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Aim: Trauma-informed care (TIC) is a strengths-based organizational approach which recognizes the prevalence and impact of trauma on an individual's neurological, sensorimotor, and emotional responses and development. There is limited research on pediatric occupational therapy providers' (OTPs) and physical therapy providers' (PTPs) perceptions on incorporating TIC into their practice. This pilot study aims to describe the confidence, attitudes, barriers, and education of pediatric OTPs and PTPs regarding TIC. Method: OTPs and PTPs (n = 87) working in pediatric settings in the U.S. completed an electronic survey regarding their perceptions of TIC. Results: OTPs reported higher confidence in TIC compared to PTPs. Most participants reported favorable attitudes toward TIC, yet no statistical significance was identified between the two professions' overall attitudes toward TIC. Collectively, participants reported lack of time and training as barriers. There was a statistically significant difference between how the two professions rated competency, training, and concern over clients' retraumatization. There was significant association between years of professional experience and TIC education. Conclusion: Preliminary findings indicate an overall agreement of OTPs and PTPs with principles of TIC and common barriers to TIC practice. There are implications to further integrate opportunities for TIC training into foundational education and professional practice. [ABSTRACT FROM AUTHOR]

Introduction: Musculoskeletal pain affecting children is common. Rehabilitation and treatment effectiveness can be influenced by multiple individual and contextual factors. The need for more rigorous evaluation of physiotherapy treatment for children's pain, identification of the role of specific techniques, and exploration of the influence of the therapeutic alliance is needed. This scoping review of research aimed to examine: (1) What are the perceptions of children, parents, and physiotherapists about the importance of therapeutic alliance during musculoskeletal pain treatment? (2) What are the key characteristics of therapeutic alliance during a child's musculoskeletal pain treatment from the perspectives of children, parents, and physiotherapists? and (3) What are the perceived impacts of therapeutic alliance (positive and negative) during a child's physiotherapy treatment for musculoskeletal pain? Methods: The scoping review, based on Arksey and O'Malley's framework and reporting was guided by PRISMA-ScR. The search strategy was based on three concept blocks: (1) Study population: Children (<18 years); (2) Medical condition: Any musculoskeletal pain (acute, chronic primary, chronic secondary); (3) Intervention: Qualitative exploration of experience of physiotherapy treatment delivered by a physiotherapist from the perspective of a child, parent, or physiotherapist. The search (no date limit) was conducted in February 2024 across Medline, AMED and CINAHL. Results: Following duplicate removal and assessment of eligibility of the initial 236 articles, nine articles were included; of these, only one specifically aimed to explore therapeutic alliance and it was the only paper to directly mention therapeutic alliance. All nine articles presented the child's experience. One overarching theme "Finding resilience within me through therapeutic alliance" and three main themes: "A trusted guide through the ups and the downs of rehabilitation"; "Having a route map"; and "Take me seriously but make it fun" were identified. Discussion: Therapeutic alliance was considered important by children, parents and physiotherapist and it influenced child and parent perceptions of physiotherapy and overall treatment outcomes. Physiotherapists can foster the children's resilience when experiencing musculoskeletal pain by providing disciplinary expertise, connecting and collaborating with the child by becoming their trusted guide, and co-creating a route map for rehabilitation by helping them to learn about their body, pain and recovery timeline. [ABSTRACT FROM AUTHOR]

This study aimed to examine physical therapists' perspectives in conservative treatments of pediatric patients with adolescent idiopathic scoliosis (AIS). A cross-sectional survey design was used. A validated questionnaire was distributed to physical therapists, and the responses were analyzed. Preferred treatment frequency was 60 minutes (53.8%), twice weekly (41.5%), over 3 to 5 months (44.6%). Top 3 clinical interventions were core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%), and postural correction (80.0%). Top 3 therapeutic goal-setting parameters were activity-based (78.5%), quality-of-life measure-based (56.9%), and participation-based (50.8%). The most common quality-of-life survey used was Oswestry low back pain disability questionnaire (15.6%) followed by Scoliosis Research Society-22 instrument (12.5%). According to our data, physical therapists believe that pediatric patients with AIS can benefit with addressing core and trunk stability, a 60-minute per session, twice weekly, over 3 to 5 months based on activity-based goal-setting and quality-of-life measures using Oswestry questionnaire. [ABSTRACT FROM AUTHOR]

