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Cury GCT, Sá LÁLD, Oliveira CD, Caires NV, Filho AGDJ, Schroder e Souza BG. Conservative Approach to Type III Ulnar Club Hand: Case Report. Rev Bras Ortop 2024; 59:e12-e16. [PMID: 39027181 PMCID: PMC11254420 DOI: 10.1055/s-0041-1735137] [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: 12/23/2020] [Accepted: 04/07/2021] [Indexed: 10/20/2022] Open
Abstract
Ulnar club hand is a rare condition of the upper limbs, for which treatment depends on the degree of morphological and functional impairment, correlating with the radiographic classification of Dobyns, Wood, and Bayne. The aim of the present study is to report a case of a 6-year-old male patient, followed up for type III ulnar club hand (total ulnar dysplasia). Despite the initial difficulty of manipulating objects and performing everyday tasks, conservative physical therapy treatment provided strength gain and development of functional skills for daily life. We conclude that patients with type III deformity can be properly managed with rehabilitation although they require outpatient follow-up until skeletal maturity is reached, as dynamic deformities and new functional limitations may lead to need for corrective surgeries.
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Affiliation(s)
| | | | | | | | - Arnaldo Gonçalves de Jesus Filho
- Departamento de Ortopedia e Cirurgia da Mão, Hospital Universitário, Universidade Federal de Juiz de Fora, MG, Brasil
- Departamento de Ortopedia e Cirurgia da Mão, Santa Casa de Misericórdia de Juiz de Fora, MG, Brasil
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Ippolito C, Canthiya L, Floreani A, Luckhart K, Hoffman A, McAdam L. Twice-Weekly Outpatient Rehabilitation Intervention for Young Children With Spinal Muscular Atrophy Treated With Genetic-Based Therapies: Protocol for a Feasibility Study. JMIR Res Protoc 2023; 12:e46363. [PMID: 37917140 PMCID: PMC10654912 DOI: 10.2196/46363] [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: 02/10/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is a progressive neuromuscular disorder that causes muscle weakness and is the leading genetic cause of infant mortality worldwide. While no definitive cure exists, the approval of 3 genetic-based therapies in Canada since 2018 has led to significant improvements in muscle function for children with SMA. With that, there are no evidence-based rehabilitation interventions and minimal evidence on the combined effects of genetic-based therapies and rehabilitation. OBJECTIVE This protocol describes the methodology to assess the feasibility of a twice-weekly outpatient rehabilitation intervention focusing on gross and fine motor function to inform the methodology and sample size of a definitive clinical trial. METHODS We will conduct a single-center nonrandomized pilot and feasibility trial to explore an outpatient rehabilitation intervention for children aged 6 months to 3 years with SMA treated with genetic-based therapies. Participation in the study will occur over a 25-week period, with a baseline assessment visit followed by a 12-week intervention period and a 12-week nonintervention period. The rehabilitation intervention comprises weekly physical and occupational therapy for 11 weeks. Assessments will occur at baseline (week 0), end of intervention or early withdrawal (week 12), and follow-up (week 24). Predetermined feasibility indicators will evaluate study feasibility across process (recruitment rates, eligibility criteria, adherence rates, retention rates, questionnaire suitability, and acceptability), resource (time, implementation, and execution), management (materials and data), and scientific (safety, tolerability, and preliminary efficacy) domains. RESULTS This project was funded in March 2022, and data will be collected between March 2023 and December 2023. Data analysis will occur between January 2024 and March 2024, with publication expected in the fall of 2024. The protocol for the feasibility trial will be considered successful if it meets the success criteria set out for the feasibility indicators. Indicators of specific interest include all process indicators, as well as time. Exploratory indicators will be reported. Pragmatically, the results of the feasibility trial will inform changes to the protocol and the start-up of a definitive multisite trial. CONCLUSIONS This novel twice-weekly outpatient rehabilitation intervention will be the first step toward filling the need for an evidence-based rehabilitation intervention for children with SMA treated with genetic-based therapies. It is expected that consistent and intensive rehabilitation therapy will augment functional gains being observed in this population. In the future, a definitive trial will measure the efficacy of the intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05638750; https://clinicaltrials.gov/study/NCT05638750. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46363.
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Affiliation(s)
- Christina Ippolito
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Lathushikka Canthiya
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Amanda Floreani
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | | | - Andrea Hoffman
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Laura McAdam
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Stefanac S, Oppenauer C, Zauner M, Durechova M, Dioso D, Aletaha D, Hobusch G, Windhager R, Stamm T. From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health. Ann Med 2022; 54:2816-2827. [PMID: 36259346 PMCID: PMC9586611 DOI: 10.1080/07853890.2022.2131326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVE(S)/INTRODUCTION In clinical practice, treatment goals are often set up without exploring what patients really want. We, therefore, collected individualised treatment goals of patients with osteoarthritis (OA), categorised and mapped them to the World Health Organisation International Classification for Functioning, Disability and Health (ICF). PATIENTS/MATERIALS AND METHODS A longitudinal prospective cohort study was conducted (2019-2021). We used descriptive statistics and Chi2/Fisher's Exact Tests, where appropriate, as well as Kruskal-Wallis-Tests for the mean score ranks of the patients' goals. RESULTS In total, 305 goals reported by 132 participants were analysed (267 women vs. 38 men). The top 3 ICF categories were sensation of pain (ICF:b280), mobility of joint (ICF:b710) and muscle power functions (ICF:b730). Overall, 51% of all individually reported functional goals were achieved after 3 months. Men were more likely to achieve their goals than women (p = 0.009). The majority of the "very important" goals (51%) and "very difficult" goals (57%) was not improved. Goals' mean score ranks significantly differed between baseline and follow-up. CONCLUSION(S) As the human lifespan as well as the number of people affected by OA worldwide increase, there is a growing need to identify and evaluate rehabilitation outcomes that are relevant to people with OA.Key MessagesTreat-to-target agreements between patients and health care providers present a step towards more personalised precision medicine, which will eventually lead to better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.
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Affiliation(s)
- Sinisa Stefanac
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Claudia Oppenauer
- Karl Landsteiner Private University for Health Sciences, Krems, Lower Austria
| | - Michael Zauner
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Martina Durechova
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daffodil Dioso
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Hobusch
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Tanja Stamm
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
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Rosenberg L, Maeir A, Gilboa Y. Evaluating a Therapeutic Powered Mobility Camp for Children with Severe Cerebral Palsy. The Canadian Journal of Occupational Therapy 2021; 88:294-305. [PMID: 34435918 PMCID: PMC8640274 DOI: 10.1177/00084174211034938] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background. Children and youth with severe cerebral palsy (CP) have limited independent mobility, which affects opportunities for overall development. Purpose. To examine the effectiveness of Power Fun, a therapeutic powered mobility summer camp. Methods. A quasi-experimental, repeated-measure design was used, with participants acting as their own control. Twenty-four participants with severe CP (aged 7-20 years) attended Power Fun for three weeks, five days/week. Assessments of powered mobility skills and functional mobility goals were conducted three weeks before the camp (T1), at baseline (T2), postintervention (T3), and at three-week follow-up (T4). Findings. An analysis of variance results indicated significant improvements in powered mobility skills (F(1,22) = 56.61, p < 0.001, η2p = 0.74) and functional mobility goals (F(1,58) = 80.17, p < 0.001, η2p = 0.74), with 70% of goals achieved postintervention. A descriptive analysis revealed three learning profiles. Implications. This study provides initial evidence supporting the effectiveness of Power Fun as an intervention promoting powered mobility for children with severe CP, across a range of abilities.
