PURPOSE: A health promotion and physical wellness (HPPW) life course approach for pediatric physical therapy (PT) is recommended to improve children's health outcomes across the lifespan. SUMMARY OF KEY POINTS: A life co...PURPOSE: A health promotion and physical wellness (HPPW) life course approach for pediatric physical therapy (PT) is recommended to improve children's health outcomes across the lifespan. SUMMARY OF KEY POINTS: A life course approach describes how a child's individual responses to environmental factors influence health outcomes. Using HPPW strategies, pediatric physical therapists can identify health risks and promote positive outcomes. Outcome measures and intervention recommendations are outlined to assist therapists in integrating HPPW strategies to ensure a longitudinal plan of care and optimal health outcomes for children. CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: A child's health trajectory begins in the prenatal period and is influenced by individual and environmental factors. Pediatric PT uses child- and family-centered approaches and environmental assessments to design plans of care that address child and family HPPW goals. Incorporating HPPW strategies into pediatric PT facilitates positive health and physical wellness across a child's lifespan.See the video abstract for insights from the authors. VIDEO ABSTRACT: Supplemental digital content available at https://www.dropbox.com/scl/fi/3g468hj1rpxrrivbeses0/HPPW-Video-Abstract_1080.mp4?rlkey=4p1i8z1gynroz064zpx3alijz&st=8u0gqemz&dl=0 .
PURPOSE: This study investigated differences in cardiorespiratory fitness (CRF) and other physical literacy domains between children with a chronic medical condition (CMC) who adhered to with the physical activity guidel...PURPOSE: This study investigated differences in cardiorespiratory fitness (CRF) and other physical literacy domains between children with a chronic medical condition (CMC) who adhered to with the physical activity guideline and those who did not. METHOD: Forty children with a CMC (7-12 years) wore an accelerometer for 7 days to measure moderate-to-vigorous physical activity. CRF and muscle power were assessed with a maximal cardiopulmonary exercise test, and motor performance was measured with an exercise course. Motivation, confidence, knowledge, and understanding were assessed with a questionnaire. RESULTS: Children who adhered to the PA guideline ( n = 13) scored significantly higher for CRF, muscle power, motivation and confidence than children who did not adhere to the PA guideline ( n = 27). No significant differences were found for motor performance, knowledge and understanding. CONCLUSION: Future research should investigate the effect of paying specific attention to motivation and confidence in children with a CMC to stimulate their adherence to the PA guideline.
PURPOSE: Evaluate the content and variability of infant motor milestone education provided to parents in popular sources. METHODS: Sources were screened for inclusion, and their motor milestone content was coded. Descrip...PURPOSE: Evaluate the content and variability of infant motor milestone education provided to parents in popular sources. METHODS: Sources were screened for inclusion, and their motor milestone content was coded. Descriptive and inferential analyses were performed. RESULTS: Content from 241 websites, applications, and books was evaluated; 6984 motor milestones were extracted, representing 146 unique milestone codes across 14 categories. Books and applications had more milestone content than websites. There was variability in the milestones mentioned and their associated ages across the sources and relative to the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) content. Several frequently mentioned milestones were behaviors that facilitate early learning. CONCLUSIONS: There is variability among sources in the motor milestones they provide to parents of infants. The AAP and CDC content likely has some influence on the broader content available, but there is substantial deviation from the information they provide.
PURPOSE: To characterize physical therapy (PT) dose for children with cerebral palsy (CP) after multi-level surgery (MLS) and examine variation by ambulatory status and surgical burden. METHODS: PT dose (Frequency, Inten...PURPOSE: To characterize physical therapy (PT) dose for children with cerebral palsy (CP) after multi-level surgery (MLS) and examine variation by ambulatory status and surgical burden. METHODS: PT dose (Frequency, Intensity, Time, Type) data were extracted from electronic records of children with CP who received outpatient PT the year after MLS. RESULTS: Seventeen children, mean 9 years, female (n=10), ambulatory (n=10), and high surgical burden (n=12) were included. In the year after surgery, 345 visits occurred. Intensity across visits was above average. Time was greatest for pre-functional activities, gait, and transitions/transfers. Types most often delivered were neuromuscular, musculoskeletal, and education/training. Ambulatory children received significantly more visits, higher intensity, and time in pre-functional activities and gait than non-ambulatory children. No differences in type by ambulatory status and PT dose by surgical burden were found. CONCLUSION: PT dose varied the first year after MLS indicating the need for guidelines by ambulatory status. VIDEO ABSTRACT: Supplemental Digital Content available at: http://links.lww.com/PPT/A516.
PURPOSE: The aim of this study was to describe existing GoBabyGo (GBG) programs with physical or occupational therapist (PT or OT) involvement and identify eligibility criteria and evaluation processes of organizations t...PURPOSE: The aim of this study was to describe existing GoBabyGo (GBG) programs with physical or occupational therapist (PT or OT) involvement and identify eligibility criteria and evaluation processes of organizations that build modified ride-on cars (MROCs). METHODS: Forty-four PTs and OTs completed a survey including descriptive information about GBG programs, barriers and facilitators, and functional aspects of the programs such as inclusion and exclusion criteria, outcome measure use, and follow-up practices. RESULTS: Findings demonstrated the heterogeneous nature of GBG programs. GBG programs most commonly serve 2 to-5-year-olds with cerebral palsy, spina bifida, and chromosomal abnormalities. Outcome measure use and follow-up was minimal, and successful MROC use definitions varied from independent driving to passive use. CONCLUSIONS: Clinicians can use this information to help improve existing GBG programs and start new chapters as well as make appropriate referrals for clients who may benefit from a MROC.
