PURPOSE: The purpose of this special communication is to provide practical, evidence-based recommendations and examples of inclusive and accessible teaching practices that can be effectively used in pediatric physical th...PURPOSE: The purpose of this special communication is to provide practical, evidence-based recommendations and examples of inclusive and accessible teaching practices that can be effectively used in pediatric physical therapy (PT) education to: (1) ensure equity in education, (2) elevate all voices, and (3) facilitate anti-oppressive learning environments. SUMMARY OF KEY POINTS: Concrete action items and strategies addressing these 3 recommendations are provided at all levels of the ecological model framework. STATEMENT OF CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: Pediatric PT clinical and academic educators must work proactively to ensure learning environments are inclusive of everyone. Pediatric PT educators need to take the time to self-reflect, change their behaviors, and use inclusive, accessible, and anti-oppressive education practices. This will create equitable learning opportunities to successfully meet the needs of our learners, children, and families with whom we engage regularly in our personal and professional lives.
PURPOSE: The purpose of this Special Communication is to describe the processes of Education Summit III, sponsored by the Academy of Pediatric Physical Therapy, with an emphasis on the review, update, and integration of...PURPOSE: The purpose of this Special Communication is to describe the processes of Education Summit III, sponsored by the Academy of Pediatric Physical Therapy, with an emphasis on the review, update, and integration of contemporary language and the Competency-Based Education framework into a revision of the Essential Core Competencies (ECCs). SUMMARY OF KEY POINTS: The Academy of Pediatric Physical Therapy has consistently supported pediatric professional education, including sponsoring 3 Education Summits in 2012, 2016, and 2023. The most recent summit focused on a revision of the ECCs and the development of materials to support their implementation. RECOMMENDATIONS FOR PRACTICE: These revised domains of competence and associated competencies will support and guide pediatric physical therapy education for professional students. Educators are encouraged to use their creativity and resources to integrate these into teaching and learning activities.
PURPOSE: This case series investigated the implementation fidelity, feasibility, and effectiveness of integrating continuous heart rate monitoring with visual feedback into an established, intensive physical therapy camp...PURPOSE: This case series investigated the implementation fidelity, feasibility, and effectiveness of integrating continuous heart rate monitoring with visual feedback into an established, intensive physical therapy camp for children with neuromotor disorders. SUMMARY OF KEY POINTS: The provision of continuous visual feedback through color-coded, individually calculated heart rate zones was a feasible and effective intervention, encouraging pediatric gait camp participants to exercise at intensities that produced aerobic and functional gains. The use of technology facilitated participation with peers, an outcome equally as important as their endurance and functional improvements. CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: Pediatric physical therapists play a crucial role in enhancing the well-being and physical fitness of children with disabilities. Encouraging regular exercise in a social environment fosters enjoyable, inclusive experiences while promoting overall health. It is important for clinicians in various pediatric rehabilitation settings to establish programs that offer such opportunities for children with neuromotor disorders.
PURPOSE: To create a multicriteria index with clinical factors associated with abnormal general movements (GMs) trajectories during a stay in the neonatal intensive care unit. METHODS: A longitudinal study assessed abnor...PURPOSE: To create a multicriteria index with clinical factors associated with abnormal general movements (GMs) trajectories during a stay in the neonatal intensive care unit. METHODS: A longitudinal study assessed abnormal GMs trajectories in preterm infants in the neonatal intensive care unit. The multicriteria index included clinical factors such as intraventricular hemorrhage, respiratory support, gestational age, patent ductus arteriosus, and infection based on multi-attribute utility theory. RESULTS: A total of 52 preterm newborns, 57.7% male, were evaluated. The multicriteria index correlated with abnormal GMs trajectories and explained 26.5% of the variance in these trajectories. CONCLUSION: The developed multicriteria index, with the inclusion of combined clinical factors, allowed the identification of part of the abnormal trajectories of GMs in preterm infants. The multicriteria analysis can help clinicians to identify infants who have a greater chance of poor developmental trajectories before hospital discharge.
PURPOSE: To explore the benefits of a Partial Body Weight Support (PBWS) harness system within a play enriched environment on gross motor development and mastery motivation of infants with Down Syndrome (DS). METHODS: A...PURPOSE: To explore the benefits of a Partial Body Weight Support (PBWS) harness system within a play enriched environment on gross motor development and mastery motivation of infants with Down Syndrome (DS). METHODS: A randomized crossover study with 17 pre-walking infants with DS in two conditions-play with or without the harness engaged-each for 3×/week over 3 weeks with a 1-week washout. Assessments took place at baseline, crossover, and completion. RESULTS: Statistically and clinically significant changes were evident on the Gross Motor Function Measure-88; however, there were no significant changes in parent-reported mastery motivation. CONCLUSION: The combination of PBWS harness system support and high frequency-facilitated play within an enriched play environment positively affected gross motor development. The intervention did not impact mastery motivation skills, and the direct impact of the harness remains unclear.
PURPOSE: Children with Autism Spectrum Disorder (ASD) have motor, social communication, and behavioral challenges. During the pandemic, children lost access to face-to-face (F2F) services and had to revert to telehealth...PURPOSE: Children with Autism Spectrum Disorder (ASD) have motor, social communication, and behavioral challenges. During the pandemic, children lost access to face-to-face (F2F) services and had to revert to telehealth (TH) options. We compared the efficacy, fidelity, acceptability, and feasibility of a general motor (GM) intervention using an F2F or telehealth (TH) format. METHODS: Fifteen children with ASD participated in an 8-week program involving gross motor games to promote motor and social communication skills. Differences across TH and F2F formats for motor and socially directed verbalization as well as stakeholder feedback on formats were collected. RESULTS: Gross motor and socially directed verbalization did not differ between the F2F and TH subgroups, and parents and trainers were satisfied with either format. However, TH interventions were longer, had more technological challenges, and required more parental effort. CONCLUSIONS: The findings of this study support the use of TH as a comparable and viable substitute for F2F interactions for children with ASD.
