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Livingstone RW, Paleg GS, Field DA. Supported standing and stepping device use in young children with cerebral palsy, gross motor function classification system III, IV and V: A descriptive study. Assist Technol 2024; 36:264-274. [PMID: 37988126 DOI: 10.1080/10400435.2023.2283461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
This study described and compared use of supported-standing and stepping devices by young children with cerebral palsy, Gross-Motor Function Classification System (GMFCS) levels III-V following power mobility introduction. Data was collected at two time-points, 5-6 months apart, for 42 participants, aged 18-80 months, using the Home Use of Technology for CHildren (HUTCH). Supported-standing and stepping device choice and time in each device remained stable over 6 months. Associations between device use and three functional classifications were examined. Children with more impaired motor, postural and manual abilities were more likely to use a supine stander rather than a prone/upright stander or no stander. Children at GMFCS V tended to use hands-free stepping devices, while support-arms stepping devices were more common for children at GMFCS IV. Only children at GMFCS III used convertible stepping devices. Using power mobility, standers and supported-stepping devices was feasible and 19/34 classified at GMFCS IV/V used all three devices over 6 months. A key finding was that introduction of power mobility did not reduce use of supported-stepping devices at any GMFCS level. Use of multiple upright positioning and mobility devices may assist children with limited mobility to be actively engaged and participate in daily life.
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Affiliation(s)
- Roslyn W Livingstone
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Occupational Therapist II, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada
- Investigator, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Ginny S Paleg
- Physical Therapist, Montgomery County Infants and Toddlers Program, Rockville, Maryland, USA
| | - Debra A Field
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Occupational Therapist II, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada
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2
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Kenyon LK, McNally D, Ray J, Vanderest S, Best KL. Factors clinicians consider when providing pediatric wheelchair skills training: a modified think aloud study. Disabil Rehabil Assist Technol 2024; 19:1956-1963. [PMID: 37480332 DOI: 10.1080/17483107.2023.2238004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Children who use a manual wheelchair (WC) or a power WC may not receive adequate WC skills training. Clinicians report knowledge as a barrier to the provision of paediatric WC skills training. The purpose of this study was to explore the breadth and depth of specific factors clinicians consider when providing WC skills training for children. METHODS Data in this modified Think Aloud study were gathered via one-on-one, Zoom-based, audio-recorded Think Aloud Sessions. Sessions consisted of participants viewing four videos, each of different children performing a different WC skill while thinking aloud (verbally expressing) about the factors they recognized, observed, and considered while watching the video. After each video, participants also responded to questions regarding the specific WC skill and the provision of WC skills training for the child in the video. Factors participants reported were independently identified by three researchers through a deductive process of directed content analysis and categorized using the International Classification of Functioning, Disability and Health (ICF) coding system. RESULTS Twenty-eight English-speaking clinicians participated in the study. A total of 1246 distinct factors were mapped to 352 unique ICF codes spanning all four ICF Domains. The largest number of identified factors mapped to codes within the Activities and participation Domain (42.25%). CONCLUSION Participants reported considering multiple factors across the ICF in the provision of WC skills training for children. Providing paediatric WC skills training is a complex activity requiring clinicians to consider a wide range of factors that go beyond a child's motor abilities.
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Affiliation(s)
- Lisa K Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Daniel McNally
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Jacob Ray
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Sebastian Vanderest
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Krista L Best
- Faculty of Medicine, Université Laval, Quebec City, Quebec, CA, USA
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Noten S, Pettersson K, Czuba T, Cloodt E, Casey J, Rodby-Bousquet E. Probability of independent walking and wheeled mobility in individuals with cerebral palsy. Dev Med Child Neurol 2024; 66:326-332. [PMID: 37559231 DOI: 10.1111/dmcn.15731] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
AIM To estimate the probability of independent walking and wheeled mobility in individuals with cerebral palsy (CP) at home and in the community in relation to age and gross motor function. METHOD This was a longitudinal cohort study using data reported into the combined Swedish CP follow-up programme and national quality registry from October 2000 to October 2022. Walking, walking with aids, wheeled mobility, and assisted mobility defined independent or assisted mobility at home and in the community, based on the Functional Mobility Scale with additional data on wheelchair performance, were assessed. RESULTS There were 52 858 examinations reported for 6647 individuals with CP (age range 0-32 years, follow-up period 0-22 years). Most children and adults in Gross Motor Function Classification System (GMFCS) levels I or II walked without assistive devices. The probability of dependence on others for mobility in the community was high for both children and adults in GMFCS levels III to V. INTERPRETATION Although independent mobility is vital for participation and social inclusion, many children and adults with CP are dependent on others for mobility. We recommend clinicians, together with families and individuals with CP, explore how to increase access to independent mobility from an early age and continuously throughout the life course. WHAT THIS PAPER ADDS • There is a high probability of independent walking in Gross Motor Function Classification System (GMFCS) levels I to II. • Mobility options vary most at home and in the community in GMFCS level III. • Being dependent on others for mobility is likely in GMFCS levels III to V.