PURPOSE: To develop a fidelity tool to support the implementation of clinical practice guidelines to improve physical function for children and young people with cerebral palsy. METHODS: Fidelity tool development followe...PURPOSE: To develop a fidelity tool to support the implementation of clinical practice guidelines to improve physical function for children and young people with cerebral palsy. METHODS: Fidelity tool development followed a 5-step process: the pilot study, using a mixed-methods action research approach, and including focus groups, questionnaires, and field notes. RESULTS: A 21-item fidelity tool representing the core components of the clinical practice guidelines was developed, including subsections of goal setting, intervention, and elements seen throughout therapeutic intervention. Clinicians and supervisors reported this tool as acceptable and feasible, especially when used as a self-reflection tool. CONCLUSIONS: A fidelity tool has been developed that clinicians, supervisors and organizations can use to reflect on current practice and plan for changes to align practice with guidelines to improve function in children with cerebral palsy.
OBJECTIVE: Describe the development and implementation of an evidence-based practice (EBP) training program for occupational and physical therapists in a large pediatric hospital. CONTEXT: EBP is valued, but a known know...OBJECTIVE: Describe the development and implementation of an evidence-based practice (EBP) training program for occupational and physical therapists in a large pediatric hospital. CONTEXT: EBP is valued, but a known knowledge-to-practice gap between academic training and clinical practice limits routine use. This gap was addressed through an academic-clinical partnership to develop an EBP training program. RESULTS: Sixty-one therapists completed the program. Therapists demonstrated improved EBP skills, knowledge, and confidence following training and a positive trend in change score for clinical outcomes and decision-making scores was noted. CONCLUSION: Academic-clinical partnerships have a unique and valuable role to support professional EBP knowledge and skill development. Stakeholder support and engagement supported program development, execution, and meaningful outcomes. IMPACT STATEMENT: The knowledge-to-practice gap for EBP is a challenge to regular EBP use. The described program addressed this challenge and improved therapists' knowledge, skills, and confidence. It provides a model for professional development.
Congenital muscular torticollis (CMT) is a postural condition evident shortly after birth. The 2013 CMT Clinical Practice Guideline (2013 CMT CPG) set standards for the identification, referral, and physical therapy mana...Congenital muscular torticollis (CMT) is a postural condition evident shortly after birth. The 2013 CMT Clinical Practice Guideline (2013 CMT CPG) set standards for the identification, referral, and physical therapy management of infants with CMT, and its implementation resulted in improved clinical outcomes. It was updated in 2018 to reflect current evidence and 7 resources were developed to support implementation. Purpose: This 2024 CMT CPG is intended as a reference document to guide physical therapists, families, health care professionals, educators, and researchers to improve clinical outcomes and health services for children with CMT, as well as to inform the need for continued research. Results/Conclusions: The 2024 CMT CPG addresses: education for prevention, screening, examination and evaluation including recommended outcome measures, consultation with and referral to other health care providers, classification and prognosis, first-choice and evidence-informed supplemental interventions, discontinuation from direct intervention, reassessment and discharge, implementation and compliance recommendations, and research recommendations.
Pediatr Phys Ther
· 2024 Oct · PMID 39316782
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Full text
PURPOSE: This study investigated the psychometric properties of a 4-second interval scoring modification of the Assessment of Problem-Solving in Play (ie, Assessment of Problem-Solving in Play 4-second interval scoring [...PURPOSE: This study investigated the psychometric properties of a 4-second interval scoring modification of the Assessment of Problem-Solving in Play (ie, Assessment of Problem-Solving in Play 4-second interval scoring [APSP-4]). METHODS: A total of 95 children (3-48 months) with or at high risk for neuromotor delay were assessed with the APSP-4 and Bayley Scales of Infant and Toddler Development-III (Bayley). APSP-4 and Bayley cognitive raw scores were compared by age (construct validity) and over time (responsiveness). Twenty percent of videos were scored twice for intra- and interrater reliability. RESULTS: The APSP-4 demonstrated excellent interrater (intraclass correlations [ICCs] ≥ 0.96) and intrarater (ICCs ≥ 0.99) reliability and performed similar to Bayley cognitive raw scores at different ages ( r s > 0.5), and over time ( r = 0.81). The motor delay had similar effects on APSP-4 and Bayley scores. CONCLUSIONS: Results support the validity and reliability evidence of the APSP-4 for use over time in tracking problem-solving skills in young children aged 3 to 48 months. Future research investigating clinical implementation of the APSP-4 is needed.
PURPOSE: Containers (eg, strollers, bouncers) are an important part of infants' environment but may negatively impact infant development and health. This study evaluated movement and play opportunities, constraints, and...PURPOSE: Containers (eg, strollers, bouncers) are an important part of infants' environment but may negatively impact infant development and health. This study evaluated movement and play opportunities, constraints, and manufacturers' developmental claims for infant containers. METHODS: Containers were identified through Amazon.com. A content analysis of identified products was conducted to identify movement and visual-manual play opportunities, constraints, and developmental claims. RESULTS: Content was analyzed for 460 containers. Containers varied in their movement and play opportunities; however, most did not incorporate toys and restricted trunk movement, self-directed locomotion, and independent head and trunk control. Containers, especially those with built-in toys, often had claims related to gross motor, sensory, and fine motor development. CONCLUSION: These findings demonstrate the variability of movement and play opportunities observed across and within categories of infant containers. General recommendations about container use may be less effective than more specific education to parents about selecting and implementing containers.