PURPOSE: To describe a home program for a child with medical complexity using an over-ground body weight support (BWS) system. SUMMARY OF KEY POINTS: Children with medical complexity often use home programs due to challe...PURPOSE: To describe a home program for a child with medical complexity using an over-ground body weight support (BWS) system. SUMMARY OF KEY POINTS: Children with medical complexity often use home programs due to challenges with regular therapy attendance. In this case, effective home program components including child centered design, family leadership, and best practice principles were prioritized around the PUMA (portable mobility aid for children). This BWS system was to be used for 1 hour per day to support mobility and active play. STATEMENT OF CONCLUSIONS: The CMC and family demonstrated high adherence, using over-ground BWS 87% of the 135 days it was accessible with an average daily usage of 59 min spread across 1-3 bouts per day. The average daily fun index during usage was 7/10. RECOMMENDATIONS FOR CLINICAL PRACTICE: This home program demonstrated over-ground BWS technology as a feasible, fun platform for functional mobility and socialization in a child with significant medical and physical limitations.
PURPOSE: To share my perspectives on how pediatric physical therapists support children with disabilities and their families to maximize their potential to flourish. KEY POINTS: Best practice supports the inclusion of pe...PURPOSE: To share my perspectives on how pediatric physical therapists support children with disabilities and their families to maximize their potential to flourish. KEY POINTS: Best practice supports the inclusion of people with disabilities in all aspects of society. Policy statements from governmental agencies, research universities, advocacy, and non-governmental organizations all support inclusion. The concept of belonging and how pediatric physical therapists can promote belonging is less familiar to pediatric physical therapists than inclusion and participation. Essential elements necessary to bring about a sense of belonging in young children will be presented, leading to a discussion on the role of the pediatric physical therapist and key implications for the early childhood system of care. CONCLUSIONS: Pediatric physical therapists support children with disabilities and their families to maximize the potential of every child. I propose that to do this, we must focus our interventions to promote a child's active participation in community life and build programs and relationships that promote belonging. CLINICAL RELEVANCE: Interventions for children with disabilities will be successful by focusing on the outcomes that promote inclusion, participation, and belonging.
PURPOSE: To determine whether foot and ankle functions are correlated with the limits of stability (LoS) while standing in individuals with bilateral spastic cerebral palsy (BSCP). METHODS: Eighteen people who could walk...PURPOSE: To determine whether foot and ankle functions are correlated with the limits of stability (LoS) while standing in individuals with bilateral spastic cerebral palsy (BSCP). METHODS: Eighteen people who could walk and with BSCP and 18 people without disability participated. Anteroposterior LoS was measured using a force platform. To quantify ankle and foot functions, spasticity, isometric muscle strength, passive range of motion, and plantar light touch-pressure sensation were assessed. RESULTS: In the BSCP group, anteroposterior LoS was significantly decreased, and anterior LoS reduction was correlated with decreases in plantar flexor and toe flexor strength and in sensitivity of the forefoot to light touch-pressure sensation, whereas the posterior LoS reduction was correlated with reduced dorsiflexor strength. CONCLUSIONS: The present findings suggest that improvement in these foot and ankle functions in BSCP may increase LoS while standing.
PURPOSE: To examine the intrarater and interrater reliability and construct validity of the Functional Symmetry Observation Scale, Version 2 (FSOS-V2) in infants with congenital muscular torticollis (CMT). METHODS: The F...PURPOSE: To examine the intrarater and interrater reliability and construct validity of the Functional Symmetry Observation Scale, Version 2 (FSOS-V2) in infants with congenital muscular torticollis (CMT). METHODS: The FSOS-V2 is a video-based measure of postural and movement symmetry in infants with CMT. Four examiners scored 50 participants' videos twice. Scores obtained by the same rater and across 4 raters were compared to examine intrarater and interrater reliability, respectively. Participants' habitual head deviation from midline in supine photographs was measured using a protractor. Relationship between the head tilt angles and FSOS-V2 scores was examined to assess construct validity. RESULTS: Fifty infants with CMT, age range 1 to 16 months, participated. Results indicated moderate to good intrarater and poor to moderate interrater reliability. The FSOS-V2 construct validity was supported. CONCLUSION: The FSOS-V2 can be used by the same therapist repeatedly to make clinical decisions. Further research will strengthen its psychometric properties.
PURPOSE: To determine the feasibility of modified constraint-induced movement therapy (mCIMT) paired with neuromuscular electrical stimulation (NMES) for infants with asymmetrical hand function (AHF). METHODS: Five infan...PURPOSE: To determine the feasibility of modified constraint-induced movement therapy (mCIMT) paired with neuromuscular electrical stimulation (NMES) for infants with asymmetrical hand function (AHF). METHODS: Five infants received an experimental ABA design: (A1) 3 weeks of our Standard AHF Care, (B) 3 weeks mCIMT-NMES, and (A2) 3 weeks of our Standard AHF Care. Parents tracked key data in a daily log, and infants were assessed 4 times using the Hand Assessment for Infants and Peabody Developmental Motor Scale-2. RESULTS: There was a high level of participant enrollment, visit frequency adherence, and compliance with the treatment protocol. No adverse events were reported. Mean Hand Assessment for Infants Both Hands measure scores changed more after mCIMT-NMES than after our Standard AHF Care. CONCLUSIONS: mCIMT-NMES is a feasible early intervention for infants with AHF at risk for unilateral cerebral palsy. A future study in a larger sample should examine the efficacy of mCIMT-NMES in this population.