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Affiliation(s)
- Lori Rosenberg
- Lori Rosenberg, School of Occupational Therapy, 1 Churchill Blvd, PO Box 24026, Jerusalem, Israel.
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Evaluating Traditional Chinese Medicine Interventions on Chronic Low Back Pain Using Goal Attainment Scaling. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8854927. [PMID: 33354222 PMCID: PMC7735859 DOI: 10.1155/2020/8854927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/22/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Extensive studies have been conducted to evaluate the pain relief effect of traditional Chinese medicine (TCM) interventions on patients with low back pain, including in China. However, there is a dearth in the literature documenting the diverse goals of TCM interventions, let alone the overall effect of such interventions. In this study, the goal attainment scaling (GAS) method was adopted to evaluate individualised TCM interventions on chronic low back pain. METHODS A pre-post intervention study was conducted on patients with chronic low back pain who received individualised TCM interventions in community health services. The study was undertaken in three community health centres in Hangzhou of China. A total of 165 eligible patients were invited, and 150 participated in the study, including 136 who completed both pre- and postintervention surveys. Each participant was asked to identify three to five intended goals from a pool of 26 outcome indicators and their corresponding expectations of these goals prior to the TCM interventions. Their conditions were rated against the selected indicators on a self-report five-point Likert scale before and after the TCM interventions, respectively. Gaps between the actual conditions and the expected goals were summed up for each participant and converted into a standardised GAS score, with a higher score indicating higher achievements, and 50 indicting patient expectations were met. Linear regression models were established to determine the factors associated with the pre-post GAS changes after adjustment for variations in other variables. RESULTS On average, an increase of 14.99 (SD = 9.81) in the GAS scores was achieved. This resulted in a mean GAS score of 48.33 (SD = 9.74) after the TCM interventions, falling slightly short (<2) of patient expectations. The multivariate linear regression models revealed that local residents, the retired, and those who perceived lower professional competency of their attending doctors had a smaller increase in the GAS scores after adjustment for variations in other variables. CONCLUSION The individualised TCM interventions can help patients with low back pain to achieve their expected goals as measured by the GAS. Further studies are needed to better understand how patients set up their goals and the professional competency requirements to meet patient expectations.
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Adams C, Gaile J. Evaluation of a parent preference-based outcome measure after intensive communication intervention for children with social (pragmatic) communication disorder and high-functioning autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 105:103752. [PMID: 32771922 DOI: 10.1016/j.ridd.2020.103752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND/OBJECTIVES Children with Social (Pragmatic) Communication Disorder (SPCD) or High-Functioning Autism Spectrum Disorder (HFASD) have persistent deficits in language structure and language use (pragmatics). This feasibility study evaluated a novel parent preference-based outcome measure and secondary outcomes associated with the Social Communication Intervention Programme (SCIP). METHODS 15 UK speech and language practitioners identified 20 children aged 5-11 years with pragmatics/language needs. Practitioners received SCIP training and supervision. Children received 20 SCIP therapy sessions. Primary endpoint was a goal attainment scale (SCIP-GAS). Before intervention (T1), parents provided three prioritised communication goals, refined into a series of steps. After intervention (T2) parents and practitioners rated each goal compared to T1 and parents provided a narrative on outcomes. SECONDARY OUTCOMES Children's Communication Checklist-2, Social Language Development Test (SLDT), and observational ratings of conversational interaction (TOPICC-2). RESULTS All children except one progressed on T2 SCIP-GAS parent outcomes. All children progressed on practitioner SCIP-GAS ratings. 82.5 % of parent comments supported their own SCIP-GAS ratings. Secondary outcomes measures: Only SLDT Making Inferences scores and TOPICC-2 ratings showed improvement at T2. CONCLUSIONS A preference-based social communication measure showed feasibility as an outcome measure following social communication intervention for children who have HFASD or SPCD.
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A Structured Goal-Setting Process to Promote Functional and Measurable Outcomes in School-Based Physical Therapy: A Knowledge Translation Study. Pediatr Phys Ther 2020; 32:211-217. [PMID: 32604362 DOI: 10.1097/pep.0000000000000707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Goal setting is an important component of school-based physical therapy; however, evidence suggests that therapists may not consistently write goals that are relevant, context specific, and measurable. The aims of this knowledge translation study were to evaluate implementation of a goal-setting method for school-based therapists. METHOD This study was created to align with the Knowledge to Action framework and included 1-day training and follow-up mentorship. Goals were assessed pre- and posttraining, and questionnaires assessed barriers and facilitators. RESULTS Twenty-two physical therapists participated. Nineteen participants (90%) strongly agreed/agreed that the training helped change their perspectives about goal setting in the school environment. There was a statistically significant difference in goal quality pre- and posttraining. Therapists identified barriers and facilitators to implementation of effective goal setting in practice. DISCUSSION Results indicate that this method may be effective at improving goal writing that is relevant, context specific, and measurable in school settings.
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Rosenberg L, Maeir A, Gilboa Y. Feasibility Study of a Therapeutic Mobility Summer Camp for Children with Severe Cerebral Palsy: Power Fun. Phys Occup Ther Pediatr 2020; 40:395-409. [PMID: 31805802 DOI: 10.1080/01942638.2019.1695699] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Aim: Powered mobility has positive effects on development of children with limited independent locomotion, but many are deprived of this opportunity due to their limitations. This study aimed to evaluate the feasibility of Power Fun, a therapeutic summer camp, for students with severe cerebral palsy (CP).Methods: Five students with CP, ages 11-15, received personally adapted powered wheelchairs and participated daily in the camp. The camp ran five days a week during three weeks and included two mobility sessions daily. Assessments were conducted three weeks prior to the camp (T1), at baseline (T2), post-intervention (T3) and six weeks follow-up (T4). Measures used were Power Mobility Program (PMP), Assessment of Learning Power mobility use (ALP), Wheelchair Outcome Measure for Young People (WhOM-YP), Goal Attainment Scaling (GAS) and Dimensions of Mastery Questionnaire (DMQ).Results: All participants finished the camp. Outcome measures showed no change between T1-T2 but improved significantly (p<.05) after the intervention (T2-T3), and gains were maintained at T4 (Wilcoxon signed-rank test). Goals improved to slightly above the expected outcome (GAS average 0.11).Conclusions: Power Fun shows good feasibility and significant improvement in mobility skills and goals of children with severe CP. Further studies are warranted.
