Τα νέα του Pediatric Physical Therapy Journal

Εγγραφή στο Ροή Τα νέα του Pediatric Physical Therapy Journal Τα νέα του Pediatric Physical Therapy Journal
Pediatric Physical Therapy is the first and only peer-reviewed journal devoted to this discipline. The Journal provides a forum for scientific and professional exchange among researchers and practitioners throughout the world that represent subspecialties of the discipline, including early intervention, neonatology, pediatric sports and fitness, school physical therapy, acute care for seriously ill children, and the prevention of primary and secondary conditions that lead to disabling conditions. Official Journal of APTA Pediatrics, an Academy of the American Physical Therapy Association, The Dutch Association for Pediatric Physical Therapy, Physiotherapia Paediatrica, The New Zealand Society of Physiotherapists Pediatric Special Interest Group, and The Pediatric Division of the Canadian Physiotherapy Association.
Ενημερώθηκε: πριν από 12 ώρες 58 λεπτά

Current Trends for Children With Spina Bifida: A Survey of Pediatric Physical Therapists

Τρί, 04/06/2024 - 08:00
Purpose: To describe contemporary physical therapy practice and management of children with spina bifida (SB) in the context of the International Classification of Functioning, Disability, and Health (ICF) framework. Methods: A descriptive, cross-sectional electronic survey was sent to US pediatric physical therapy clinics and posted in the American Physical Therapy Association Pediatrics newsletter. Data were analyzed using content analysis. Codes were compared, refined, and condensed into categories. Results: A total of 163 participants were included. Most assessments evaluated the ICF Activity component. Most frequently reported ICF components: impairments = decreased strength (17.9%), activity limitations = limited walking (22.5%), and participation restrictions = restricted socializing/playing with peers or siblings (22.6%). The most prevalent intervention was strength training. Conclusions: Physical therapists (PTs) in the United States are performing assessments and interventions supported by available evidence; however, knowledge translation and more research are needed to support best practices in PT management of children with SB.

Harnessing Mobility: A Medically Complex Child’s Home Program Utilizing an In-Home Body Weight Support System

Δευ, 27/05/2024 - 08:00
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.

Inspiratory Training for Improving Respiratory Strength, Pulmonary Function, and Walking in Cerebral Palsy: A Meta-Analysis

Παρ, 29/03/2024 - 07:00
Purpose: To investigate the effects of inspiratory strength training on respiratory muscle strength, pulmonary function, and walking capacity in children with cerebral palsy, with Gross Motor Function Classification System I to III. Methods: Searches were conducted in CINAHL, LILACS, MEDLINE, and Physiotherapy Evidence Database (PEDro) databases. The outcomes of interest were respiratory muscle strength, pulmonary function, and walking capacity. The quality was assessed by PEDro Scale. The Grading of Recommendations Assessment, Development, and Evaluation system was used to summarize the quality of evidence. Results: Inspiratory strength training increased the strength of inspiratory muscles and may increase the strength of the expiratory muscles. No changes were observed in pulmonary function or walking capacity. Conclusions: This systematic review provides moderate-quality evidence that inspiratory strength training is effective for increasing inspiratory muscle strength in children with cerebral palsy. Benefits may be carried over to improving expiratory muscle strength but were not observed on pulmonary function or walking capacity.

Locomotion Efficiency in Children With Cerebral Palsy Experiencing Limited Gross Motor Function: Walking Versus Cycling

Παρ, 29/03/2024 - 07:00
Purpose: This study compares cycling and walking efficiency, and energy expenditure in children with bilateral spastic cerebral palsy (CP). In children with CP, locomotion with body weight support aids such as a tricycle is a potential alternative for less exhausting movements. Methods: Nine children with CP traveled at comfortable speed for 6 minutes by cycling and walking. The energy expenditure index (EEI) and the percentage of the reserve heart rate (%HRR) were calculated. Results: The EEI was lower while cycling than walking, the traveled distance was higher while cycling than walking, and %HRR remained similar between cycling and walking. Conclusion: Cycling appears an efficient alternative to walking for children with CP for adapted school environments and in the community.