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Affiliation(s)
- Suzie Noten
- Centre for Clinical Research, Uppsala University-Region Västmanland, Västerås, Sweden
| | - Katina Pettersson
- Centre for Clinical Research, Uppsala University-Region Västmanland, Västerås, Sweden
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
| | - Tomasz Czuba
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Erika Cloodt
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
- Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Jackie Casey
- Regional Wheelchair: Training, Research & Service Development (NI), Belfast Health & Social Care Trust, Belfast, UK
| | - Elisabet Rodby-Bousquet
- Centre for Clinical Research, Uppsala University-Region Västmanland, Västerås, Sweden
- Department of Clinical Sciences, Orthopaedics, Lund University, Lund, Sweden
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Felix JB, de Campos AC, Logan SW, Machado J, Souza Monteiro K, Longo E. Go Zika Go: feasibility study with modified motorized ride-on cars for the mobility of children with Congenital Zika Syndrome (CZS). Disabil Rehabil Assist Technol 2024:1-14. [PMID: 38166551 DOI: 10.1080/17483107.2023.2300052] [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: 06/23/2023] [Accepted: 12/21/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE To explore the feasibility of an intervention using modified ride-on cars in terms of acceptability and potential changes in goal attainment, mobility, social function, and participation of children with Congenital Zika Syndrome (CZS). MATERIALS AND METHODS A pre- and post-intervention feasibility study was conducted with children with CZS, levels IV and V of the Gross Motor Function Classification System (GMFCS). The intervention consisted of 12 weeks of training (3 times a week for 40 min per session) and 4 weeks of follow-up. The primary outcomes included adherence, satisfaction, and learning in mobility. Secondary outcomes encompassed goal attainment, mobility, social/cognitive function, and participation. Descriptive statistics were performed. To explore potential individual changes with the intervention, Wilcoxon test was used to analyze Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) data and Young Children's Participation and Environment Measure (YC-PEM)/Participation and Environment Measure for Children and Youth (PEM-CY), along with standard error measurements of the PEDI-CAT domains. RESULTS Four children participated (median age 4.75 years; two females: three at level V on the GMFCS). Adherence was 75% of the total intervention time, and family members reported being satisfied or very satisfied. Children showed gains in learning the use of the modified ride-on cars and an increase in goal attainment after the intervention. Individual changes were observed in the PEDI-CAT domains (mobility and social/cognitive), but there were no significant changes in participation outcomes. CONCLUSIONS Children with CZS at GMFCS levels IV and V can learn to use motorized ride-on cars, attainment goals, and experience satisfaction.
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Affiliation(s)
- Jean Bendito Felix
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
| | | | - Samuel W Logan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Julianne Machado
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
| | - Karoline Souza Monteiro
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
| | - Egmar Longo
- Postgraduate Program in Rehabilitation Sciences, University of Rio Grande do Norte/Faculty of Health Sciences of Trairi, Santa Cruz, Brazil
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Kenyon LK, Straw L, Wassermann M, Yasick EL, Kiger AL. School-Based Therapists' Perspectives of Wheelchair Use in US Schools: A Survey Study. Pediatr Phys Ther 2024; 36:71-78. [PMID: 38033270 DOI: 10.1097/pep.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
PURPOSE To gather information concerning the current state of students' wheelchair (WC) use in US schools from the perspective of school-based therapists. METHODS This descriptive study used a Web-based survey to gather information regarding factors that facilitated or hindered student WC use at school, the frequency at which various tasks related to WC provision were performed, and factors that would facilitate students' independence with WC use. RESULTS A dependent manual WC was the most common type of WC mobility used at school. Various student and nonstudent factors were reported as a facilitator or a barrier to students' WC use at school. CONCLUSIONS Although most respondents reported working with a student who used a WC, few reported active engagement in tasks related to WC service provision. Future research exploring potential attitudinal issues influencing students' WC use at school and ways to optimally support students' independent WC use is indicated.