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Affiliation(s)
- Lori Rosenberg
- School of Occupational Therapy, Hebrew University, Jerusalem, Israel.,Ilanot School, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Hebrew University, Jerusalem, Israel
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Hartley H, Carter B, Bunn L, Pizer B, Lane S, Kumar R, Cassidy E. E-Survey of Current International Physiotherapy Practice for Children with Ataxia Following Surgical Resection of Posterior Fossa Tumour. JOURNAL OF REHABILITATION MEDICINE - CLINICAL COMMUNICATIONS 2019; 2:1000020. [PMID: 33884121 PMCID: PMC8008714 DOI: 10.2340/20030711-1000020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/25/2019] [Indexed: 11/16/2022]
Abstract
Objective To determine current international practice regarding physiotherapy input for children with ataxia following surgery for posterior fossa tumour. Design: An e-survey covering the following domains: participant demographics, treatment/ intervention, virtual training, intensity/timing of treatment, and aims and outcomes of physiotherapy management. Participants Physiotherapists involved in the management of children with ataxia following surgical resection of posterior fossa tumour. Participants were contacted via 6 key groups; Paediatric Oncology Physiotherapy Network (POPs), Association of Paediatric Chartered Physiotherapists (APCP), European Paediatric Neurology Society (EPNS), International Society of Paediatric Oncology (SIOP)-Europe Brain Tumour Group, Posterior Fossa Society (PFS), and Pediatric Oncology Special Interest Group (SIG) (American Physical Therapy Association). Results A total of 96 physiotherapists participated: UK (n =53), rest of Europe (n = 23), USA/ Canada (n = 10), and Australia/NZ (n = 10). The most common physiotherapy interventions used were balance exercises, gait re-education and proximal control activities. The most frequently used adjuncts to treatment were mobility aids and orthotics. Challenges reported regarding physiotherapy treatment were: reduced availability of physiotherapy input following discharge from the acute setting, lack of evidence, impact of adjuvant oncology treatment, and psychosocial impact. Conclusion This e-survey provides an initial scoping review of international physiotherapy practice in this area. It establishes a foundation for future research on improving rehabilitation of ataxia in this population.
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Affiliation(s)
- Helen Hartley
- Physiotherapy Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Bernie Carter
- Children's Nursing, Edge Hill University, Ormskirk, UK
| | - Lisa Bunn
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - Barry Pizer
- Oncology Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Steven Lane
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Ram Kumar
- Department of Neurology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Elizabeth Cassidy
- Department of Physiotherapy, LUNEX International University of Sport, Exercise and Health, Differdange, Luxemburg
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Ruggeri A, Dancel A, Johnson R, Sargent B. The effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:544-568. [PMID: 31782658 DOI: 10.1177/1362361319885215] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Difficulty performing age-appropriate motor skills affects up to 83% of children with autism spectrum disorder. This systematic review examined the effect of motor and physical activity intervention on motor outcomes of children with autism spectrum disorder and the effect of motor learning strategies on motor skill acquisition, retention, and transfer. Six databases were searched from 2000 to 2019. Forty-one studies were included: 34 intervention studies and 7 motor learning studies. The overall quality of the evidence was low. Participants included 1173 children with autism spectrum disorder ranging from 3 to 19 years. Results from level II and III intervention studies supported that participation outcomes improved with a physical education intervention; activity outcomes improved with aquatic, motor activity, motor skill, and simulated horse riding interventions; and body structure and function outcomes improved with aquatic, exergaming, motor activity, motor skill, and simulated horse riding interventions. Results from level II and III motor learning studies supported that motor skill acquisition improved with visual, versus verbal, instructions but was not influenced by differences in instructional personnel. More rigorous research on motor intervention is needed with well-controlled study designs, adequate sample sizes, and manualized protocols. In addition, research on motor learning strategies is warranted as it generalizes across motor interventions.
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Affiliation(s)
- Anneliese Ruggeri
- Children’s Hospital Los Angeles, USA
- University of Southern California, USA
| | - Alina Dancel
- Children’s Hospital Los Angeles, USA
- University of Southern California, USA
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Nguyen L, Cross A, Rosenbaum P, Gorter JW. Use of the International Classification of Functioning, Disability and Health to support goal-setting practices in pediatric rehabilitation: a rapid review of the literature. Disabil Rehabil 2019; 43:884-894. [PMID: 31345067 DOI: 10.1080/09638288.2019.1643419] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The International Classification of Functioning, Disability and Health (referred to as the ICF) is the World Health Organization's framework for health. It can be used to identify goals that capture all aspects of a person's life and to inform clinical goal-setting processes. This review aims to report how healthcare providers are using the ICF framework to support goal-setting practices in pediatric rehabilitation services. METHODS A rapid review was conducted using scoping review principles in the following databases: CINAHL, Medline and PsycINFO. Key terms included: "ICF", "goal-setting" and "pediatrics". RESULTS Sixteen studies met the inclusion criteria. Three main themes emerged about the use of the ICF in pediatric rehabilitation: 1) match the content of goals to the ICF domains; 2) implement with existing tools for goal-setting; and 3) inform the development of new tools for goal-setting. Healthcare providers often use a combination of goal-setting tools. The SMART approach is used to frame goals, while the Canadian Occupational Performance Measure and Goal Attainment Scale have been used to document and evaluate goals. CONCLUSION The ICF framework can be used with current goal-setting practices and offers a common lens and language with which to facilitate collaborative goal-setting with families and healthcare providers.Implications for RehabilitationThe International Classification of Functioning, Disability and Health (ICF) provides a common framework and language to support collaborative goal-setting between families and healthcare providersDespite the opportunity for the ICF to be used as a framework with goal-setting approaches, to date the ICF has mainly been used to match the content of goals to ICF domains for documentation purposesThe ICF should be incorporated into the established clinical routines in order to promote its use among healthcare providersThe ICF can be used with existing goal-setting tools in clinical practice and to inform the ongoing development of new tools to support the goal-setting process in family-centred services.
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Affiliation(s)
- Linda Nguyen
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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12
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Sang RC, Vawda Y, Greenspoon D, Reed N, Hunt AW. An innovative approach to measuring youth concussion recovery: Occupational performance. Br J Occup Ther 2019. [DOI: 10.1177/0308022619851415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Concussion is a common injury in youth. Studies report that active rehabilitation interventions reduce symptoms in these youth. There is no literature that addresses its impact on occupational performance. The purpose of this study was to identify: (a) occupational performance issues experienced by these youth; (b) changes in occupational performance and satisfaction following participation in a 6-week active rehabilitation intervention; and (c) the relationship between changes in occupational performance and symptoms. Method As part of a larger prospective repeated measures study, measures of occupational performance (Canadian Occupational Performance Measure) and self-reported symptoms (Post-Concussion Symptom Inventory) were collected pre and post intervention. Paired t-test, Spearman correlation, and descriptive analyses were conducted. Results Youth (9–18 years; n = 52) reported a range of occupational performance issues in self-care, productivity, and leisure domains. The most frequently reported occupational performance issues were sport (32.70%) and school (31.75%) activities. Positive changes were found in both performance and satisfaction of occupational performance issues post intervention ( p<.001). Correlation analysis revealed that as symptoms decreased, occupational performance improved ( rs = –.359, p = .020). Conclusion Using a measure of occupational performance may provide meaningful insight into the functional recovery of concussion, and can help identify targeted functional approaches to paediatric concussion management.
