arch Height Index (AHI) in assessing the medial longitudinal arch (MLA) structure in children with spastic diplegic cerebral palsy (CP). METHODS: Twenty children with spastic diplegic cerebral palsy (CP), aged 5-18 years, were assessed. AHI measurements were taken in sitting and standing positions. Arch flexibility index (AFI) was calculated. Reliability was analyzed using intraclass correlation coefficients (ICC), and validity was evaluated by correlating AHI with clinical parameters. RESULTS: AHI measurements showed high interobserver reliability. AHI was significantly correlated with calcaneal pitch, navicular index, and Meary's angle. A lower AHI was associated with decreased gross motor function, greater hip adductor spasticity, and ankle eversion range of motion. CONCLUSIONS: The AHI is a valid and reliable tool for assessing MLA in children with spastic diplegic CP. Lower arch height is associated with greater functional impairments.
PURPOSE: This case study highlights team collaboration, individualized interventions, and an inclusive environment to optimize participation in school-aged children with bilateral congenital transfemoral limb loss. SUMMA...PURPOSE: This case study highlights team collaboration, individualized interventions, and an inclusive environment to optimize participation in school-aged children with bilateral congenital transfemoral limb loss. SUMMARY OF KEY POINTS: Two students with bilateral transfemoral limb loss diagnosed with fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) achieve independence in mobility through collaborative goals and strategies following the International Classification of Functioning Disability and Health Model and a clinical practice guideline published by the US Department of Veterans Affairs and the US Department of Defense. The educational team, including the physical therapist, supports students' mobility and participation using individualized interventions. CONCLUSION: The collaborative approach supports the students' complexities and participation with framework-guided strategies. An inclusive school creates a community for students to develop autonomy, self-reliance, and independence. RECOMMENDATIONS FOR CLINICAL PRACTICE: These cases serve as a model for integrating clinical practice guidelines into best practices for physical therapy in the school setting. WHAT THIS ADDS TO EVIDENCE: This is the first documented case study of children with FATCO and school-based practices.
PURPOSE: This case report describes the feasibility, acceptance, and satisfaction associated with community-based implementation of a novel upper extremity (UE) training program using a joystick-operated powered ride-on...PURPOSE: This case report describes the feasibility, acceptance, and satisfaction associated with community-based implementation of a novel upper extremity (UE) training program using a joystick-operated powered ride-on toy with an 8-year-old male child with unilateral cerebral palsy(UCP). SUMMARY OF KEY POINTS: The 8-session, 1 month training program was feasible to implement in collaboration with the child's caregiver, was enjoyable and well-accepted by the child and his caregiver and associated with improvements in the child's affected UE motor function on participant-report and video-based measures. CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE: Ride-on toys are versatile, easy-to-operate, family-friendly tools that can be used across a variety of naturalistic settings. Intervention programs using joystick-operated ride-on toys may be used to create intrinsically motivating training opportunities to encourage children with UCP to spontaneously use their affected UE for task-oriented sensorimotor exploration of their physical environment and improve movement control in the affected UE.
PURPOSE: A workforce shortage exists within pediatric physical therapy (PT) which is likely contributing to limited access to services for children. The purpose of this study was to investigate the factors associated wit...PURPOSE: A workforce shortage exists within pediatric physical therapy (PT) which is likely contributing to limited access to services for children. The purpose of this study was to investigate the factors associated with a physical therapist's decision to practice pediatrics. METHODS: Pediatric physical therapists completed an online questionnaire investigating the level of perceptions and influences associated with the choice to practice pediatrics. RESULTS: Participants (80%) chose their pediatric practice before or during their professional education and participated in a full-time pediatric clinical experience. The perception of pediatric PT was more positive in items representing clinical care, mentorship, and education. Factors that positively influenced participants' choice of the pediatric practice were clinical care, mentorship, education, and personal/professional. CONCLUSIONS: Results will guide students, faculty, and mentors to understand factors that influence the choice of pediatric PT and help mitigate the workforce shortage.
PURPOSE: To examine the factors that influence the usability of a video-based mobile application (app) by parents of infants born full-term and preterm. METHODS AND PROCEDURES: This study enrolled 75 infants born full-te...PURPOSE: To examine the factors that influence the usability of a video-based mobile application (app) by parents of infants born full-term and preterm. METHODS AND PROCEDURES: This study enrolled 75 infants born full-term and 47 infants born preterm for the Alberta Infant Motor Scale (AIMS) assessment at ages 4, 6, 8, 10, 12, and 14 months. Their parents were asked to upload home videos of AIMS items using the newly designed Baby Go app at ages 5, 7, 9, 11, and 13 months. Information from the videos will be used for future artificial intelligence modeling. Infant and socioenvironmental variables were examined as potential influencing factors. RESULTS: Eighty-two parents (67.2%) uploaded 1406 home videos. Multivariate logistic regression analysis revealed that medical issues and the number of children were significantly associated with parental adherence to app use. CONCLUSIONS: Medical issues and having no siblings enhanced parental adherence to video uploading via the app.