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Affiliation(s)
- Lisa K Kenyon
- The Department of Physical Therapy and Athletic Training, Grand Valley State University (Drs Kenyon, Straw, Wassermann, and Yasick), Grand Rapids, Michigan; Permobil, Inc (Ms Kiger), Lebanon, Tennessee
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Huang HH, Tsai WY, Lin YN, Hung CY, Chan AT. Caregivers' Perceptions of Ride-On Cars and Behavioral Changes for Young Children With Motor Delays. Pediatr Phys Ther 2024; 36:42-51. [PMID: 37820358 DOI: 10.1097/pep.0000000000001066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
PURPOSE To investigate caregivers' perceptions of using a ride-on car (ROC) and observe behavioral changes in their children following ROC training and conventional therapy. METHODS The study included 37 toddlers with motor delays and their caregivers, divided into an ROC training group (27 participants) and a conventional therapy group (10 participants). A binary, multiple-choice, and open-ended questionnaire was administered before and after a 3-month intervention period. RESULTS Over 70% of caregivers had no experience using mobility devices before the intervention. Before the intervention, children's ability and age were key barriers to using mobility devices. After the intervention, caregivers in the ROC group were more inclined than those in the control group to allocate a larger budget for these devices. CONCLUSIONS The findings highlight the importance of pediatric physical and occupational therapists working collaboratively with caregivers during such interventions and raising awareness about government subsidies and resources available for mobility devices.
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Affiliation(s)
- Hsiang-Han Huang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences (Dr Huang and Ms Hung), Chang Gung University, Taoyuan, Taiwan; Joint Appointment with Department of Physical Medicine and Rehabilitation (Dr Huang), Chang Gung Memorial Hospital, Linkou, Taiwan; Shi Yuan Poly Clinic (Ms Tsai), Longtan, Taoyuan, Taiwan; Institute of Brain Science (Ms Lin), National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Rehabilitation (Ms Chan), China Medical University Hsinchu Hospital, Hsinshu, Taiwan
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Paguinto SG, Kasparian NA, Bray P, Farrar M. Multidisciplinary perspectives and practices of wheelchair prescription for children with neuromuscular conditions. Disabil Rehabil Assist Technol 2023; 18:166-174. [PMID: 33147417 DOI: 10.1080/17483107.2020.1839793] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE Clinical practice guidelines for paediatric neuromuscular disorders (NMDs) recommend timely provision of wheelchair equipment. The aim of this qualitative study was to understand healthcare professionals' clinical perspectives and practices when recommending wheelchair equipment for the first time, as well as perceived barriers and enablers to timely wheelchair provision. METHODS Twenty-one healthcare professionals (HCPs) from Australia and the United States participated in an interview (response rate: 88%, 16/21 women). Participants were from diverse disciplines, based in hospital or community health settings, and had at least one year of experience working in paediatric neuromuscular care. RESULTS Child fatigue, falls and engagement in age-appropriate activity were common reasons for HCP's wheelchair recommendation. HCPs were acutely aware of parents' experiences of grief and loss throughout the wheelchair prescription process, and over half acknowledged the lack of psychological care available to families affected by NMDs. Multi-disciplinary collaboration, psychologically-informed care, and shared decision-making with stakeholders were perceived enablers of wheelchair transition. Barriers included limited access to equipment, lengthy funding processes and lack of funding for home and vehicle modifications. CONCLUSIONS Integrated psychosocial care is needed to support families throughout their child's disease progression, including wheelchair transition. Implementation of readiness for change tools, and development of tailored informational resources is recommended. Improved access to equipment options and trials, and more efficient funding processes are highly likely to improve parental engagement throughout the wheelchair prescription process.Implications for rehabilitationHealthcare professionals express a strong demand for integrated psychosocial care within paediatric neuromuscular clinics to support families throughout transitions, including wheelchair introduction.Identifying parents' readiness for change can inform their information and support needs, strengthen their decision-making capacity and facilitate timely wheelchair introduction.Stronger collaboration between hospital- and community-based health professionals working in paediatric neuromuscular care is recommended to facilitate knowledge exchange and support families' transition to wheelchair use.Access to equipment options for extended loan or trial in the community can support timely wheelchair introduction.