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Affiliation(s)
- Robyn Chen Sang
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Yasira Vawda
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Dayna Greenspoon
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Nick Reed
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Anne W Hunt
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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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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14
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Harpster K, Sheehan A, Foster EA, Leffler E, Schwab SM, Angeli JM. The methodological application of goal attainment scaling in pediatric rehabilitation research: a systematic review. Disabil Rehabil 2018; 41:2855-2864. [PMID: 29954232 DOI: 10.1080/09638288.2018.1474952] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: The objectives of this review article were to (1) describe the populations and interventions to which Goal Attainment Scaling (GAS) has been applied in pediatric rehabilitation, (2) summarize the scientific rigor of published studies utilizing GAS as an outcome measure in pediatric rehabilitation, and (3) illustrate the responsiveness of GAS following intervention.Materials and methods: Four electronic databases were searched for English language, human subject studies. Two reviewers independently extracted data, graded evidence, and rated study quality.Results: Fifty-two studies utilizing GAS as an outcome measure within pediatric rehabilitation were included. A majority of studies were characterized as low-level evidence in the Sackett hierarchy (Sackett levels IV-V; 33 of 52). Quality appraisal scores for all reviewed studies ranged from 1-13 points (17 possible points) and averaged 4.71 points. GAS appeared to detect meaningful change in more than 60% of studies.Conclusions: GAS is a clinically useful tool for measuring progress toward goals, but has not been utilized with a high level of methodological rigor in research. Emphasis on reduced variation in administration and interpretation will strengthen the utility of GAS for efficacy and program evaluation in future research.Implications for rehabilitationGoal Attainment Scaling (GAS) can be used across a diversity of interventions and diagnoses as an outcome measure in pediatric rehabilitation.Careful consideration should be used in the study design to standardize administration and scoring of GAS to strengthen the study.Goal Attainment Scaling is responsive to change, and the tool appears to detect meaningful change the majority of the time in pediatric rehabilitation.
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Affiliation(s)
- Karen Harpster
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Amber Sheehan
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ellen A Foster
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Eryn Leffler
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sarah M Schwab
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer M Angeli
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati, Cincinnati, OH, USA
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15
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Salavati M, Rameckers E, Waninge A, Krijnen W, van der Schans C, Steenbergen B. Evaluating the outcome of an individual functional therapy program focused on children with cerebral palsy and cerebral visual impairment: a multiple case study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2017.1374455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Masoud Salavati
- Royal Dutch Visio, Center of Expertise for Blind and Visually Impaired People, Haren, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Eugene Rameckers
- Department of Rehabilitation Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Adelante Center of Expertise in Rehabilitation and Audiology, Valkenburg and Hoensbroek, The Netherlands
- AVANSplus, University for Professionals for Paediatric Physical Therapy, Breda, The Netherlands
| | - Aly Waninge
- Royal Dutch Visio, Center of Expertise for Blind and Visually Impaired People, Haren, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Wim Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Cees van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
- School of Psychology, Australian Catholic University, Melbourne, Australia
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16
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Goal setting in paediatric rehabilitation for children with motor disabilities: a scoping review. Clin Rehabil 2018; 32:954-966. [DOI: 10.1177/0269215518758484] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: The three objectives of this scoping review were to (1) identify key conceptual/theoretical frameworks and the extent to which they are used to inform goal setting related to rehabilitation goal setting with children with motor disabilities, (2) describe research that has evaluated goal setting processes and outcomes, and (3) summarize the purposes of goal setting described in paediatric rehabilitation literature. Methods: The scoping review process described by Arksey and O’Malley was used to guide article selection and data extraction. Results: A total of 62 articles were included in the final review. While the concept of family-centered care was well represented, theoretical frameworks specific to goal setting (i.e. goal setting theory described by Locke and Latham, mastery motivation, social cognitive, personal construct, and self-determination theories) were rarely addressed. No articles reviewed addressed prominent behavior change theory. With the exception of the description of tools specifically designed for use with children, the role of the child in the goal setting process was generally absent or not well described. Few studies ( n = 6) discussed the linkage between goals and intervention strategies explicitly. Only two studies in the review evaluated outcomes associated with goal setting. The primary purpose for goal setting identified in the literature was to develop goals that are meaningful to families ( n = 49). Conclusion: The results highlight significant gaps in the literature explicating a sound theoretical basis for goal setting in paediatric rehabilitation and research evaluating the effects of goal qualities and goal setting processes on the achievement of meaningful outcomes.
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17
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Alaniz ML, Rosenberg SS, Beard NR, Rosario ER. The Effectiveness of Aquatic Group Therapy for Improving Water Safety and Social Interactions in Children with Autism Spectrum Disorder: A Pilot Program. J Autism Dev Disord 2017; 47:4006-4017. [PMID: 28864911 DOI: 10.1007/s10803-017-3264-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Drowning is the number one cause of accidental death in children with Autism Spectrum Disorder (ASD). Few studies have examined the effectiveness of swim instruction for improving water safety skills in children with moderate to severe ASD. This study examines the feasibility and effectiveness of an aquatic therapy program on water safety and social skills in children with mild to severe ASD (n = 7). Water safety skills were evaluated using the Aquatics Skills Checklist and social skills were measured using the Social Skills Improvement Scale. We provide preliminary evidence that children with ASD can improve water safety skills (p = 0.0002), which are important for drowning prevention after only 8 h of intervention. However, social skills did not respond to intervention (p = 0.6409).
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Affiliation(s)
- Michele L Alaniz
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.
| | - Sheila S Rosenberg
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.,Casa Colina's Research Institute, Pomona, CA, USA
| | - Nicole R Beard
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.,Curative New Berlin Therapies, New Berlin, WI, USA.,Children's Services Center, University of Southern California, Los Angeles, CA, USA
| | - Emily R Rosario
- Children's Services Center, Casa Colina Hospital and Centers for Healthcare, 255 E. Bonita Ave., P.O. Box 6001, Pomona, CA, 91769, USA.,Casa Colina's Research Institute, Pomona, CA, USA
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18
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Calder S, Ward R, Jones M, Johnston J, Claessen M. The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review. Disabil Rehabil 2017; 40:2599-2622. [PMID: 28715915 DOI: 10.1080/09638288.2017.1353144] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. MATERIALS AND METHODS A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. RESULTS Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. CONCLUSION Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as multidisciplinary outcome measures for children with developmental disability. The selection of an appropriate outcome measure depends on the age of the child, individual goals of the family, and the type of intervention. This requires the combination of measures as no one measure alone will capture all components of the International Classification of Functioning-Child & Youth.
