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LaForme Fiss A, Chiarello LA, Hsu LY, McCoy SW. Adaptive behavior and mastery motivation in children with physical disabilities. Physiother Theory Pract 2024; 40:1616-1627. [PMID: 36847241 DOI: 10.1080/09593985.2023.2181118] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/30/2022] [Accepted: 02/09/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Adaptive behavior consists of conceptual, social, and practical skills and describes the ability of individuals to manage environmental demands, interact with others, and engage in activities to meet ones needs. Mastery motivation is an intrinsic characteristic that enables persistence when attempting to master a skill. Children with physical disabilities often demonstrate less effective adaptive behaviors and lower mastery motivation than their peers without disabilities, which may subsequently impact development and participation in daily activities. Therefore, it may be beneficial for pediatric rehabilitation practitioners to focus intentionally on facilitating effective adaptive behaviors in children with physical disabilities as they aim to support child development and function. OBJECTIVE This perspective paper highlights the importance of adaptive behavior for children with physical disabilities, discusses methods of assessment, and illustrates intervention principles and strategies to support the development of appropriate adaptive behaviors across childhood. Key intervention principles include: 1) engage children and address motivation; 2) collaborate with others; 3) support real-life meaningful experiences; 4) scaffold the just-right challenge; and 5) guide children in discovering solutions.
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Affiliation(s)
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA USA
| | - Lin-Ya Hsu
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA USA
| | - Sarah Westcott McCoy
- Department of Rehabilitative Medicine, University of Washington, Seattle, WA USA
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2
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Levac DE. Individual and contextual factors influencing children's effort in pediatric rehabilitation interventions. Dev Med Child Neurol 2024; 66:23-31. [PMID: 37082901 DOI: 10.1111/dmcn.15609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023]
Abstract
Rehabilitation clinicians strive to encourage children's sustained effort within challenging practice conditions. Effort influences intervention success, yet it is rarely defined or measured. Effort can be conflated with individual factors, such as motivation and engagement, that might influence it. Contextual factors that likely impact children's effort, such as practice conditions and therapeutic interactions, are generally under-described. Defining, describing, and measuring effort and its influencers is necessary to enhance understanding of differences in rehabilitation intervention outcomes across individuals and contexts and to support the development of personalized precision rehabilitation approaches. This narrative review describes effort conceptualization in rehabilitation, particularly in relation to intensity, engagement, and participation nomenclature. The review outlines individual and contextual factors that may influence children's effort in rehabilitation and describes potential next steps for effort description and measurement. Subsequent work should aim to identify factors that can be targeted in clinical practice to promote and sustain children's effort in the rehabilitation process, thereby individualizing interventions and potentially improving their effectiveness. WHAT THIS PAPER ADDS: Effort as it relates to rehabilitation is confusingly described and infrequently measured. Engagement, involvement, intensity, and participation are terms alluding to effort. Child-specific and therapy-specific factors, alone and in combination, may influence children's effort. Clearer conceptualization of effort and the factors that influence it will support personalization of interventions. Better measurement will enhance knowledge about relationships between effort and therapeutic outcomes.
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Affiliation(s)
- Danielle E Levac
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada
- CHU Sainte-Justine Research Center, Montreal, Canada
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Srinivasan S, Amonkar N, Kumavor P, Morgan K, Bubela D. Outcomes Associated with a Single Joystick-Operated Ride-on-Toy Navigation Training Incorporated into a Constraint-Induced Movement Therapy Program: A Pilot Feasibility Study. Behav Sci (Basel) 2023; 13:bs13050413. [PMID: 37232651 DOI: 10.3390/bs13050413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Our research aims to evaluate the utility of joystick-operated ride-on-toys (ROTs) as therapeutic adjuncts to improve upper extremity (UE) function in children with hemiplegic cerebral palsy (HCP). This study assessed changes in affected UE use and function following a three-week ROT navigation training incorporated into an existing constraint-induced movement therapy (CIMT) camp in 11 children (3-14 years old) with HCP. We report changes in scores on the standardized Shriners Hospital Upper Extremity Evaluation (SHUEE) from pretest-to-posttest and changes from early-to-late sessions in percent time spent by the affected arm in: (a) "moderate-to-vigorous activity", "light activity" and "no activity" bouts based on accelerometer data and (b) "independent", "assisted", and "no activity" bouts based on video data. We also explored relationships between standardized measures and training-specific measures of affected UE activity. We found small-to-medium improvements in the SHUEE scores. Between 90 and 100% of children also showed medium-to-large improvements in affected UE activity from early-to-late sessions using accelerometers and small improvements via video-based assessments. Exploratory analyses suggested trends for relationships between pretest-posttest and training-specific objective and subjective measures of arm use and function. Our pilot data suggest that single joystick-operated ROTs may serve as motivating, child-friendly tools that can augment conventional therapies such as CIMT to boost treatment dosing, promote affected UE movement practice during real-world navigation tasks, and ultimately improve functional outcomes in children with HCP.