Identify the perceptions and experiences of how UK entry-level programs educationally prepared pediatric physiotherapists for their first clinical role. Review the extent programs taught essential, recommended, and additional content as per the International Organisation of Physical Therapists in Pediatrics (IOPTP). Mixed methods design involving qualified UK pediatric physiotherapists. Forty-two physiotherapists completed an online questionnaire and nine (21%) completed a follow-up semi-structured interview. All 42 respondents felt they were "Not Well" (median 2, IQR 1.75–2.75) prepared for clinical practice. Not enough curricula emphasis was given to pediatric content (100%), with 31% (n = 13, CI 95% 19–46) reporting no pediatric content throughout their program. Only 15 (36%, 23–51) respondents experienced a pediatric placement. Themes from the follow-up interviews were (1) UK programs are adult focused; (2) placements are the only meaningful opportunity to develop competency; (3) programs lacked non-clinical content; and (4) experiencing pediatric patients was overwhelming due poor preparation. The majority of the IOPTP curriculum guidance is not embedded within UK curriculums. Respondents reported they were not well prepared for pediatric clinical practice. Some entry-level programs did not include any pediatric teaching throughout the entirety of the course. [ABSTRACT FROM AUTHOR]

To explore experiences, expectations, and involvement of children and young people (CYP) in decision-making for selective dorsal rhizotomy (SDR) surgery, post-operative physiotherapy treatment and outcomes. A qualitative study design using one to one interviews. Five CYP (2 girls and 3 boys) participated, and interviews lasted between 45 min and 2 h. Data were analyzed using thematic analysis. Children and young people are reliant on their parents to make decisions and inform them of the SDR process. Experiences of living with cerebral palsy and its management are centered on their routine social, psychological, and physiological challenges. Individual characteristics and attributes of CYP have an impact on how they cope with the rehabilitation burden and adjust to their changing levels of function and participation. Although CYP reported that SDR offers them a greater 'freedom to choose' in how they participate in daily life, further consideration is required to meet their psychosocial needs, particularly in preparing for SDR and adjusting afterwards. [ABSTRACT FROM AUTHOR]

Background and purpose: Diversity within the physical therapy profession lags in comparison to the United States population. As the profession strives to diversify, faculty must pay attention to diversity, equity, inclusion, and belonging (DEI-B) in curricular approaches, including classroom materials, instruction, and assessment. With critical application, students from equity-deserving groups (EDGs) can provide unique perspectives to faculty about curricular approaches. Case study purposes were to 1) enable students from EDGs to partner with faculty, as student pedagogical consultants (SPCs), in 2 courses in a Doctor of Physical Therapy program to provide feedback on DEI-B efforts related to curricular approaches and 2) describe the outcomes of SPCs experience. Case description: Eight female students from EDGs partnered with 3 White, female, faculty members in 2 courses: pediatrics and neurorehabilitation. Two SPCs teams observed the classrooms, met with faculty, and administered two-minute papers to classmates to gather feedback on DEI-B curricular approaches. Faculty and student SPCs wrote reflective papers, postproject, documenting their experiences. Outcomes: Themes informed a conceptual framework describing SPCs: 1) motivation for engaging in partnership; 2) creation of a pedagogical partnership space to promote dialogue and problem-solve barriers to DEI-B; 3) deeper understanding of teaching; 4) transfer of learning from the SPC experience to future work locations; and 5) faculty modification of teaching. Discussion and conclusion: Students raised awareness regarding the pain of exclusion and provided suggestions for modifying curricular approaches to consider DEI-B. Curriculum redesign using innovative strategies can meet the contemporary needs of students from EDGs. [ABSTRACT FROM AUTHOR]