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Affiliation(s)
- Sarah-Grace Paguinto
- Occupational Therapy Department, Sydney Children's Hospital, Sydney, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
| | - Nadine A Kasparian
- Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Paula Bray
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Michelle Farrar
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, Australia
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Arps K, Darr N, Katz J. Effect of adapted motorized ride-on toy use on developmental skills, quality of life, and driving competency in nonambulatory children age 9-60 months. Assist Technol 2023; 35:83-93. [PMID: 34376119 DOI: 10.1080/10400435.2021.1956643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Adapted motorized ride-on toys (AMTs) provide a feasible option for independent mobility in children with physical limitations. This study explores implications of AMT use on developmental domains and participation in daily activities. It also pilots the Power Mobility Skills Checklist (PMSC) for assessment of AMT operation competency. Nine nonambulatory children, ages 10-35 months, completed a 16-week AMT intervention. The Battelle Developmental Inventory-2 (BDI-2) and Assessment for Life Habits for Children (Life-H) were completed pre- and poststudy to evaluate developmental skills and participation in daily activities. The PMSC was completed at 2-week intervals to assess AMT driving ability. PMSC scores improved significantly for all participants across the intervention. BDI-2 developmental quotients demonstrated clinically significant gains in motor, cognitive, adaptive, communication, and personal-social domains, which varied between participants. Life-H changes were not significant. Improvements in PMSC change scores were associated with more total AMT sessions and increased BDI-2 gains. The PMSC may be effective for obtaining quantitative data on AMT operation and sensitive for assessing change in driving competency.
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Affiliation(s)
- Kara Arps
- School of Physical Therapy, Belmont University, Nashville, Tennessee, USA
| | - Nancy Darr
- School of Physical Therapy, Belmont University, Nashville, Tennessee, USA
| | - Jamie Katz
- School of Physical Therapy, Belmont University, Nashville, Tennessee, USA
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Abstract
Mobility is a human right. The traditional definition of mobility in physical therapy practice is centered on translocation and, while accurate, is not comprehensive. In this article, we propose the ON Time Mobility framework: that all children have the right to be mobile throughout their development to explore, engage in relationships, and develop agency to cocreate their lives. This perspective highlights interconnected principles of timing, urgency, multimodal, frequency, and sociability to begin discussions on supporting the right to hours of active mobility each day for all children. We propose critical evaluation and discussion of these principles followed by a call to action to shift our conceptualization and enactment of mobility. This mobility rights perspective challenges current medical systems, industry, and government to collaborate with children with disabilities, their families and communities to support mobility as a source of physical and social interactions that define and develop individuals (see Supplemental Digital Content 1, the Video Abstract, available at: http://links.lww.com/PPT/A398 ).
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10
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Ouellet B, Best KL, Wilson D, Miller WC. Exploring the Influence of a Community-Based Peer-Led Wheelchair Skills Training on Satisfaction with Participation in Children and Adolescents with Cerebral Palsy and Spina Bifida: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11908. [PMID: 36231211 PMCID: PMC9564843 DOI: 10.3390/ijerph191911908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Peer-led approaches improve satisfaction with participation, wheelchair skills and wheelchair use self-efficacy in adults, but the evidence is limited in children. This pilot study aimed to explore the influence of community-based, peer-led, group wheelchair training program (i.e., Seating To Go) on satisfaction with participation (primary outcome), wheelchair skills, and wheelchair use self-efficacy in children and adolescents with cerebral palsy and spina bifida. METHODS A single group pre-post design was used. Invitations were shared online and diffused by clinicians and advocacy and provider groups to recruit a convenience sample of eight pediatric wheelchair users. Participants completed the Seating To Go program in groups that were facilitated by adult wheelchair users. Satisfaction with participation (Wheelchair Outcome Measure-Young People), wheelchair skills (Wheelchair Skills Test), wheelchair use self-efficacy (Wheelchair Use Confidence Scale), and perceived wheelchair skills capacity (Wheelchair Skills Test Questionnaire; proxy rating: parents) were evaluated before and after the Seating To Go program. Descriptive statistics and nonparametric longitudinal data analysis were conducted to explore changes in all outcomes from baseline to post-intervention. RESULTS Pediatric wheelchair users (ranging in age from 5 to 15 years) and their parents reported statistically significant improvements in satisfaction with participation. The improvements in wheelchair skills and wheelchair confidence were also statistically significant, but not the parents' perception of their children's wheelchair skills. CONCLUSIONS A community-based peer-led approach to wheelchair skills training seems promising for improving wheelchair outcomes in pediatric wheelchair users. Further controlled studies with larger samples are warranted.