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Affiliation(s)
| | - Roslyn Ward
- b Department of Paediatric Rehabilitation , Princess Margaret Hospital for Children , Perth , WA , Australia.,c School of Paediatrics and Child Health , The University of Western Australia , Perth , WA , Australia
| | - Megan Jones
- d School of Psychology and Speech Pathology , Curtin University , Perth , WA , Australia
| | - Jenelle Johnston
- b Department of Paediatric Rehabilitation , Princess Margaret Hospital for Children , Perth , WA , Australia
| | - Mary Claessen
- d School of Psychology and Speech Pathology , Curtin University , Perth , WA , Australia
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19
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Pletschko T, Felnhofer A, Schwarzinger A, Weiler L, Slavc I, Leiss U. Applying the International Classification of Functioning-Children and Youth Version to Pediatric Neuro-oncology. J Child Neurol 2017; 32:23-28. [PMID: 28257280 DOI: 10.1177/0883073816669647] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Given the increased survival rates in patients with pediatric central nervous system tumors, late effects such as treatment- and/or illness-related neurologic sequelae as well as neuropsychological deficits and social difficulties have moved into focus in follow-up care. In order to provide personalized treatment recommendations for pediatric brain tumor survivors, it is crucial not only to assess cognitive impairments but also to measure a patient's functional deficiencies, for example, restricted participation in everyday social activities. Thus, this article introduces the International Classification of Functioning-Children and Youth version (ICF-CY) as a conceptual framework for quantifying functional limitations and informing long-term care in pediatric neuro-oncology. A standardized self-report and proxy-report questionnaire for measuring participation is briefly discussed and specific recommendations based on so-called core sets for clinical practice in pediatric neuro-oncology are provided.
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Affiliation(s)
- Thomas Pletschko
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Anna Felnhofer
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Agathe Schwarzinger
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Liesa Weiler
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Ulrike Leiss
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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20
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Bagatto MP, Moodie ST. Relevance of the International Classification of Functioning, Health and Disability: Children & Youth Version in Early Hearing Detection and Intervention Programs. Semin Hear 2016; 37:257-71. [PMID: 27489403 PMCID: PMC4954788 DOI: 10.1055/s-0036-1584406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Early hearing detection and intervention (EHDI) programs have been guided by principles from the Joint Committee on Infant Hearing and an international consensus of best practice principles for family-centered early intervention. Both resources provide a solid foundation from which to design, implement, and sustain a high-quality, family-centered EHDI program. As a result, infants born with permanent hearing loss and their families will have the support they need to develop communication skills. These families also will benefit from programs that align with the framework offered by the World Health Organization's International Classification of Functioning, Disability and Health: Children & Youth Version (ICF-CY). Within this framework, health and functioning is defined and measured by describing the consequences of the health condition (i.e., hearing loss) in terms of body function, structures, activity, and participation as well as social aspects of the child. This article describes the relevance of the ICF-CY for EHDI programs and offers a modified approach by including aspects of quality of life and human development across time.
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Affiliation(s)
- Marlene P. Bagatto
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Sheila T. Moodie
- National Centre for Audiology and School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
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21
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O'Connor B, Kerr C, Shields N, Imms C. A systematic review of evidence-based assessment practices by allied health practitioners for children with cerebral palsy. Dev Med Child Neurol 2016; 58:332-47. [PMID: 26645152 DOI: 10.1111/dmcn.12973] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 12/16/2022]
Abstract
AIM The routine use of psychometrically robust assessment tools is integral to best practice. This systematic review aims to determine the extent to which evidence-based assessment tools were used by allied health practitioners for children with cerebral palsy (CP). METHOD The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols 2015 was employed. A search strategy applied the free text terms: 'allied health practitioner', 'assessment', and 'cerebral palsy', and related subject headings to seven databases. Included articles reported assessment practices of occupational therapists, physiotherapists, or speech pathologists working with children with CP aged 0 to 18 years, published from the year 2000. RESULTS Fourteen articles met the inclusion criteria. Eighty-eight assessment tools were reported, of which 23 were in high use. Of these, three tools focused on gross motor function and had acceptable validity for use with children with CP: Gross Motor Function Measure, Gross Motor Function Classification System, and goniometry. Validated tools to assess other activity components, participation, quality of life, and pain were used infrequently or not at all. INTERPRETATION Allied health practitioners used only a few of the available evidence-based assessment tools. Assessment findings in many areas considered important by children and families were rarely documented using validated assessment tools.
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Affiliation(s)
- Bridget O'Connor
- School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia
| | - Claire Kerr
- Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Nora Shields
- School of Allied Health, La Trobe University, Bundoora, Vic., Australia.,Northern Centre for Health Education and Research, Epping, Vic., Australia
| | - Christine Imms
- Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia
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22
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Ward R, Reynolds JE, Bear N, Elliott C, Valentine J. What is the evidence for managing tone in young children with, or at risk of developing, cerebral palsy: a systematic review. Disabil Rehabil 2016; 39:619-630. [DOI: 10.3109/09638288.2016.1153162] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Roslyn Ward
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jess E. Reynolds
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Sport, Science, Exercise and Health, the University of Western Australia, Perth, Western Australia, Australia
| | - Natasha Bear
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Physiotherapy, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- Department of Clinical Research, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Catherine Elliott
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Occupational Therapy and Social Work, Curtin University, Western Australia, Australia
| | - Jane Valentine
- Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
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23
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Krasny-Pacini A, Evans J, Sohlberg MM, Chevignard M. Proposed Criteria for Appraising Goal Attainment Scales Used as Outcome Measures in Rehabilitation Research. Arch Phys Med Rehabil 2016; 97:157-70. [DOI: 10.1016/j.apmr.2015.08.424] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/13/2015] [Accepted: 08/18/2015] [Indexed: 11/24/2022]
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24
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Angsupaisal M, Maathuis CGB, Hadders-Algra M. Adaptive seating systems in children with severe cerebral palsy across International Classification of Functioning, Disability and Health for Children and Youth version domains: a systematic review. Dev Med Child Neurol 2015; 57:919-30. [PMID: 25857828 DOI: 10.1111/dmcn.12762] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to systematically review the effect of adaptive seating systems (AdSSs) in young people less than 19 years of age with severe cerebral palsy (CP), with particular focus on child-related outcomes across all components of the functioning and disability domains of the International Classification of Functioning, Disability, and Health for Children and Youth version (ICF-CY). METHOD Literature searches of studies published from 1975 to October 2014 were performed. Methodological quality and the risk of bias were analysed using Sackett's level of evidence, the American Academy for Cerebral Palsy and Developmental Medicine guidelines, and Mallen criteria for observational studies. RESULTS Nine studies fulfilled the selection criteria. All studies had level IV evidence and were of moderate methodological quality. The results focused on the effects of AdSSs on postural control and on upper extremity function and on additional child-related outcomes. The results suggested that AdSSs that include trunk and hip support devices may improve postural control outcomes, and that special-purpose AdSSs may improve self-care and play behaviour at home. INTERPRETATION Because of a low level of evidence and the moderate methodological quality of the studies available, no robust conclusions can be drawn. Nevertheless, the data suggest that AdSSs may be able to improve activity and participation at home among children with severe CP. More studies of high methodological quality addressing the effect of AdSSs on activity and participation are urgently needed. Suggestions for future research are provided.