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Affiliation(s)
- Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT 06268, USA
- The Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT 06268, USA
| | - Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT 06268, USA
- The Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT 06268, USA
| | - Patrick Kumavor
- Biomedical Engineering Department, University of Connecticut, Storrs, CT 06268, USA
| | - Kristin Morgan
- Biomedical Engineering Department, University of Connecticut, Storrs, CT 06268, USA
| | - Deborah Bubela
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06268, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT 06268, USA
- The Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT 06268, USA
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Silvério APM, Mancini MC, Antunes FIT, Figueiredo PRP, Bueno KMP, Brandão MB. 'Thinking about myself?' Experiences of parents of adolescents with cerebral palsy: A qualitative study to guide the implementation of a service for families. Child Care Health Dev 2023. [PMID: 36597412 DOI: 10.1111/cch.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/17/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
BACKGROUND Recently, there has been an increase in the development of transition services for adolescents with cerebral palsy (CP). Studies have emphasized the importance of addressing parents' needs during their children's adolescence. AIMS This study aimed to understand how parents experience the adolescence and transition to adulthood of their adolescents with CP and to identify relevant components for the development of a service for families. METHODS AND PROCEDURES A qualitative study was conducted with 18 families of adolescents with CP. Caregivers were purposely recruited from a transition programme called Adolescence in Focus Program. Individual interviews were conducted using a semistructured script. Then, the caregivers were invited to participate in focus groups. The interviews and focus groups were recorded and transcribed for content analysis. RESULTS Three categories emerged: 'The onset of adolescence', 'What will our future be?' and 'Support and services: paths to follow'. The adolescents' behavioural changes seemed to be intensified by their restricted social participation. Parents reported the desire for their adolescents to become independent in daily activities. Regarding their own future, they aimed to re-establish the occupational roles that were interrupted. CONCLUSION Information from this study guided the design of a programme for families regarding content, format and outcomes.
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Affiliation(s)
- Ana Paula M Silvério
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Associação Mineira de Reabilitação, Belo Horizonte, Brazil
| | - Marisa C Mancini
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda I T Antunes
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Priscilla R P Figueiredo
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Associação Mineira de Reabilitação, Belo Horizonte, Brazil
| | - Kátia M P Bueno
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marina B Brandão
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Perpetuini D, Russo EF, Cardone D, Palmieri R, Filippini C, Tritto M, Pellicano F, De Santis GP, Pellegrino R, Calabrò RS, Filoni S, Merla A. Psychophysiological Assessment of Children with Cerebral Palsy during Robotic-Assisted Gait Training through Infrared Imaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15224. [PMID: 36429941 PMCID: PMC9690262 DOI: 10.3390/ijerph192215224] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Cerebral palsy (CP) is a non-progressive neurologic pathology representing a leading cause of spasticity and concerning gait impairments in children. Robotic-assisted gait training (RAGT) is widely employed to treat this pathology to improve children's gait pattern. Importantly, the effectiveness of the therapy is strictly related to the engagement of the patient in the rehabilitation process, which depends on his/her psychophysiological state. The aim of the study is to evaluate the psychophysiological condition of children with CP during RAGT through infrared thermography (IRT), which was acquired during three sessions in one month. A repeated measure ANOVA was performed (i.e., mean value, standard deviation, and sample entropy) extracted from the temperature time course collected over the nose and corrugator, which are known to be indicative of the psychophysiological state of the individual. Concerning the corrugator, significant differences were found for the sample entropy (F (1.477, 5.907) = 6.888; p = 0.033) and for the mean value (F (1.425, 5.7) = 5.88; p = 0.047). Regarding the nose tip, the sample entropy showed significant differences (F (1.134, 4.536) = 11.5; p = 0.041). The findings from this study suggests that this approach can be used to evaluate in a contactless manner the psychophysiological condition of the children with CP during RAGT, allowing to monitor their engagement to the therapy, increasing the benefits of the treatment.