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Krista L. Best
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Deb Wilson
- Seating To Go—Geneva Healthcare, Hamilton 3204, New Zealand
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- G.F. Strong Rehabilitation Centre—Rehabilitation Research Lab, Vancouver, BC V5Z 2G9, Canada
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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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12
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Krasovsky T, Shammah C, Addes A, Brezner A, Barak S. The Development and Evaluation of the Powered Mobility Function Scale (PMFS) for Children and Adolescents with Cerebral Palsy. Dev Neurorehabil 2021; 24:338-347. [PMID: 33703993 DOI: 10.1080/17518423.2021.1898057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aims: To describe the development and evaluation of a novel task-based measure of powered mobility function: the Powered Mobility Function Scale (PMFS).Methods: PMFS was developed in Hebrew in four phases, with feedback from clinicians and clients. Psychometric properties (inter-rater, test-retest reliability, concurrent, convergent and known-groups validity) were evaluated for N = 49 children and adolescents with Cerebral Palsy (11.1 ± 4.8y) using Powered Mobility Program (PMP), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS) and Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT)Results: PMFS development involved 3 versions over three years. Inter-rater reliability was κ=0.75-0.95 (video/observation). Test-retest reliability was κ=0.93-0.96. Concurrent validity (PMP) was ρ=-0.84-to-0.96. Convergent validity (PEDI-CAT) was ρ=-0.47-to-0.70. Known-groups validity (GMFCS/MACS) demonstrated medium effect sizes (r = 0.33-0.46)Conclusions: PMFS is valid and reliable for measuring powered mobility function in children and adolescents with CP. Future validation of the English version of PMFS is warranted.
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Affiliation(s)
- Tal Krasovsky
- University of Haifa, Haifa, Israel.,The Edmond & Lily Safra Children's Hospital, Ramat-Gan, Israel
| | - Chana Shammah
- Merkaz Shikum Yeladim (MESHI) Kindergarten and School, Jerusalem, Israel
| | - Anat Addes
- Merkaz Shikum Yeladim (MESHI) Kindergarten and School, Jerusalem, Israel
| | - Amichai Brezner
- The Edmond & Lily Safra Children's Hospital, Ramat-Gan, Israel
| | - Sharon Barak
- The Edmond & Lily Safra Children's Hospital, Ramat-Gan, Israel.,Kaye Academic College of Education, Be'er Sheba, Israel
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13
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Kenyon LK, Massingill B, Farris JP. Using a child's power mobility learner group to tailor power mobility interventions: a case series. Disabil Rehabil Assist Technol 2021:1-7. [PMID: 34002667 DOI: 10.1080/17483107.2021.1926562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this case series was to explore using a child's power mobility learner group (exploratory, operational, or functional) to tailor power mobility interventions. Materials and methods: Five cases representing 2 exploratory power mobility learners, 2 operational power mobility learners, and 1 functional power mobility learner are presented. In each case, the participant's power mobility learner group was used to tailor his/her power mobility intervention program including establishing desired outcomes/goals of power mobility use, selecting outcome measures, determining the power mobility device to be used, and identifying the specific intervention strategies to be used. RESULTS All participants demonstrated improvements in power mobility device use following provision of the tailored intervention. Cases involving use of the Canadian Occupational Performance Measure demonstrated clinically significant improvements in post-intervention scores. CONCLUSIONS These cases illustrate a means to tailor power mobility interventions that may potentially optimise learning by providing an environment and conditions that meet each child's specific needs. The short-term and long-term gains made by the children in these cases warrants a controlled study exploring the use of a child's power mobility learner group to tailor power mobility interventions.IMPLICATIONS FOR REHABILITATIONUsing a child's power mobility learner group to tailor power mobility intervention may potentially optimise learning by providing an environment and conditions that meet each child's specific needs.Children across the learning continuum represented by the 3 power mobility learner groups (exploratory, operational, and functional) may benefit from power mobility interventions.Using a child's power mobility learner group to tailor power mobility interventions may support translation research knowledge into clinical practice.