Introducing the i-Rainbow©: An Evidence-Based, Parent-Friendly Care Pathway Designed for Critically Ill Infants in the NICU Setting

Παρ, 29/03/2024 - 07:00
Purpose: This study investigated the feasibility and effectiveness of a novel, evidence-based developmental care pathway to be used by health care providers and parents in the neonatal intensive care unit (NICU) setting. The i-Rainbow is based on current evidence and responds to individual infant health status. It is not based on infant age. Methods: After development and implementation of the i-Rainbow, pre- and postimplementation nurse and parent survey data were collected and pre- and post–developmental care rates were compared. Results: After i-Rainbow implementation, disagreement among providers on appropriate developmental care interventions significantly decreased, total minutes of daily developmental care and swaddled holding increased significantly, and parents reported that they would recommend the tool. Conclusion: The i-Rainbow is a unique, parent-friendly, infant-based tool that guides sensory interventions in the NICU by staging infants based on cardiorespiratory status and physiologic maturity, not age. The i-Rainbow improved the delivery of developmental care activities in our unit and was well received by parents and nurses. Video Abstract: Supplemental Digital Content available at: http://links.lww.com/PPT/A516

Trauma-Informed Care in Pediatric Physical Therapy as a Standard Precaution: The Time Is Here

Παρ, 29/03/2024 - 07:00
In this special communication, an overview of the research on trauma, resilience, and action items for the pediatric physical therapist (PT) is addressed. The experiences of early childhood, positive and negative, impact overall development and well-being throughout the lifespan. Childhood trauma can include exposure to abuse, neglect, violence, racism, or medical procedures. These adverse childhood experiences are associated with poor physical and mental health outcomes that can extend into adulthood and can appear in the pediatric rehabilitative realm as caregivers who become labeled noncompliant. Trauma is common and impacts all children; however, some populations, such as children with disabilities, have greater risk for experiencing adversity. An individual's trauma history is not always visible, necessitating a standard approach. Pediatric PTs must take an intentional approach to address the detrimental effects of trauma on those we serve. Many organizations recommend adopting trauma-informed care as the standard of care for all populations.

Journey to 1 Million Steps: A Retrospective Case Series Analyzing the Implementation of Robotic-Assisted Gait Training Into an Outpatient Pediatric Clinic

Παρ, 29/03/2024 - 07:00
Purpose: To describe the implementation of an exoskeleton program in a rehabilitation setting using a Design Thinking framework. Methods: This is a retrospective case series of 3 randomly selected children who participated in skilled physical therapy using a pediatric exoskeleton that occurred on our journey to walking 1 000 000 steps in the exoskeleton devices. Participants ranged in age from 3 to 5 years, and all had neurologic disorders. Results: All participants improved toward achieving their therapy goals, tolerated the exoskeleton well, and had an increased number of steps taken over time. Conclusion: The implementation of new technology into pediatric care and an established outpatient therapy clinic is described. The Design Thinking process applies to health care professionals and improves clinical care. Exoskeletons are effective tools for use in pediatric physical therapy.

Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline

Παρ, 29/03/2024 - 07:00
Background: Children with cerebral palsy (CP) who walk have complex gait patterns and deviations often requiring physical therapy (PT)/medical/surgical interventions. Walking in children with CP can be assessed with 3-dimensional instrumented gait analysis (3D-IGA) providing kinematics (joint angles), kinetics (joint moments/powers), and muscle activity. Purpose: This clinical practice guideline provides PTs, physicians, and associated clinicians involved in the care of children with CP, with 7 action statements on when and how 3D-IGA can inform clinical assessments and potential interventions. It links the action statement grades with specific levels of evidence based on a critical appraisal of the literature. Conclusions: This clinical practice guideline addresses 3D-IGA’s utility to inform surgical and non-surgical interventions, to identify gait deviations among segments/joints and planes and to evaluate the effectiveness of interventions. Best practice statements provide guidance for clinicians about the preferred characteristics of 3D-IGA laboratories including instrumentation, staffing, and reporting practices. Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A524.