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Affiliation(s)
- Mattana Angsupaisal
- Department of Paediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Carel G B Maathuis
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Mijna Hadders-Algra
- Department of Paediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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25
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Rosenberg L, Maeir A, Yochman A, Dahan I, Hirsch I. Effectiveness of a Cognitive–Functional Group Intervention Among Preschoolers With Attention Deficit Hyperactivity Disorder: A Pilot Study. Am J Occup Ther 2015; 69:6903220040p1-8. [DOI: 10.5014/ajot.2015.014795] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. To test functional improvement after a group cognitive–functional occupational therapy intervention for preschoolers with attention deficit hyperactivity disorder (ADHD).
METHOD. Seventeen preschooler–parent dyads attended 11 weekly group sessions focused on acquiring executive strategies through occupational performance. Functional improvement was measured using the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS); executive function, using the Behavior Rating Inventory of Executive Function–Pediatric; ADHD symptomatology, using Conners’ Parent Rating Scale–Revised and Conners’ Teacher Rating Scale–Revised; and social functioning, using the Social Participation scale of the Sensory Processing Measure.
RESULTS. Significant improvement was found on the COPM and GAS measures, whereas mixed results were found on the other measures, with improvements found in children whose scores indicated impairment at baseline.
CONCLUSIONS. Cognitive–functional group intervention appears to significantly improve daily functioning, executive function, and social functioning for children who demonstrate clinical impairment. Further research with a larger sample, a control group, and follow-up is required.
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Affiliation(s)
- Lori Rosenberg
- Lori Rosenberg, MSc, OT, is Head of Occupational Therapy, Ilanot School, Jerusalem, Israel, and Lecturer, School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel;
| | - Adina Maeir
- Adina Maeir, PhD, OT, is Head, School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
| | - Aviva Yochman
- Aviva Yochman, PhD, OT, is Lecturer and Researcher, School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
| | - Idit Dahan
- Idit Dahan, MSc, OT, is Head, Pediatric Occupational Therapy, Maccabi Health Service, Jerusalem, Israel
| | - Idit Hirsch
- Idit Hirsch, MSc, OT, is Occupational Therapist, Maccabi Health Service, Jerusalem, Israel
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26
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Vargus-Adams JN, Majnemer A. International Classification of Functioning, Disability and Health (ICF) as a framework for change: revolutionizing rehabilitation. J Child Neurol 2014; 29:1030-5. [PMID: 24850572 DOI: 10.1177/0883073814533595] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/07/2014] [Indexed: 11/15/2022]
Abstract
The International Classification of Functioning, Disability and Health (ICF) utilizes domains of body functions and structures, activities and participation, as well as environmental and personal factors to fully encapsulate the concepts of health and disability. The International Classification of Functioning, Disability and Health provides a rich and holistic understanding of functioning that is particularly valuable in the setting of childhood disability and rehabilitation. With applicability that enhances a nuanced understanding of each child within their family, school, and community, the International Classification of Functioning, Disability and Health also ensures facile and meaningful communication between professionals. Use of the International Classification of Functioning, Disability and Health promotes improved treatment plans for individual children and for larger programmatic decisions. This article demonstrates how the International Classification of Functioning, Disability and Health has reinvented the language and understanding of childhood disability and rehabilitation.
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Affiliation(s)
- Jilda N Vargus-Adams
- Departments of Pediatrics and Neurology & Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Annette Majnemer
- School of Physical & Occupational Therapy, Department of Pediatrics and Neurology & Neurosurgery, McGill University, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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27
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Wright FV, Majnemer A. The concept of a toolbox of outcome measures for children with cerebral palsy: why, what, and how to use? J Child Neurol 2014; 29:1055-65. [PMID: 24820336 DOI: 10.1177/0883073814533423] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/03/2014] [Indexed: 11/15/2022]
Abstract
Accurate and well-targeted measurement of a child's abilities and participation in daily activities pre- and post-intervention is essential to understanding the effects of therapies provided by pediatric practitioners. There is growing interest in identification of outcome core sets for specified client groups. This article elaborates on the concepts to consider when selecting and interpreting measures from an outcomes toolbox for children with cerebral palsy. Principles discussed include use of self-report measures to open a dialogue with the child/parent; a holistic assessment approach to identify a child's challenges, strengths, and contextual factors that can influence functioning; links between measurement and heightened engagement of the child/family in the rehabilitation process and goals; and the need to plan the evaluation and dialogue aspects of the assessment process. If clinicians across the international rehabilitation community draw from the same toolbox, the end result could be a cohesive approach and common language to outcome measurement.
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Affiliation(s)
- F Virginia Wright
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Annette Majnemer
- School of Physical & Occupational Therapy, McGill University, Montréal, Quebec, Canada Montreal Children's Hospital-McGill University Health Centre, Montréal, Quebec, Canada
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28
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Mumford L, Lam R, Wright V, Chau T. An access technology delivery protocol for children with severe and multiple disabilities: a case demonstration. Dev Neurorehabil 2014; 17:232-42. [PMID: 23869969 DOI: 10.3109/17518423.2013.776125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study applied response efficiency theory to create the Access Technology Delivery Protocol (ATDP), a child and family-centred collaborative approach to the implementation of access technologies. METHODS We conducted a descriptive, mixed methods case study to demonstrate the ATDP method with a 12-year-old boy with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with a custom smile-based access technology. RESULTS At the 16 week mark, the new access technology offered better response quality; teacher satisfaction was high; average technology usage was 3-4 times per week for up to 1 h each time; switch sensitivity and specificity reached 78% and 64%, respectively, and participation scores increased by 38%. CONCLUSION This case supports further development and testing of the ATDP with additional children with multiple or severe disabilities.
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29
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McDougall J, Wright V, DeWit D, Miller L. ICF-based functional components and contextual factors as correlates of perceived quality of life for youth with chronic conditions. Disabil Rehabil 2014; 36:2143-51. [PMID: 24575718 PMCID: PMC4364266 DOI: 10.3109/09638288.2014.892642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 02/04/2014] [Accepted: 02/05/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore International Classification of Functioning, Disability and Health (ICF)-based functional components and contextual factors associated with perceived quality of life (QOL) for youth with chronic conditions from the perspective of youth and parents. METHOD Baseline data were obtained from a longitudinal study examining predictors of changes in perceived QOL for youth with chronic conditions. 439 youth aged 11-17 (and one of their parents) completed a questionnaire. Standardized tools were used to measure youth functioning, contextual factors and perceived QOL. Multivariate linear regression analyses, controlling for socio-demographic and health information, were conducted to explore correlations among youth functioning/contextual factors and youth and parent perceptions of youth QOL. RESULTS Significant (p ≤ 0.05) negative correlates with both youth and parent perceptions of youth QOL included pain/other physical symptoms and emotional symptoms. Significant factors positively correlated with youth and parent perceptions of youth QOL included school productivity and spirituality. Other significant positive correlates of youth perspectives were family social support and school belongingness/safety. Family functioning was positively correlated, and youth social anxiety and environmental barriers were negatively correlated, with parent perceptions of youth QOL. CONCLUSIONS This study provides preliminary evidence of factors upon which services aimed at improving perceived QOL of youth with chronic conditions could be based. IMPLICATIONS FOR REHABILITATION This study supports the utility of clinicians assessing the QOL of youth with chronic conditions in terms of youths' and their families' perspectives. This is the first study to identify key factors that impact perceived QOL at one point in time across a group of youth with chronic conditions, offering clinicians a main starting-point for considering youths' strengths and needs and the supportiveness of the environment. Findings suggest youth and families would benefit from the availability of services that encompass the full scope of the ICF.