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Affiliation(s)
- David Perpetuini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - Roberta Palmieri
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Child Neuropsychiatry, University of Bari, 70121 Bari, Italy
| | - Chiara Filippini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Federica Pellicano
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Grazia Pia De Santis
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
- ITAB, Institute for Advanced Biomedical Technologies, 66100 Chieti, Italy
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Feasibility of Using Joystick-Operated Ride-on-Toys to Promote Upper Extremity Function in Children With Cerebral Palsy: A Pilot Study. Pediatr Phys Ther 2022; 34:508-517. [PMID: 36044637 DOI: 10.1097/pep.0000000000000944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the feasibility of implementation, acceptance, and perceived efficacy of a joystick-operated ride-on-toy intervention to promote upper extremity (UE) function in 3- to 14-year-old children with hemiplegic cerebral palsy. METHODS Exit questionnaires were collected from children, caregivers, and clinicians/camp staff following a 3-week ride-on-toy training program incorporated within a summer camp for children with hemiplegic cerebral palsy. Training encouraged children to use their affected UE to maneuver the ride-on-toy. Questionnaires included Likert scale and open-ended questions to assess enjoyment, acceptance, feasibility, and perceived efficacy of the training. RESULTS All stakeholder groups indicated that the training was enjoyable. Clinicians/staff and caregivers indicated that the training increased children's motivation to use their affected UE and reported perceived improvements in UE movement control and function following training. CONCLUSIONS Our promising preliminary findings call for future research to systematically assess the efficacy of ride-on-toys to promote UE control and function in children with hemiplegic cerebral palsy.Supplemental Digital Content 1 video abstract, available at: http://links.lww.com/PPT/A404.
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Demers M, Fung K, Subramanian SK, Lemay M, Robert MT. Integration of Motor Learning Principles Into Virtual Reality Interventions for Individuals With Cerebral Palsy: Systematic Review. JMIR Serious Games 2021; 9:e23822. [PMID: 33825690 PMCID: PMC8060861 DOI: 10.2196/23822] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/06/2020] [Accepted: 03/13/2021] [Indexed: 01/08/2023] Open
Abstract
Background Increasing evidence supports the use of virtual reality systems to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated into the development of rehabilitation interventions using virtual reality. Objective The objective of this study was to determine the extent to which motor learning principles are integrated into virtual reality interventions targeting upper limb function in individuals with cerebral palsy. Methods A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was performed in 10 databases using a combination of keywords related to cerebral palsy, virtual reality, video games, and rehabilitation. Studies were divided into 2 categories: commercial video game platforms and devices and custom virtual reality systems. Study quality was assessed using the modified Downs and Black checklist. Results The initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as “fair” according to the modified Downs and Black checklist. The majority of studies provided enhanced feedback and variable practice and used functionally relevant and motivating virtual tasks. The dosage varied greatly (total training time ranged from 300 to 3360 minutes), with only 6 studies reporting the number of movement repetitions per session. The difficulty progression and the assessment of skills retention and transfer were poorly incorporated, especially for the commercial video games. Conclusions Motor learning principles should be better integrated into the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020151982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151982
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Affiliation(s)
- Marika Demers
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Karen Fung
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Sandeep K Subramanian
- Department of Physical Therapy, School of Health Professions, UT Health San Antonio, San Antonio, TX, United States
| | - Martin Lemay
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montreal, QC, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montreal, QC, Canada
| | - Maxime T Robert
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, QC, Canada
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Amiri A, Kalantari M, Rezaee M, Baghban AA, Gharebashloo F. Predictive role of individual factors in the leisure preferences of children and adolescents with cerebral palsy: a cross-sectional study in Iran. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims The participation of children and adolescents with cerebral palsy in leisure activities is associated with their preferences. A better understanding of their leisure preferences and the factors that influence them can help therapists to promote young patients' participation in leisure activities. The aim of this study was to describe the role of individual factors in the prediction of leisure preferences of children and adolescents with cerebral palsy in Iran. Methods A cross-sectional study design was used. A total of 152 children and adolescents with cerebral palsy were selected to complete the Preferences for Activities of Children questionnaire. Simple and multiple linear regression analyses were performed to assess the role of individual factors in the prediction of preferences for leisure activities. Results Individual factors played a significant role in the prediction of leisure preferences. Their influence on the preferences for recreational, physical and self-improvement domains (r2=0.215; 0.154; 0.127, respectively) were greater than for social and skill-based domains (r2=0.045; 0.052, respectively). Conclusions Preferences for physical activities need to be augmented while a high preference for social and recreational activities could be used to promote participation in leisure activities. Therapists and other healthcare professionals should consider individual factors relating to leisure preferences when devising therapeutic plans that aim to promote participation in leisure activities.
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Affiliation(s)
- Alireza Amiri
- Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Kalantari
- Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaee
- Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Centre, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Gharebashloo
- Physiotherapy Research Centre, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dehghanizadeh M, Khalafbeigi M, Akbarfahimi M, Yazdani F, Zareiyan A. Exploring the contributing factors that influence the volition of adolescents with cerebral palsy: A directed content analysis. Scand J Occup Ther 2020; 28:553-563. [PMID: 32089013 DOI: 10.1080/11038128.2020.1723686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Communication, behavioural disturbances and low motivation influence the functional potential and the effectiveness of interventions in adolescents with cerebral palsy (CP). While the model of human occupation (MOHO) is a conceptual model in occupational therapy, no research on the volition of adolescents with CP in daily activities has been undertaken. AIM To explore the elements contributing to the volition of adolescents with CP based on their own experience. METHODS A qualitative approach using directed content analysis with volition of MOHO as a framework was applied. Semi-structured in-depth interviews were carried out with five adolescents with CP and five parents of the same adolescents. RESULTS In this study primary codes were categorized into eight categories: family and community-related values, individual values, individual perceptions of ability level, sense of control over conditions, enjoying performing activities, enjoying interpersonal relationships, physical context features and social context features. CONCLUSIONS Personal causation in interaction with environmental features is strongly influenced by adolescents' motivation. SIGNIFICANCE Occupational therapists could improve the motivation of adolescents with CP in interaction with the individual's volition with focussing on self-efficacy for promoting personal causation. Adapting to the physical environment and changing the attitudes of others to these adolescents is necessary.
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Affiliation(s)
- Moslem Dehghanizadeh
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Khalafbeigi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Malahat Akbarfahimi
- Department of Occupational Therapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Yazdani
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Armin Zareiyan
- Department of Public Health Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
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Pritchard-Wiart L, Thompson-Hodgetts S, McKillop AB. A review of goal setting theories relevant to goal setting in paediatric rehabilitation. Clin Rehabil 2019; 33:1515-1526. [DOI: 10.1177/0269215519846220] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Goal setting in paediatric rehabilitation is influenced by shifting parent, sibling, caregiver, and child roles over time and evolving child developmental capacity for participation in the process. A theoretical and evidence-informed approach to goal setting, specific to paediatrics, would provide a framework for goal setting in practice and facilitate systematic evaluation of the effects of goal-setting processes on child and family outcomes. Objective: To provide an overview of relevant goal-setting theories and their implications for paediatric rehabilitation. Methods: Prevalent theories were identified from relevant rehabilitation, motivation, behaviour change, and goal-setting literature. Implications for goal setting in paediatrics are summarized according to goal-setting and action-planning phases: (1) preparation, (2) formulation of goals, (3) formulation of action plan, (4) coping planning, and (5) follow up. Results: Social cognitive theory, self-determination theory, Health Action Process Approach, Mastery Motivation, and goal-setting theory are reviewed. Examples of implications for goal setting include, sharing information with families about the purpose of goal setting; identifying goals that are specific, proximal, challenging, and important to the child; and addressing self-efficacy. Conclusion: The theories reviewed have clear implications for paediatric rehabilitation research and practice. They address considerations not typically discussed in adult rehabilitation such as observing children to obtain information about meaningful goals when they are unable to communicate them directly and the importance of establishing flexible processes that will accommodate changing family roles over time. Research is needed to evaluate the effects of goal-setting processes and strategies on outcomes in paediatric rehabilitation.