Background: Physical therapy is the preferred conservative treatment for patients with temporomandibular disorder (TMD). However, few studies have investigated the application of physical therapy in adolescents, especially follow‐up studies on the long‐term prognosis of these patients. This study investigated the short‐term effects and long‐term prognosis of physical therapy in adolescent patients with TMD and the factors influencing long‐term symptoms. Methods: Information regarding baseline data, specific treatment methods, treatment times and evaluation results was collected retrospectively for adolescent patients with TMD who received physical therapy. Patients were followed up via telephone and online questionnaires, and the influence of age, sex, disease course, mouth opening, pain intensity, oral parafunctional habits and treatment methods on long‐term symptoms was analysed. Results: Pain intensity, maximum mouth opening and the joint noise score improved significantly in 270/286 patients who received individualised comprehensive physical therapy. TMD‐related symptoms improved with no noticeable impact on daily life in 187/199 patients who were followed up for an extended period (average, 30.71 ± 10.86 months) and were divided into asymptomatic or symptomatic groups according to the persistence of symptoms. Logistic regression analysis revealed that uncorrected oral parafunctional habits and fewer treatments were related to long‐term symptoms. Conclusion: The long‐term prognosis of adolescent patients with TMD after physical therapy was satisfactory. However, 52.8% of the patients experienced persistent TMD‐related symptoms for an extended period, possibly due to insufficient treatment times and parafunctional habits. Trial Registration: ClinicalTrials.gov identifier: NCT05781607 [ABSTRACT FROM AUTHOR]

Adaptive behavior consists of conceptual, social, and practical skills and describes the ability of individuals to manage environmental demands, interact with others, and engage in activities to meet ones needs. Mastery motivation is an intrinsic characteristic that enables persistence when attempting to master a skill. Children with physical disabilities often demonstrate less effective adaptive behaviors and lower mastery motivation than their peers without disabilities, which may subsequently impact development and participation in daily activities. Therefore, it may be beneficial for pediatric rehabilitation practitioners to focus intentionally on facilitating effective adaptive behaviors in children with physical disabilities as they aim to support child development and function. This perspective paper highlights the importance of adaptive behavior for children with physical disabilities, discusses methods of assessment, and illustrates intervention principles and strategies to support the development of appropriate adaptive behaviors across childhood. Key intervention principles include: 1) engage children and address motivation; 2) collaborate with others; 3) support real-life meaningful experiences; 4) scaffold the just-right challenge; and 5) guide children in discovering solutions. [ABSTRACT FROM AUTHOR]

Background: Many challenges exist in promoting inclusion in childcare settings. Adequate support from specialized professionals is necessary to create inclusive childcare settings. Understanding which services are being delivered by specialized professionals in childcare contexts is an important first step. The aim of this study was to (1) describe the services currently being delivered by specialized professionals in childcare settings in Quebec (Canada) and (2) seek childcare administrators' perspectives on their preferred services. Methods: An online province‐wide descriptive survey was conducted with childcare administrators (n = 344). Questions focused on 11 service delivery dimensions (e.g. professionals involved, children served). Descriptive statistics were calculated. Results: Childcare settings received services from a median of two specialized professionals (IQR [1–4]). Most services were delivered by early childhood special educators (61.3%), speech‐language pathologists (57.6%), psycho‐educators (43.6%) and occupational therapists (43.3%). Childcare administrators identified these four services as being particularly supportive. Professionals delivered a median of 0.4 h of service per week in each childcare setting (IQR [0.1–3.0]). A high percentage (91.2%) of administrators reported unmet needs for professional support in at least one developmental domain, with a high percentage (57.3%) of administrators identifying needs in the socio‐emotional domain. Most (63.3%) expressed a desire to prioritize services for children without an established diagnosis but identified by early childhood educators as having needs for professional support. Most administrators (71.4%) also preferred in‐context services. Conclusions: Childcare administrators perceive an important role for specialized professionals in supporting inclusion in their settings. Recommendations emerging are based on the four main professional service needs identified: (1) increasing the intensity and stability of services; (2) providing services for undiagnosed children identified by early childhood educators as having unmet needs; (3) ensuring that services encompassing all developmental domains with a focus on the socio‐emotional domain; and (4) prioritizing of in‐context services. [ABSTRACT FROM AUTHOR]