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Affiliation(s)
- Janette McDougall
- Research Program, Thames Valley Children's Centre, London, Ontario, Canada
| | - Virginia Wright
- Evaluation and Care, Bloorview Research Institute, Toronto, Ontario, Canada
| | - David DeWit
- Social and Epidemiological Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada
| | - Linda Miller
- School of Graduate and Postdoctoral Studies, Western University, London, Ontario, Canada
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Chang KWC, Justice D, Chung KC, Yang LJS. A systematic review of evaluation methods for neonatal brachial plexus palsy: a review. J Neurosurg Pediatr 2013; 12:395-405. [PMID: 23930602 DOI: 10.3171/2013.6.peds12630] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Neonatal brachial plexus palsy (NBPP) affects 0.4-2.6 newborns per 1000 live births in the US. Many infants recover spontaneously, but for those without spontaneous recovery, nerve and/or secondary musculoskeletal reconstruction can restore function to the affected arm. This condition not only manifests in a paretic/paralyzed arm, but also affects the overall health and psychosocial condition of the children and their parents. Currently, measurement instruments for NBPP focus primarily on physical ability, with limited information regarding the effect of the disablement on activities of daily living and the child's psychosocial well-being. It is also difficult to assess and compare overall treatment efficacy among medical (conservative) or surgical management strategies without consistent use of evaluation instruments. The purpose of this study is to review the reported measurement evaluation methods for NBPP in an attempt to provide recommendations for future measurement usage and development. METHODS The authors systematically reviewed the literature published between January 1980 and February 2012 using multiple databases to search the keywords "brachial plexus" and "obstetric" or "pediatrics" or "neonatal" or "congenital." Original articles with primary patient outcomes were included in the data summary. Four types of evaluation methods (classification, diagnostics, physical assessment, and functional outcome) were distinguished among treatment management groups. Descriptive statistics and 1-way ANOVA were applied to compare the data summaries among specific groups. RESULTS Of 2836 articles initially identified, 307 were included in the analysis, with 198 articles (9646 patients) reporting results after surgical treatment, 70 articles (4434 patients) reporting results after medical treatment, and 39 articles (4247 patients) reporting results after combined surgical and medical treatment. Among medical practitioners who treat NBPP, there was equivalence in usage of classification, diagnostic, and physical assessment tools (that focused on the Body Function and Structures measure of the International Classification of Functioning, Disability, and Health [ICF]). However, there was discordance in the functional outcome measures that focus on ICF levels of Activity and Participation. Of the 126 reported evaluation methods, only a few (the Active Movement Scale, Toronto Scale Score, Mallet Scale, Assisting Hand Assessment, and Pediatric Outcomes Data Collection Instrument) are specifically validated for evaluating the NBPP population. CONCLUSIONS In this review, the authors demonstrate disparities in the use of NBPP evaluation instruments in the current literature. Additionally, valid and reliable evaluation instruments specifically for the NBPP population are significantly lacking, manifesting in difficulties with evaluating the overall impact and effectiveness of clinical treatments in a consistent and comparative manner, extending across the various subspecialties that are involved in the treatment of patients with NBPP. The authors suggest that all ICF domains should be considered, and future efforts should include consideration of spontaneous (not practitioner-elicited) use of the affected arm in activities of daily living with attention to the psychosocial impact of the disablement.
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Borgestig M, Falkmer T, Hemmingsson H. Improving computer usage for students with physical disabilities through a collaborative approach: a pilot study. Scand J Occup Ther 2013; 20:463-70. [PMID: 24041227 DOI: 10.3109/11038128.2013.837506] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. METHODS Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers' opinions of goal setting were collected at follow-up. RESULTS The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. DISCUSSION The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students' computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.
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Affiliation(s)
- Maria Borgestig
- Department of Social and Welfare Studies, Linköping University , Linköping, Sweden
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Dalen HE, Nyquist A, Saebu M, Roe C, Bautz-Holter E. Implementation of ICF in goal setting in rehabilitation of children with chronic disabilities at Beitostolen Healthsports Centre. Disabil Rehabil 2012; 35:198-205. [PMID: 22671288 DOI: 10.3109/09638288.2012.690499] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Develop an International Classification of Functioning, Disability and Health (ICF) Code Set, useful in goal oriented rehabilitation of a study population of children with chronic disabilities. METHOD A triangulation of methods, using an interview to identify the main needs and goals of the study population, and a questionnaire to identify the main problems, with a registration of the frequency within each category. After qualitative and quantitative analyses this resulted in two sets of ICF categories. These two sets were then compared and merged into a proposed ICF Code Set for goal setting. RESULTS Thirty categories were identified from the interviews and the following linking process. Problems were reported in all suggested categories within the ICF questionnaire, resulting in 49 categories. The comparison of the two sets of categories resulted in a proposed ICF Code Set of 40 categories. CONCLUSIONS Through a triangulation of methods, we developed a tailored code set for the goal setting process in rehabilitation for children with a disability, taking into account both individual preferences and the health professionals' perspective. Although the external validity is limited, our methodological procedures may have relevance for the implementation of ICF in other clinical settings and populations.
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Illustrating Child-Specific Linking Issues Using the Child Health Questionnaire. Am J Phys Med Rehabil 2012; 91:S189-98. [DOI: 10.1097/phm.0b013e31823d53cf] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Quality of life and leisure participation in children with neurodevelopmental disabilities: a thematic analysis of the literature. Qual Life Res 2011; 21:427-39. [DOI: 10.1007/s11136-011-0063-9] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2011] [Indexed: 11/27/2022]
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Maggs J, Palisano R, Chiarello L, Orlin M, Chang HJ, Polansky M. Comparing the priorities of parents and young people with cerebral palsy. Disabil Rehabil 2011; 33:1650-8. [DOI: 10.3109/09638288.2010.542875] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Adolfsson M, Malmqvist J, Pless M, Granuld M. Identifying child functioning from an ICF-CY perspective: Everyday life situations explored in measures of participation. Disabil Rehabil 2011; 33:1230-44. [DOI: 10.3109/09638288.2010.526163] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Steenbeek D, Gorter JW, Ketelaar M, Galama K, Lindeman E. Responsiveness of Goal Attainment Scaling in comparison to two standardized measures in outcome evaluation of children with cerebral palsy. Clin Rehabil 2011; 25:1128-39. [PMID: 21795404 DOI: 10.1177/0269215511407220] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess the responsiveness of Goal Attainment Scaling compared with the Pediatric Evaluation of Disability Inventory (PEDI) and the 66-item Gross Motor Function Measure (GMFM-66) in multidisciplinary rehabilitation practice. DESIGN Observational study. Pretest-posttest design. SUBJECTS/PATIENTS Twenty-three children with cerebral palsy, aged 2-13 years. METHODS Goal Attainment Scaling, PEDI and GMFM-66 assessments were performed before and after six months of treatment. Physical, occupational and speech therapists constructed and scored 6-point Goal Attainment Scaling scales meeting predetermined criteria, describing the main functional goal per discipline. The contents of the three measures were compared using International Classification of Functioning, Disability and Health child and youth version (ICF-CY) codes. Spearman's rho correlations between Goal Attainment Scaling change scores per discipline and change scores obtained with the PEDI functional skills scales and GMFM-66 were calculated. Complete goal attainment was compared with significant change in terms of the standardized measures. RESULTS Twenty per cent of the Goal Attainment Scaling items were not covered by items of the PEDI or the GMFM-66. Inconclusive correlations were found between Goal Attainment Scaling and PEDI change scores (r 0.28-0.64). Even after exclusion of the non-corresponding items, correlations were moderate (r 0.57-0.73). Of 39/64 Goal Attainment Scaling scales scored as complete goal attainment, 16 individual PEDI scores did not show change on the corresponding scale. Low correlation was found between Goal Attainment Scaling change scores and GMFM-66 change scores. CONCLUSION Goal Attainment Scaling, PEDI and GMFM-66 were complementary in their ability to measure individual change over time in children with cerebral palsy. Using only the standardized instruments could have caused many individual rehabilitation goals actually attained being missed in the outcome evaluation.