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Affiliation(s)
- Lisa K Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Beau Massingill
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - John P Farris
- Padnos School of Engineering and Computing, Grand Valley State University, Grand Rapids, MI, USA
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Plummer T, Logan SW, Morress C. Explorer Mini: Infants' Initial Experience with a Novel Pediatric Powered Mobility Device. Phys Occup Ther Pediatr 2021; 41:192-208. [PMID: 33019827 DOI: 10.1080/01942638.2020.1819935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIMS The purpose of this study is to describe the driving experience and emotional responses of young children who experience mobility limitations during initial use of the Explorer Mini, a new pediatric powered mobility device. METHODS The current study utilized a descriptive, cross-sectional, and mixed- method approach. Thirty-three young children between 6 and 36 months of age who experience mobility limitations participated in this study and were provided up to two, 15-minute driving sessions with the Explorer Mini. Researchers completed an observation form that included field notes (qualitative data) and answers to yes/no questions to generate percentages of observed behaviors (quantitative data) regarding young children's driving experience and emotional responses while using the Explorer Mini. RESULTS Thematic analysis from field notes (i.e., qualitative data) revealed two inter-related themes: 1) I can move, 2) I think I like it- don't I? Ninety four percent (i.e., quantitative data) of young children were able to move the Explorer Mini to explore their environment. CONCLUSIONS Young children demonstrated self-initiated mobility with a powered mobility device using the midline joystick. The results support the notion that infants 6-36 months can effectively use the Explorer Mini. The device received Food and Drug Administration 510k clearance in February 2020.
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Affiliation(s)
- Teresa Plummer
- School of Occupational Therapy, Belmont University, Nashville, Tennessee, USA
| | - Samuel W Logan
- Kinesiology, Oregon State University, Corvallis, Oregon, USA
| | - Claire Morress
- Perlman Center, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
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15
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Livingstone R, Field D, Sanderson C, Pineau N, Zwicker JG. Beginning power mobility: parent and therapist perspectives. Disabil Rehabil 2020; 44:2832-2841. [PMID: 33174476 DOI: 10.1080/09638288.2020.1842916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To explore parent and therapist experiences of early power mobility following participation in a Power Mobility Day - a 60-90 min play-based session where children with mobility limitations (<6 years of age) experienced four different early power mobility devices. METHOD Participants were purposefully selected from parents and therapists who took part in Power Mobility Days as part of a larger cross-sectional study. One semi-structured interview with each participant was conducted via telephone. Interviews were audio-recorded, transcribed, and analyzed using a content analysis approach. RESULTS Of 35 adults approached, 11 parents and 11 occupational or physical therapists completed interviews averaging 20 min (range 10-45 min), one week to three months after the session. Participants were parents or therapists of children aged 12 to 48 months of age with a variety of neuromotor diagnoses from different areas of the province. The overarching theme Empowering Children and Families to Explore was developed from themes: Earlier Experiences; A Novel Introduction; and Moving Forward. CONCLUSION Power Mobility Days provided a welcoming and inclusive child- and family-led introduction to power mobility. This novel approach may help change both therapists' and families' perception of child potential and perspectives on power mobility as an intervention.IMPLICATIONS FOR REHABILITATION:Exploratory sessions can provide a novel introduction to power mobility interventions.Child enjoyment has a reciprocal impact on family engagement with early power mobility.Experiential child- and family-led learning can increase awareness of power mobility options and possibilities.