Importance: Clinicians and researchers can leverage clinical documentation of therapy services for quality improvement and research purposes. However, documentation is often institution specific and may not adequately capture the dose of therapy delivered, thus limiting collaboration. Objective: To implement documentation of pediatric occupational and physical therapy dose from one institution to another institution. Dose documentation includes the frequency, intensity, time, and type of interventions delivered (FITT Epic® Flowsheet) at each session. Design: Prospective time-series quality improvement study. Setting: Two large urban pediatric hospitals. Participants: Occupational and physical therapy staff members. Intervention: Staff training and feedback loops utilizing existing groups. Outcomes and Measures: The process measure (number of available staff trained and using the FITT Epic Flowsheet over time) and the outcome measure (percentage of FITT Epic Flowsheets used for treatment visits each month) were analyzed using a statistical process control chart. The balancing measure (percentage of notes closed before 7 p.m. on the same day as the encounter) was analyzed using mean per month across three time periods. Results: Fifty-seven staff members (68%) attended formal training. On average, clinicians documented 90% of sessions using the FITT Epic Flowsheet after implementation. There was no change observed in the balancing measure. Conclusions and Relevance: Documentation of dose was spread from one institution to another. Shared documentation will facilitate future collaboration for quality improvement and research purposes. Occupational therapy practitioners and leaders should consider implementing documentation with common dose elements. Plain-Language Summary: Occupational therapy documentation is often institution specific and may not adequately capture the dose of therapy (frequency, intensity, time) or types of interventions that were delivered, thus limiting opportunities for collaboration between institutions. This article adds to the literature on administrative supports for clinical and quality improvement research by illustrating a specific example of how documentation of dose can be shared from one institution to another. The data show that clinicians at one institution started using a new style of documentation using the FITT Epic® Flowsheet and shared discrete dose elements with another institution, creating new opportunities for collaboration. Shared documentation can facilitate future collaboration for quality improvement and research purposes. This article adds to the literature on administrative supports for clinical and quality improvement research by illustrating a specific example of how documentation of dose can be shared from one institution to another. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight. Methods: In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture. Results: A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups. Conclusions: There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5–6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity. [ABSTRACT FROM AUTHOR]

A novel entry-level collaborative clinical learning experience (CLE) in pediatric physical therapy (PT) delivered via telehealth was implemented involving 12 families, 54 DPT students, and 12 clinical instructors (CIs). Children of various ages, a wide range of home environments, and diagnoses received individualized PT via telehealth during a four-week CLE. Retrospective quantitative and qualitative analyses of student documentation, video recordings of sessions, and CI, student, and caregiver survey responses were performed. All children demonstrated qualitative improvements and 73% demonstrated quantitative improvements. CIs, students, and caregivers believed the children benefited from the experience and 98% believed the children were able to work toward their goals. Most students (95%) and CIs (100%) felt that it was a valuable and effective learning experience. Most (>71%) CIs and students believed students were able to learn in all relevant domains of the clinical performance instrument. This model provides a unique CLE for students in both pediatric PT and telehealth. [ABSTRACT FROM AUTHOR]

To identify factors and barriers, which affect the utilisation of spinal manipulation and mobilisation among infants, children, and adolescents. Twenty-six international expert physiotherapists in manual therapy and paediatrics were invited to participate in a Delphi investigation using QualtricsⓇ. In Round-1 physiotherapists selected from a list of factors and barriers affecting their decision to use spinal manipulation and mobilisation in the paediatric population and had opportunity to add to the list. Round-2 asked respondents to select as many factors and barriers that they agreed with, resulting in a frequency count. The subset of responses to questions around barriers and facilitators are the focus of this study. Twelve physiotherapists completed both rounds of the survey. Medical diagnosis, mechanism of injury, patient presentation, tolerance to handling, and therapist's knowledge of techniques were the dominant deciding factors to use spinal manipulation and mobilisation among infants, children, and adolescents across spinal levels. More than 90% of the respondents selected manipulation as inappropriate among infants as their top barrier. Additional dominant barriers to using spinal manipulation among infants and children identified by ≥ 75% of the respondents included fear of injuring the patient, fear of litigation, lack of communication, lack of evidence, lack of guardian consent, and precision of the examination to inform clinical reasoning. This international survey provides much needed insight regarding the factors and barriers physiotherapists should consider when contemplating the utilisation of spinal mobilisation and manipulation in the paediatric population. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study is to compare the ergonomic risk levels, musculoskeletal complaints and quality of life of physiotherapists (PTs) according to their field of work. Methods. A total of 107 volunteer PTs participated in the study, whose information was recorded. Ergonomic risk levels were determined using rapid entire body assessment (REBA). Complaints about the musculoskeletal system of PTs were evaluated with the Cornell musculoskeletal discomfort questionnaire (CMDQ) and quality of life was evaluated by the Nottingham health profile. Results. PTs who worked with pediatric patients (Grouppediatric; n = 47) were younger (p<0.001). PTs who worked with adult patients (Groupadult; n = 60) had a higher daily number of patients (p<0.001). The REBA score did not make a difference between the groups (p = 0.379). The difference was found in the upper back region of the CMDQ (p<0.05). There was no difference between groups for quality of life (p>0.05). Conclusions. Grouppediatric may be working in ergonomically demanding positions, although there is no statistical difference. The injury sites of the musculoskeletal system can differ. However, the reflection of musculoskeletal system problems on quality of life does not show any difference between the groups of PTs. [ABSTRACT FROM AUTHOR]