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Löwing K, Hamer EG, Bexelius A, Carlberg EB. Exploring the relationship of family goals and scores on standardized measures in children with cerebral palsy, using the ICF-CY. Dev Neurorehabil 2011; 14:79-86. [PMID: 21410399 DOI: 10.3109/17518423.2011.552088] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To explore the relationships of family selected goals and scores on standardized measures using the ICF-CY as a classification system. METHODS Goal attainment scaling (GAS)-goals (n = 110) of 22 children, 11 girls, 1-6 years, bilateral or unilateral cerebral palsy, GMFCS I-IV and MACS I-IV were linked to the ICF-CY. The children had participated in goal-directed therapy during 12 weeks. GAS-goals, baseline assessments and change scores from PEDI and GMFM-66 were used to explore the relationships. RESULTS All GAS-goals were classified in the Activity and Participation domain within ICF-CY. The number of GAS-goals correlated to baseline scores in PEDI and GMFM-66. The change scores in PEDI and GMFM-66 correlated to goal attainment in the Mobility and the Self-Care chapter. CONCLUSIONS The family goals were reflected in standardized measures. The combined use of standardized and individual measures offers a possibility to explore the focus in therapy and the impact in children with cerebral palsy.
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Affiliation(s)
- Kristina Löwing
- Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Beghi E, Chiappedi M, Ferrari-Ginevra O, Ghezzo A, Maggioni E, Mattana F, Spelta P, Stefanini MC, Biserni P, Tonali P. Inter-rater agreement in the assessment of response to motor and cognitive rehabilitation of children and adolescents with epilepsy. Eur J Paediatr Neurol 2011; 15:254-9. [PMID: 21227723 DOI: 10.1016/j.ejpn.2010.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 10/27/2010] [Accepted: 12/18/2010] [Indexed: 10/18/2022]
Abstract
INTRODUCTION To assess inter-rater agreement among child neurologists and psychiatrists on evaluation of response to physical and cognitive rehabilitation of children and adolescents with epilepsy. MATERIALS AND METHODS Five child neurologists/psychiatrists ("raters") were invited to draw 2-3 short case reports among those most commonly seen. 14 case histories were presented and raters used a structured questionnaire to report changes after selected rehabilitation programs. Response was coded as "Yes", "No", or "Uncertain" in different functional domains (Motor, Social, Alimentary, Communication, Personal Autonomy). Inter-rater agreement was measured using the kappa statistic. Raters where then asked to discuss any reason for disagreement. The test was repeated with different cases (16 case histories) adding a sixth rater, who had participated to the discussion. RESULTS Even with this small number of cases, the agreement mostly ranged from poor to good in the first test (worse for Social, Personal Autonomy and Communication). Training improved agreement in almost all domains. There were no frank outliers. The agreement was lower with a specific approach (i.e. grouping "Uncertain" to "No") than with sensitive approach (i.e. grouping "Uncertain" to "Yes"). DISCUSSION The interpretation of patients' response to physical and cognitive rehabilitation tends to vary among Italian child neurologists/psychiatrists depending on measures and training procedures. Discussion and training improves agreement, although this is only a pilot study conducted using a non standardized questionnaire.
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Affiliation(s)
- Ettore Beghi
- Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
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Martins EF, De Sousa PHC, De Araujo Barbosa PHF, De Menezes LT, Souza Costa A. A Brazilian experience to describe functioning and disability profiles provided by combined use of ICD and ICF in chronic stroke patients at home-care. Disabil Rehabil 2011; 33:2064-74. [DOI: 10.3109/09638288.2011.560332] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tilton A, Vargus-Adams J, Delgado MR. Pharmacologic treatment of spasticity in children. Semin Pediatr Neurol 2010; 17:261-7. [PMID: 21183133 DOI: 10.1016/j.spen.2010.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Many clinicians frequently face the dilemma of whether and how to medically treat spasticity. When pharmacologic intervention is deemed appropriate, treatment decisions must first be based on accurate assessment using valid and reliable clinical instruments, and, importantly, specific, measurable, achievable, and realistic treatment goals should be delineated. For the treatment of localized or segmental spasticity, botulinum toxin (BoNT-A) is recommended as an effective and generally safe treatment. For more generalized spasticity, a number of useful oral agents and intrathecal baclofen are available, each with their positive and negative attributes. Fundamental knowledge of pharmacologic properties and toxicities of these medications is required for safe and appropriate use. To achieve optimum results, spasticity treatment should be part of an integrated therapeutic approach in which patients, caregivers, therapists, physicians, and surgeons have an open and clear communication about the overall rehabilitation process of the patient. This review summarizes the current pharmacologic approaches to spasticity treatment in children, critically evaluating published studies in the context of established evidence-based criteria.
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Affiliation(s)
- Ann Tilton
- Louisiana State University, New Orleans, LA, USA
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McDougall J, Wright V, Rosenbaum P. The ICF model of functioning and disability: incorporating quality of life and human development. Dev Neurorehabil 2010; 13:204-11. [PMID: 20450470 DOI: 10.3109/17518421003620525] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Since its 2001 publication, a number of issues have been raised about the ICF. The World Health Organization anticipated the ICF would undergo a continuous process of revision. This paper adds to this process. METHOD This article describes how the ICF framework shares a number of tenets with a systems perspective. An argument is built for why the ICF model of functioning and disability should be expanded to include the concepts of quality of life and human development. A modified model is presented that depicts a person's life quality and his/her potential for development as the outcomes and processes that arise from the interconnected, ever-changing influences of health, functioning and contextual factors. CONCLUSIONS A modified ICF model based on a systems perspective depicts a holistic view that acknowledges health, functioning, life quality and development are intertwined and are essential concepts to consider in the lives of all people.
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