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Affiliation(s)
- Lesley Pritchard-Wiart
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sandra Thompson-Hodgetts
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ashley B McKillop
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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11
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Salavati M, Vameghi R, Hosseini SA, Saeedi A, Gharib M. Mastery Motivation in Children with Cerebral Palsy (CP) Based on Parental Report: Validity and Reliability of Dimensions of Mastery Questionnaire in Persian. Mater Sociomed 2018; 30:108-112. [PMID: 30061799 PMCID: PMC6029913 DOI: 10.5455/msm.2018.30.108-112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introduction: The present study aimed to investigate validity and reliability of Persian Dimensions of Mastery Questionnaire (DMQ18) in children with cerebral palsy. Material and Methods: The original version was carried out through back translation into Persian, and then the construct validity was assessed by confirmatory factor analysis; and reliability was evaluated through Cronbach’s alpha (n=230). Intra-class correlation coefficient (ICC) was used for test retest reliability (n=32). Results: 230 parents (155 (67.4%) mothers and 75 (32.6%) fathers) of children and adolescents with CP with an average age of 126.99±24.59 months participated in the present research. Non-questions excluded from the confirmatory factor analysis, and thus all questions remained. Internal consistency reliability and total score were acceptable in all domains (higher than 0.70) except for negative reactions, sadness/shame (Cronbach’s alpha of 0.414). Intra-class correlation coefficient of all domains and total score were significant (p<0.001). Conclusion: DMQ18 (parental report) was valid and reliable for children with cerebral palsy. It also provided valuable information about different aspects of motivation in CP children according to their parents’ opinion, and thus it can be used in clinical interventions.
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Affiliation(s)
- Mahyar Salavati
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Roshanak Vameghi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ahmad Saeedi
- Department of Statistical Research and Information Technology, Institute for Research and Planning in Higher Education, Tehran, Iran
| | - Masoud Gharib
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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12
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Kenyon LK, Farris JP, Aldrich NJ, Rhodes S. Does power mobility training impact a child’s mastery motivation and spectrum of EEG activity? An exploratory project. Disabil Rehabil Assist Technol 2017; 13:665-673. [DOI: 10.1080/17483107.2017.1369587] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Lisa K. Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - John P. Farris
- Padnos School of Engineering and Computing, Grand Valley State University, Grand Rapids, MI, USA
| | - Naomi J. Aldrich
- Department of Psychology, Grand Valley State University, Allendale, MI, USA
| | - Samhita Rhodes
- Padnos School of Engineering and Computing, Grand Valley State University, Grand Rapids, MI, USA
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13
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Kenyon LK, Farris JP, Gallagher C, Hammond L, Webster LM, Aldrich NJ. Power Mobility Training for Young Children with Multiple, Severe Impairments: A Case Series. Phys Occup Ther Pediatr 2017; 37:19-34. [PMID: 26735082 DOI: 10.3109/01942638.2015.1108380] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Young children with neurodevelopmental conditions are often limited in their ability to explore and learn from their environment. The purposes of this case series were to (1) describe the outcomes of using an alternative power mobility device with young children who had multiple, severe impairments; (2) develop power mobility training methods for use with these children; and (3) determine the feasibility of using various outcome measures. METHODS Three children with cerebral palsy (Gross Motor Function Classification System Levels IV, V, and V) ages 17 months to 3.5 years participated in the case series. Examination included the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) and the Dimensions of Mastery Questionnaire (DMQ). An individualized, engaging power mobility training environment was created for each participant. Intervention was provided for 60 minutes per week over 12 weeks. RESULTS All participants exhibited improvements in power mobility skills. Post-intervention PEDI-CAT scores increased in various domains for all participants. Post-intervention DMQ scores improved in Participants 1 and 2. DISCUSSION The participants appeared to make improvements in their beginning power mobility skills. Additional research is planned to further explore the impact of power mobility training in this unique population.
