Purpose: To determine the level of burnout and investigate the relationship between effort-reward imbalance and burnout among early intervention (EI) physical therapists. Method: Study participants included EI physical therapists from 1 state within the United States. Participants completed an online survey that included demographic questions, the Oldenburg Burnout Inventory, and the Effort-Reward Imbalance Scale. Linear regression examined the relationship between effort-reward imbalance and burnout. Results: A total of 127 participants were included. Effort, reward, and overcommitment explained 49% (R2 = .490) of the variance in exhaustion (F4,118 = 28.38; P < .001) and 29.7% of the variance in disengagement (F4,118 = 12.48; P < .001) components of burnout. Conclusion: Physical therapists practicing in EI report high levels of emotional exhaustion, disengagement, and burnout. The results suggest that strategies to manage job demands, rewards, and overcommitment may help EI organizations decrease burnout among EI physical therapists.

Purpose: To introduce a clinical reasoning tool that helps clinicians and families collaboratively identify intervention components in pediatric rehabilitation. Key Points: This special communication presents the F-words Lens Tool, designed to integrate the F-words for Child Development framework with the Rehabilitation Treatment Specification System to enhance clinical reasoning in pediatric rehabilitation. The tool supports families and clinicians in selecting and evaluating intervention components based on the child’s goals. Recommendations: Clinicians should use the F-words Lens Tool to ensure interventions align with the child’s functional goals and actively involve families in the clinical reasoning process.

Purpose: Determine the safety and effectiveness of hybrid serial casting (fiberglass and soft casting tape) to increase ankle dorsiflexion passive range of motion (ADF PROM) in children with idiopathic toe walking (ITW). Methods: A retrospective cohort study of 65 children with ITW undergoing ankle hybrid serial casting was completed. Casts were applied weekly until age-based ADF PROM was achieved. Results: Children were casted an average of 3.8 weeks on the left leg and 3.1 weeks on the right. ADF PROM significantly improved from −0.3° (SD: 7.1) to 18.0° (SD: 5.6) on the left and 0.2° (SD: 8.7) to 18.4° (SD: 5.3) on the right. 5.0% of casts were removed early. Skin irritation caused a 1-week pause in casting in 6.2% of children. Conclusion: Hybrid serial casting may be a safe and effective method to improve ADF PROM for ITW and offers the advantage of removal without a cast saw.

Purpose: To investigate the responsiveness of the patient-reported outcome measure pediatric physical therapy (PROM-ppt), a questionnaire used to also stimulate shared decision making in Dutch pediatric physical therapy practices. Methods: Children completed the PROM-ppt at intake and 3 months after intervention or post-intervention. Reported problems were categorized as motor or pain related goals for intervention. Responsiveness was examined to test the a priori hypotheses and area under the curve (AUC). The Global Perceived Effect scale was used for comparison. Results: Overall, the hypotheses were confirmed in 60% of the cases with adequate AUCs. In children with motor problems, 80% of the hypotheses were matched, with adequate AUCs. In children with pain related problems, 40% of the hypotheses were matched, with inadequate AUCs. Conclusion: The PROM-ppt had moderate responsiveness in the pediatric population, good responsiveness in children with interventions for motor problems, and poor responsiveness to pain related problems.

Purpose: This case report describes the combined use of whole-body vibration (WBV), serial casting (SC), and physical therapy (PT) for a child with hemiplegic cerebral palsy (HCP). Summary of Key Points: A 3-year 10-month-old male with HCP was followed for 10 months. Treatment included 9 weeks of SC due to ankle plantarflexion contracture, hypertonicity, poor orthotic tolerance, and gait limitations. WBV was introduced during week 4 to address hypertonicity and poor tolerance of manual therapy. PT sessions included stretching, gait training, and strengthening exercises, integrating SC and WBV into a comprehensive intervention. Statement of Conclusion and Recommendations for Clinical Practice: This is the first report to explore combining WBV and SC within a PT program. WBV was safe and effective, potentially serving as a preparatory activity for SC. Improved orthotic wear tolerance, dorsiflexion range of motion, and gait efficiency suggest potential benefits of this multimodal approach, warranting further research. Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A657.

Purpose: Intensive pediatric physical therapy (PT) programs are increasingly common yet lack a clear definition. This study aimed to examine current practice patterns of intensive pediatric PT in the United States. Methods: A survey was developed and administered using the FITT (frequency, intensity, time, type) model and Knowledge to Action Cycle for pediatric physical therapists providing intensive PT. Survey respondents included pediatric physical therapists providing intensive physical therapy in outpatient, non-acute settings. Data analysis used descriptive statistics and cluster analysis. Results: Eighty pediatric physical therapists reported intensive programs involved children aged 4-6 years with cerebral palsy (90%), neuromuscular (78%), and neuromotor (44%) disorders. Greatest dose often-always ranged from 2-5 visits per week, ≤60-120 minute sessions over 3-8 weeks. Top interventions included locomotor training (80%), task-specific training (78%), and progressive resistive exercise (76%). Two clusters were identified based on therapist organization and dose. Conclusions: This first study of intensive pediatric PT revealed marked variability, underscoring the need for a standardized definition to improve clinical care.