Background: A significant proportion of children and adolescents experience back pain. However, a comprehensive systematic review on the effectiveness of rehabilitation interventions is lacking. Objectives: To evaluate benefits and harms of rehabilitation interventions for non-specific low back pain (LBP) or thoracic spine pain in the pediatric population. Methods: Seven bibliographic electronic databases were searched from inception to June 16, 2023. Moreover, reference lists of relevant studies and systematic reviews, three targeted websites, and the WHO International Clinical Trials Registry Platform were searched. Paired reviewers independently conducted screening, assessed risk of bias, and extracted data related to study characteristics, methodology, subjects, and results. Certainty of evidence was evaluated based on the GRADE approach. Results: We screened 8461 citations and 307 full-text articles. Ten quantitative studies (i.e., 8 RCTs, 2 non-randomized clinical trials) and one qualitative study were included. With very low to moderate certainty evidence, in adolescents with LBP, spinal manipulation (1–2 sessions/week over 12 weeks, 1 RCT) plus exercise may be associated with a greater likelihood of experiencing clinically important pain reduction versus exercise alone; and group-based exercise over 8 weeks (2 RCTs and 1 non-randomized trial) may reduce pain intensity. The qualitative study found information provided via education/advice and compliance of treatment were related to effective treatment. No economic studies or studies examining thoracic spine pain were identified. Conclusions: Spinal manipulation and group-based exercise may be beneficial in reducing LBP intensity in adolescents. Education should be provided as part of a care program. The overall evidence is sparse. Methodologically rigorous studies are needed. Trial registration: CRD42019135009 (PROSPERO) [ABSTRACT FROM AUTHOR]

Objective The implementation of early rehabilitation programs based on evidence to improve the movement abilities of preterm infants is of particular importance. The evidence about rehabilitation interventions in improving the motor development of preterm infants is diverse and scattered and there is heterogeneity in the type, dose and time of therapeutic interventions. Therefore, the purpose of this review study is to identify the types of rehabilitation interventions (occupational therapy and physiotherapy) in improving the motor skills of infants hospitalized in the intensive care unit. Materials & Methods This is a scoping review study. Research studies and indexed in scientific databases including were available in PubMed/Web of Science/Scopus or retrieved by Google Scholar search engine were searched and reviewed. Inclusion criteria included the report of studies in English and Persian papers published from 2000 to 2023 that were mainly focused and the main subject of early rehabilitation intervention studies (occupational therapy and physiotherapy) on the development of neuromotor skills of preterm infants in the neonatal intensive care unit. After selecting the keywords and organized search, the found articles were matched with the entry criteria and finally considered studies were selected. Results Among the reviewed studies, 15 studies met the inclusion criteria. Among the available studies, 7 studies related to multi-modal interventions and 2 studies related to multi-sensory intervention .2 studies related to neuro-developmental interventions. 2 studies related to interventions implemented by parents--administered. 2 studies related to interventions supporting play exploration and early developmental intervention. Conclusion Based on the findings of this research and the meetings held with experts in this field, we were able to organize early rehabilitation interventions for motor skills of preterm infants in 4 groups: 1) multimodal and multisensory interventions 2) neurodevelopmental interventions 3) parentsadministered interventions 4) supporting play exploration and early developmental intervention to categorize. In this way, all types of therapeutic interventions in improving motor skills of infants were identified. Most of the studies included interventions that were performed in a short period of time and reported short-term effects on motor improvement. Only the supportive play exploration intervention continued after discharge and bridged the gap of early NICU-to-home interventions and reported improved motor development in the short- and long-term (6, 12 months). [ABSTRACT FROM AUTHOR]