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Affiliation(s)
- Lisa K Kenyon
- a Department of Physical Therapy , Grand Valley State University , Grand Rapids , Michigan , USA
| | - John P Farris
- b Padnos College of Engineering & Computing , Grand Valley State University , Grand Rapids , Michigan , USA
| | - Cailee Gallagher
- a Department of Physical Therapy , Grand Valley State University , Grand Rapids , Michigan , USA
| | - Lyndsay Hammond
- a Department of Physical Therapy , Grand Valley State University , Grand Rapids , Michigan , USA
| | - Lauren M Webster
- a Department of Physical Therapy , Grand Valley State University , Grand Rapids , Michigan , USA
| | - Naomi J Aldrich
- c Department of Psychology , Grand Valley State University , Allendale , Michigan , USA
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14
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Ballester-Plané J, Laporta-Hoyos O, Macaya A, Póo P, Meléndez-Plumed M, Vázquez É, Delgado I, Zubiaurre-Elorza L, Narberhaus A, Toro-Tamargo E, Russi ME, Tenorio V, Segarra D, Pueyo R. Measuring intellectual ability in cerebral palsy: The comparison of three tests and their neuroimaging correlates. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 56:83-98. [PMID: 27262445 DOI: 10.1016/j.ridd.2016.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 12/22/2015] [Accepted: 04/18/2016] [Indexed: 05/09/2023]
Abstract
Standard intelligence scales require both verbal and manipulative responses, making it difficult to use in cerebral palsy and leading to underestimate their actual performance. This study aims to compare three intelligence tests suitable for the heterogeneity of cerebral palsy in order to identify which one(s) could be more appropriate to use. Forty-four subjects with bilateral dyskinetic cerebral palsy (26 male, mean age 23 years) conducted the Raven's Coloured Progressive Matrices (RCPM), the Peabody Picture Vocabulary Test-3rd (PPVT-III) and the Wechsler Nonverbal Scale of Ability (WNV). Furthermore, a comprehensive neuropsychological battery and magnetic resonance imaging were assessed. The results show that PPVT-III gives limited information on cognitive performance and brain correlates, getting lower intelligence quotient scores. The WNV provides similar outcomes as RCPM, but cases with severe motor impairment were unable to perform it. Finally, the RCPM gives more comprehensive information on cognitive performance, comprising not only visual but also verbal functions. It is also sensitive to the structural state of the brain, being related to basal ganglia, thalamus and white matter areas such as superior longitudinal fasciculus. So, the RCPM may be considered a standardized easy-to-administer tool with great potential in both clinical and research fields of bilateral cerebral palsy.
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Affiliation(s)
- Júlia Ballester-Plané
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Olga Laporta-Hoyos
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Alfons Macaya
- Grup de Recerca en Neurologia Pediàtrica, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Póo
- Servei de Neurologia, Hospital Universitari Sant Joan de Déu, Barcelona, Spain
| | - Mar Meléndez-Plumed
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Élida Vázquez
- Servei de Radiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ignacio Delgado
- Servei de Radiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Leire Zubiaurre-Elorza
- Departamento de Fundamentos y Métodos de la Psicología, Facultad de Psicología y Educación, Universidad de Deusto, Bilbo-Bizkaia, Spain
| | - Ana Narberhaus
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain
| | - Esther Toro-Tamargo
- Servei de Rehabilitació i Medicina Física, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Maria Eugenia Russi
- Servei de Neurologia, Hospital Universitari Sant Joan de Déu, Barcelona, Spain
| | - Violeta Tenorio
- Servei de Neonatologia, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Dolors Segarra
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Barcelona, Spain; Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.