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Affiliation(s)
- Roslyn Livingstone
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,Sunny Hill Health Centre, Vancouver, Canada.,BC Children's Hospital Research Institute, Vancouver, Canada
| | - Debra Field
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,Sunny Hill Health Centre, Vancouver, Canada
| | - Colleen Sanderson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Nicole Pineau
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Jill G Zwicker
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,Sunny Hill Health Centre, Vancouver, Canada.,BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Logan SW, Ross SM, Bogart KR, Feldner HA, Kenyon LK, Woekel E. Item development, internal consistency, and known-groups validity of the Self-Directed Mobility Scale. Disabil Rehabil Assist Technol 2020; 17:318-324. [PMID: 32594782 DOI: 10.1080/17483107.2020.1782489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: The aims of the current study include to: (1) describe the item development; and (2) begin the process of establishing the internal consistency and known-groups validity of the Self-Directed Mobility Scale. The purpose of the scale is to assess paediatric physical and occupational therapists' views towards self-directed mobility and their perceived ability and intentions to advocate for children's access to self-directed mobility.Methods: Three individuals with expertise in kinesiology, psychology, paediatric rehabilitation, and disability studies served as the expert panel for item development. Four samples were included to determine internal consistency and known-groups validity: 350 physical therapists, 89 occupational therapists, 279 kinesiology undergraduate students, and 528 health and wellness undergraduate students.Results: The internal consistency was above the acceptable level of 0.70 (range = 0.72-0.77) for all samples when two items regarding promoting other motor skills prior to powered mobility use and the temporary use of a mobility device were removed. Known-groups validity was established between all samples.Conclusions: The Self-Directed Mobility Scale appears to be a valid tool for assessing views of self-directed mobility and mobility advocacy intentions in paediatric physical and occupational therapists, as well as undergraduate students. Future work should examine the internal consistency based on study sample to ensure the (> 0.70) acceptable Cronbach's alpha level is met.Implications for rehabilitationThe Self-Directed Mobility Scale is a viable measurement tool to assess views of self-directed mobility and mobility advocacy intentions of pediatric physical and occupational therapists.In combination with other measures, the Self-Directed Mobility Scale may be used in future rehabilitation research to evaluate factors associated with provision of mobility technology to children with disabilities.
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Affiliation(s)
- Samuel W Logan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Samantha M Ross
- College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, WV, USA
| | - Kathleen R Bogart
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Heather A Feldner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Lisa K Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Erica Woekel
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Logan SW, Hospodar CM, Bogart KR, Catena MA, Feldner HA, Fitzgerald J, Schaffer S, Sloane B, Phelps B, Phelps J, Smart WD. Real World Tracking of Modified Ride-On Car Usage in Young Children With Disabilities. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2019; 7:336-353. [PMID: 33015208 PMCID: PMC7529107 DOI: 10.1123/jmld.2019-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Go Baby Go is a community program that provides modified ride-on cars to young children with disabilities. AIMS (1) To describe the real world modified ride-on car usage of young children with disabilities; (2) To compare subjectively reported modified ride-on car usage recorded by parents with objectively reported usage based on electronic tracking data. METHODS 14 young children (1-3 years old) with disabilities used a modified ride-on car for three months. RESULTS On average, parent-reported activity log data indicated that children used the modified ride-on car for 17.8 minutes per session (SD = 9.9) and 195.1 total minutes (SD = 234.8) over three months. Objective tracking data indicated 16.5 minutes per session (SD = 8.6) and 171.4 total minutes (SD = 206.1) over three months. No significant difference of modified ride-on car usage was found between parent-reported activity log data and objective tracking; yet, the mean absolute difference between tracking methods was 96 minutes (SD = 8.6) and suggests over- or under-reporting of families. Children used the modified ride-on car more in the first half compared to the second half of the three-month period (p < .05). CONCLUSIONS This study may inform future research studies and local chapters of the Go Baby Go community program.