PURPOSE: The purpose of this Special Communication is to provide an overview of portfolio use in health professions education and to describe the potential of a digital electronic portfolio (ePortfolio) to support develo...PURPOSE: The purpose of this Special Communication is to provide an overview of portfolio use in health professions education and to describe the potential of a digital electronic portfolio (ePortfolio) to support development and maintenance of pediatric physical therapy essential core competencies. Portfolios have been used in health professions education for formative and summative assessments, particularly for areas difficult to measure such as professionalism, core values, attitudes, and critical thinking. SUMMARY OF KEY POINTS: With a trend toward competency-based education and updated pediatric core competencies, there is unique benefit in portfolio use across the continuum of practice, from entry-level (Doctor of Physical Therapy) to advanced specialty practice and beyond. CONCLUSION: Reflection, a key component of education portfolios, promotes learning through meaning-making and self-assessment toward continued development and growth. RECOMMENDATIONS FOR CLINICAL PRACTICE: ePortfolios can be flexibly and individually applied across diverse physical therapy education goals to demonstrate learner competency and expertise in pediatric physical therapy.
PURPOSE: This study determines the inter- and intra-rater reliability and convergent validity of the Canadian Agility and Movement Skill Assessment (CAMSA) for children with critical congenital heart disease (CCHD). METH...PURPOSE: This study determines the inter- and intra-rater reliability and convergent validity of the Canadian Agility and Movement Skill Assessment (CAMSA) for children with critical congenital heart disease (CCHD). METHODS: Forty-one children aged 7 to 10 with CCHD were recruited from the Wilhelmina Children's Hospital, Utrecht. The CAMSA and Movement-ABC-2 (M-ABC-2) were assessed concurrently. Four raters independently scored video recordings of the CAMSA at 2 moments at a 2-week interval. RESULTS: The inter- and intra-rater reliability of the CAMSA was excellent with an ICC of 0.94 and 0.95, respectively. A nonstatistically significant trend was found between the CAMSA and the M-ABC-2. CONCLUSIONS: The CAMSA is a reliable measurement for assessing complex motor skills in children aged 7 to 10 with CCHD. The convergent validity between the CAMSA and M-ABC-2 was nonsignificant suggesting these 2 tests measure different motor constructs.
PURPOSE: Pediatric physical therapists care for a diverse population for whom social determinants of health (SDOH) impact health outcomes. This study examines changes in knowledge and behavior following a continuing educ...PURPOSE: Pediatric physical therapists care for a diverse population for whom social determinants of health (SDOH) impact health outcomes. This study examines changes in knowledge and behavior following a continuing education course on SDOH. METHODS: This mixed methods study design included participants from a convenience sample of pediatric physical therapists enrolled in a continuing education course in SDOH. Data were collected through surveys, cases, and interviews. Quantitative data were analyzed using descriptive frequencies and comparisons. Qualitative data were analyzed using a grounded theory approach. RESULTS: Participants significantly improved their knowledge level in all content areas and increased the frequency in which they acted related to many content areas of the course. CONCLUSIONS: This study highlights the ways physical therapists can potentially optimize health outcomes. The findings contribute to the Knowledge to Action framework.
PURPOSE: We report the effectiveness of task-specific walking training for a child with hereditary spastic paraplegia using various orthoses, assistive mobility aids, and tasks. SUMMARY OF KEY POINTS: A 4-year-8-month-ol...PURPOSE: We report the effectiveness of task-specific walking training for a child with hereditary spastic paraplegia using various orthoses, assistive mobility aids, and tasks. SUMMARY OF KEY POINTS: A 4-year-8-month-old boy, classified as Gross Motor Function Classification System level IV, had selective dorsal rhizotomy and single-event multilevel surgery. The child began walking training using knee-ankle-foot orthoses and a posterior walker, setting the tasks to be "just right" for improving the child's abilities. CONCLUSION: At 6 years and 11 months of age, the child walked using bilateral ankle-foot orthoses and crutches at school, and scores improved on the Canadian Occupational Performance Measure, Gross Motor Function Measure-66, and Functional Mobility Scale.Recommendations for Clinical Practice: Physical therapists need to carefully select the factors involved in walking training based on an assessment and the difficulty level of each child in order to optimize improvements.