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15
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Chiarello LA, Bartlett DJ, Palisano RJ, McCoy SW, Fiss AL, Jeffries L, Wilk P. Determinants of participation in family and recreational activities of young children with cerebral palsy. Disabil Rehabil 2016; 38:2455-68. [DOI: 10.3109/09638288.2016.1138548] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lisa A. Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | | | - Robert J. Palisano
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Sarah Westcott McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | | | - Lynn Jeffries
- Department of Rehabilitation Sciences, The University of Oklahoma Health Sciences Centre, Oklahoma, OK, USA
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
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16
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Miller L, Ziviani J, Ware RS, Boyd RN. Does Context Matter? Mastery Motivation and Therapy Engagement of Children with Cerebral Palsy. Phys Occup Ther Pediatr 2016; 36:155-70. [PMID: 26565438 DOI: 10.3109/01942638.2015.1076556] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To determine if mastery motivation at baseline predicts engagement in two goal-directed upper limb (UL) interventions for children with unilateral cerebral palsy (UCP). METHODS Participants were 44 children with UCP, mean age 7 years 10 months, Manual Ability Classification System level I (N = 23) or II (N = 21). Twenty-six children received intensive novel group-based intervention (Hybrid Constraint Induced Movement Therapy, hCIMT) and 18 received distributed individual occupational therapy (OT). Caregivers completed the Dimensions of Mastery Questionnaire (DMQ) parent-proxy report at baseline. Children's engagement was independently rated using the Pediatric Volitional Questionnaire (PVQ). Associations between children's mastery motivation and engagement were examined using linear regression. RESULTS Children who received hCIMT had lower DMQ persistence at baseline (p = .05) yet higher PVQ volitional (p = .04) and exploration (p = .001) scores. Among children who received hCIMT, greater object-oriented persistence was associated with task-directedness (β 0.25, p = .05), seeking challenges (β = 0.51, p = .02), exploration (β = 0.10, p = .03), and volitional scores (β = 0.23, p = .01). CONCLUSION Despite having lower levels of persistence prior to engaging in UL interventions, children who received hCIMT demonstrated greater engagement in goal-directed tasks than children who received individual OT. Within hCIMT, children's motivational predisposition to persist with tasks manifested in their exploration and engagement in therapy.
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Affiliation(s)
- Laura Miller
- a School of Allied Health , Australian Catholic University , Brisbane , Australia.,b Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland , Brisbane , Australia
| | - Jenny Ziviani
- c Queensland Children's Allied Health Research , Children's Health Queensland , Brisbane , Australia
| | - Robert S Ware
- d School of Population Health , The University of Queensland , Brisbane , Australia . Queensland Children's Medical Research Institute , The University of Queensland , Brisbane , Australia
| | - Roslyn N Boyd
- b Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine , The University of Queensland , Brisbane , Australia
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17
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Charles J. The interaction of mastery motivation, motor abilities, the appropriate task, and the therapeutic environment. Dev Med Child Neurol 2014; 56:918-9. [PMID: 24919801 DOI: 10.1111/dmcn.12504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jeanne Charles
- Physical Therapy, University of New England, Portland, ME, USA
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18
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Miller L, Ziviani J, Ware RS, Boyd RN. Mastery motivation as a predictor of occupational performance following upper limb intervention for school-aged children with congenital hemiplegia. Dev Med Child Neurol 2014; 56:976-83. [PMID: 24766637 DOI: 10.1111/dmcn.12471] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 11/27/2022]
Abstract
AIM To determine the extent to which children's mastery motivation predicts occupational performance outcomes following upper limb intervention (ULI). METHOD In this cohort study, participants received 45 hours of ULI, either in an intensive group-based or distributed individualized model. The Dimensions of Mastery Questionnaire (DMQ) measured mastery motivation at baseline. Occupational performance outcomes were assessed at baseline and 13 weeks' post-intervention using the Canadian Occupational Performance Measure (COPM). Multivariable models determined the contribution of mastery motivation to COPM outcome irrespective of group membership. RESULTS Forty-two children with congenital hemiplegia (29 males, 13 females; mean age 7y 8mo [SD 2y 2mo]; range 5y 1mo-12y 8mo; Manual Ability Classification System [MACS] I=20 and II=22; predominant motor type unilateral spastic n=41) participated in the study. Significant gains were seen in COPM performance and satisfaction scores (p<0.001) post-intervention with no between group differences. Children who had greater persistence with object-oriented tasks (p=0.02) and better manual ability (p=0.03) achieved higher COPM performance scores at 13 weeks. Children's persistence on object-oriented tasks was the strongest predictor of COPM satisfaction (p=0.01). INTERPRETATION Children's persistence with object-oriented tasks as well as manual abilities needs to be considered when undertaking ULI. Predetermining children's motivational predispositions can assist clinicians to tailor therapy sessions individually based on children's strengths, contributing to effective engagement in ULI.