Purpose: To assess the concurrent validity of 2 wearable sensors, GENEActiv (GA) and MonBaby (MB), for tracking tummy time in full-term and preterm infants at home. Methods: Nineteen full-term infants and 13 infants born preterm, aged 3 to 6 months, wore GA and MB sensors during caregivervideo-recorded active play at home over 3 days. Prone (tummy time) durations detected by each sensor were compared to video for validation. Results: Both GA and MB sensors demonstrated excellent (κ = 0.86) and substantial (κ = 0.78) second-by-second agreement with video, respectively, for tracking tummy time. For cumulative tummy time, the GA showed higher accuracy with video (GA =60 minutes, video =58 minutes, difference =2 minutes) compared to MB (MB =43 minutes, video =47 minutes, difference =4 minutes). No differences in accuracy were found between the 2 sensors. Conclusion: Wearable sensors can accurately track tummy time at home and can support adherence to movement guidelines in infants. Establishing caregiver feasibility is crucial for broader use.

Objective: The aim of the study is to compare the effects of telerehabilitation-based individual and group exercise, with routine treatment on exercise capacity,muscle strength,lung function,lower extremity explosive strength,balance,quality of life,and change in clinical status in people with cystic fibrosis (CF). Method: Eligible participants aged 8 to 18 years will be randomly allocated into 3 groups;a telerehabilitation-based indiviual or group exercise,and a control group. Exercise capacity,muscle and handgrip strength,spirometry measurements,lower extremity explosive strength,balance, quality of life will be assessed. Adherence rate to exercise programs will be calculated. Change in clinical status for all groups, motivation and enjoyment in the intervention groups will be assessed. Discussion: Telerehabilitation-based exercise programs can minimize barriers to undertaking exercise in CF. If the current research demonstrates similar effects between group and individual telerehabilitation sessions,and better results compared with routine treatment,physical therapists can integrate group tele-exercises into CF centres. This approach may not only save time, but also enhances participant adherence to exercise programs, producing many overall benefits.

Purpose: This case report presents the successful management of an adolescent with headache, dizziness, vertigo, and unsteadiness using the International Classification of Headache Disorders, 3rd edition (ICHD-3) and International Classification of Vestibular Disorders (ICVD) diagnostic criteria to screen for vestibular migraine of childhood (VMC) and rule out other conditions with similar symptoms. The physical therapist (PT) (1) used the diagnostic criteria from the ICHD-3 and the ICVD to determine the etiology, (2) taught protective lifestyle behaviors to reduce migraine symptoms, and (3) modified 2 physical therapy clinical practice guidelines to direct treatment. Key Points: The intervention prioritized adopting protective lifestyle behaviors to manage migraine symptoms before introducing exercises targeting vestibular and exertional intolerance symptoms. Conclusion and Recommendations for Clinical Practice: The diagnostic criteria helped inform the PT that the symptoms were consistent with VMC, which guided the intervention. Protective lifestyle behaviors and physical therapy strategies proved effective with symptom management.

Purpose: To explore the long-term impacts of an intensive physical therapy program, as perceived by caregivers and children. Methods: Semi-structured interviews were completed with 7 caregivers and 1 child. The data from these interviews were analyzed by an interdisciplinary coding team comprised of 3 physical therapists and 2 psychologists. Rapid qualitative inquiry (RQI) was used, which relies on intensive teamwork, iterative data analysis, and triangulation from multiple sources to get insiders’ perspectives. Results: Interviewees had positive experiences in the Intensity Program which they believed led to long-term and positive impacts in physical, psychological, and social functioning. Even though the program was challenging, and certain parts of it could be improved, interviewees were pleased with it. Conclusions: Interviewees perceived that the benefits of intensive physical therapy may persist for over a year following the completion of such a program. Perceived benefits of participating in an intensive program seem to outweigh the challenges.

Purpose: This study analyzed evidence of the impact of physical therapy-directed early mobilization (EM) on hospital and pediatric intensive care (PICU) length of stay, and mechanical ventilation days. Methods: PubMed and CINAHL were searched through January 2023. Studies included non-neonates through 18 years who participated in an EM program led by a physical therapist. Effect sizes and risk ratios were analyzed. Evidence quality of studies was assessed. Results: Six high-quality studies met the inclusion criteria. There was a statistically significant effect in the between-group analysis on hospital length of stay, PICU length of stay and mechanical ventilation days. Conclusions: This systematic review and meta-analysis support implementing EM in PICUs to reduce hospital and PICU length of stay, and mechanical ventilation days. This evidence can inform wider adoption of physical therapy-directed EM in PICUs to benefit infants and improve quality healthcare.

Purpose: The purpose of this study was to explore the experiences of pediatric physical therapists with the implementation and sustainability of pediatric intensive physical therapy (PT) programs in the United States. Methods: Data were collected from a 35-question survey consisting of multiple choice, Likert scale, and open-ended questions based on the Knowledge to Action Cycle Framework. Mixed methods were used in the data analysis of 2 quantitative questions relevant to implementing and sustaining pediatric intensive PT programs and 4 open-ended questions. Results: The sample size for quantitative questions was 80 and varied from 29 to 50 for open-ended questions depending on the question. Identified overarching themes included: Clinicians value intensive programs; “Logistically tough,” and Programs require 3 “Fs” for implementation and sustainability – Funding, Flexibility, and Foundational Knowledge. Conclusions: Pediatric physical therapists value intensive programs. Identified areas for support included formal training, improved research evidence, and institutional support.

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 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.