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Gefen N, Rigbi A, Weiss PL. Predictive model of proficiency in powered mobility of children and young adults with motor impairments. Dev Med Child Neurol 2019; 61:1416-1422. [PMID: 31115048 DOI: 10.1111/dmcn.14264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2019] [Indexed: 02/03/2023]
Abstract
AIM To identify variables that can predict proficiency in powered mobility use for children in young adults. METHOD Participants included 80 children and young adults (42 males, 38 females; mean age 10y 2mo, [SD 5y 1mo]; range: 2-22y) with cerebral palsy, neuromuscular disease, and spinal cord injury who participated in the ALYN Hospital Powered Mobility Lending Program from 2009 to 2016. Data were collected and compared before and after participation in the program and powered mobility levels were determined by the Israeli Ministry of Health (MOH) Powered Mobility Proficiency Test. Multivariate logistic regression analysis followed by a bootstrapping procedure that was based on 1000 samples were used to determine if the variables were predictive of success on the Israeli MOH Powered Mobility Proficiency Test. RESULTS Significant variables for predicting success were identified: manual wheelchair propulsion, go-stop voluntarily upon request, and using a joystick. The model was able to correctly identify 80% of the children. INTERPRETATION Children and young adults with the ability to go-stop upon request, propel a manual wheelchair short distances, and use a joystick to activate the powered wheelchair had a higher chance of becoming proficient. In countries where wheelchair proficiency is a requirement for powered wheelchair procurement, these findings may support policy changes, as they did in Israel. WHAT THIS PAPER ADDS Using powered wheelchairs offers children earlier and more natural practice to determine driving proficiency. Manual wheelchair propulsion, go-stop voluntarily upon request, and using a joystick were predictors of powered mobility proficiency. More than 80% of children use a joystick with their hand to activate a powered wheelchair.
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Affiliation(s)
- Naomi Gefen
- ALYN Hospital, Jerusalem, Israel.,Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Amihai Rigbi
- Faculty of Education, Beit Berl College, Kfar-Sava, Israel
| | - Patrice L Weiss
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
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Kenyon LK, Jones M, Breaux B, Tsotsoros J, Gardner T, Livingstone R. American and Canadian therapists' perspectives of age and cognitive skills for paediatric power mobility: a qualitative study. Disabil Rehabil Assist Technol 2019; 15:692-700. [PMID: 31299867 DOI: 10.1080/17483107.2019.1606858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To explore the views of paediatric occupational therapists and physical therapists in Canada and the USA related to (1) the rationale for the age at which power mobility is considered for children and (2) the cognitive skills considered when trialling power mobility.Materials and methods: This study was part of a larger web-based survey study and analyzed responses to two open-ended survey questions: one related to age and one related to cognitive skills. Data were analyzed using the constant comparative method.Results: Analysis revealed four unique themes in the question related to age: (1) 'Power Mobility Should be Introduced at a Specific Age or Stage'; (2) 'Child Requirements'; (3) 'Developmental Impact of All Forms of Independent Mobility'; and (4) 'Benefits of Power Mobility'. In the question concerning cognitive skills, two unique themes were identified: 'Cognitive Skill Requirements?' and 'Non-Cognitive Requirements'. Two additional themes were identified in both questions: ('Non-child Requirements' and 'Power Mobility Trials, Use, and Options Are Dependent on Age and Goal').Conclusions: Data indicate wide variability in respondents' views related to the provision of power mobility. Additional research is needed to explore both therapists' reasoning regarding power mobility use for children and how to best facilitate knowledge translation in this area.Implications for RehabilitationWide variability exists related to the provision of power mobility for children.Children's age or stage in life influences therapists' consideration of power mobility.Many respondents considered cognitive skills when trialling power mobility but some did not.
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Affiliation(s)
- Lisa K Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Maria Jones
- Department of Physical Therapy, Oklahoma City University, Oklahoma City, OK, USA
| | - Becky Breaux
- Assistive Technology Partners, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA
| | - Jessica Tsotsoros
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Tonya Gardner
- Outpatient Pediatric Rehabilitation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Roslyn Livingstone
- Therapy Department, Sunny Hill Health Centre for Children, Vancouver, BC, Canada
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Kenyon LK, Schmitt J, Otieno S, Cohen L. Providing paediatric power wheelchairs in the USA then and now: a survey of providers. Disabil Rehabil Assist Technol 2019; 15:708-717. [DOI: 10.1080/17483107.2019.1617358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Lisa K. Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Jerika Schmitt
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Sango Otieno
- Department of Statistics, Grand Valley State University, Allendale, MI, USA
| | - Laura Cohen
- Rehabilitation & Technology Consultants, LLC, Arlington, VA, USA
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21
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Rodby-Bousquet E. The gap between current knowledge and clinical practice in childhood disability. Dev Med Child Neurol 2018; 60:969-970. [PMID: 29998559 DOI: 10.1111/dmcn.13971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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