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Affiliation(s)
- Laura Miller
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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19
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Miller L, Ziviani J, Ware RS, Boyd RN. Mastery motivation: a way of understanding therapy outcomes for children with unilateral cerebral palsy. Disabil Rehabil 2014; 37:1439-45. [PMID: 25259559 DOI: 10.3109/09638288.2014.964375] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the impact of mastery motivation on occupational performance outcomes immediately following upper limb (UL) training and 6 months post-intervention for school-aged children with unilateral cerebral palsy. METHOD This prediction study was a post-hoc analysis of a matched pairs randomized comparison trial (COMBiT Trial Registration: ACTRN12613000181707). The Canadian Occupational Performance Measure (COPM) was administered at baseline, 13 and 26 weeks post-intervention. Parents completed the Dimensions of Mastery Questionnaire (DMQ), Parenting Scale and a demographic questionnaire. Children's UL capacity and performance was assessed using the Melbourne Assessment of Unilateral UL Function and assisting hand assessment (AHA). Regression models were fitted using generalized estimating equations to baseline, 13 and 26 week measurements. RESULTS Forty-six children (7.78 years SD 2.27 years, 31 males, Manual Ability Classification System I = 23, II = 23) participated. Higher levels of bimanual performance (AHA: β = 0.03, p < 0.001), greater object-oriented persistence (DMQ: β = 0.31, p = 0.05), and treatment group allocation (Standard Care: β = 0.24, p = 0.01) were positively associated with COPM performance scores post-intervention. CONCLUSIONS Children's bimanual performance and persistence with object-oriented tasks significantly impact occupational performance outcomes following UL training. Predetermining children's mastery motivation along with bimanual ability may assist in tailoring of intervention strategies and models of service delivery to improve effectiveness. Implications for Rehabilitation Children's object persistence and bimanual performance both impact upper limb training outcomes Working with children's motivational predispositions may optimize engagement and therapy outcomes. Supporting positive parenting styles may enhance a child's mastery motivation and persistence with difficult tasks.
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Affiliation(s)
- Laura Miller
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane , Australia
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20
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Shikako-Thomas K, Kolehmainen N, Ketelaar M, Bult M, Law M. Promoting leisure participation as part of health and well-being in children and youth with cerebral palsy. J Child Neurol 2014; 29:1125-33. [PMID: 24907136 DOI: 10.1177/0883073814533422] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/03/2014] [Indexed: 11/15/2022]
Abstract
Participation in leisure is a human right and is central to the health of children and youth. The World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth supported a change in thinking about what outcomes are most relevant in the context of children's health and places participation as one of the constituent elements of health. Participation is also a fundamental rehabilitation and health promotion outcome for children with cerebral palsy as identified by youth, parents, and health professionals. Several studies have identified individual and environmental factors related to participation in leisure; new studies are now determining the best interventions to promote participation. This article summarizes recent findings and proposes important topics for neurologists to consider in exploring leisure pursuits with children with cerebral palsy and their families and in working with rehabilitation professionals to promote engagement in leisure opportunities as part of integrated care.
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Affiliation(s)
- Keiko Shikako-Thomas
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Niina Kolehmainen
- Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, United Kingdom
| | - Marjolijn Ketelaar
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands Partner of NetChild, Network for Childhood Disability Research in the Netherlands, Utrecht, the Netherlands
| | - Maureen Bult
- Utrecht University, Faculty of Social Sciences, Department of Pedagogical and Educational Sciences, Utrecht, the Netherlands
| | - Mary Law
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
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