This study aimed to examine the effectiveness of an interprofessional telehealth course developed based on a collaborative needs assessment of professionals working in community-based child-development units. Ninety-six pediatric therapists, including psychologists, social workers, speech-language pathologists, physiotherapists, and occupational therapists, participated in a 10-week, 30-hour online training on best practices in telehealth delivered according to adult learning theory guidelines. Participants reported their telehealth competencies before and after the training using a questionnaire developed for the study. Repeated paired t-tests showed significant increases with high effect sizes in participants' knowledge, attitudes, emotions, and willingness to use telehealth in their practices. However, at follow-up, the implementation rates remained low. Online learning tailored to learners' needs can change knowledge, attitudes, and willingness to incorporate telehealth into routine care. Collaboration among regulators, foundations, professional associations, and clients attuned to health care's changing needs is essential to providing solutions and boosting the quality of rehabilitation services. However, providing knowledge alone is not enough: Sustainable implementation planning is essential for knowledge translation. Telehealth can enhance access to rehabilitation services, but providers require training to promote knowledge, attitudes, and willingness to incorporate telehealth into routine care. Effective training should be based on collaboration among all stakeholders, from needs assessment and content development to implementation and devising a plan to translate sustainable knowledge into rehabilitation. Training courses should combine content on best practices with a delivery approach based on adult learning principles. To translate knowledge into practice, the course must be a part of a sustainable implementation plan at the workplace. [ABSTRACT FROM AUTHOR]

School-based physical therapists (SBPTs) rapidly transitioned to telehealth during the pandemic. This study explored the perceptions of, and strategies utilized by, SBPTs delivering therapy via telehealth. Using a grounded theory qualitative design, semi-structured interviews were completed with 13 SBPTs. Interviews were transcribed and theme coded until saturation was achieved. The following themes emerged: supports and education, challenges, strategies promoting success, and the outcomes of telehealth. SBPTs overcame challenges including those associated with technology, communication, space, equipment, and examination. Coaching techniques, incorporation into the daily routine, and the sharing of demonstrations promoted success. Telehealth service delivery was perceived to improve communication with educational teams and families, improve efficiency and productivity, increase access to students, promote an appreciation of the family and home context, and enhance family engagement. SBPTs believe incorporating elements of telehealth in conjunction with in-person delivery is ideal. While the COVID-19 pandemic forced a rapid transition to telehealth for SBPTs, lessons learned could have a long-lasting positive impact on school-based services. The benefits of telehealth should be considered in the delivery of school-based physical therapy services. [ABSTRACT FROM AUTHOR]

To compare the effects of backward (BW) and forward (FW) walking training on back geometry and mobility function in children with hemiparetic cerebral palsy (CP). Fifty-five children with hemiparetic CP participated in this study. They were randomly assigned into two groups. For 12 weeks, both groups got a conventional physical therapy program three days/week. Groups A and B got a specifically developed FW walking training (25 minutes/session) and a specially designed BW walking training (25 minutes/session), respectively. The trunk imbalance, lateral deviation, pelvic tilting, pelvic torsion, surface motion, and dynamic gait index of group B improved significantly more than group A (p <.05). Both groups showed significant improvements in all measured variables (p <.05). BW walking training might be considered as an effective therapy modality for improving back geometry and mobility function in hemiparetic CP children compared with FW walking training combined with a typical program. [ABSTRACT FROM AUTHOR]

Background: The purpose of this review is to explore the evidence and efficacy of two trends in early childhood intervention services: the family-centered model and the use of tele-intervention. Methods: A systematic review was carried out following the PRISMA methodology and using three databases: Web of Science, PubMed and Scopus. The studies included were those aimed at children from 0 to 6 years of age, focused on early intervention, and which alluded to the family-centered model and/or tele-intervention. Results: a total of 33 studies were included. Five main themes were identified: (1) The participation of children and family is facilitated and improved by the family-centered model of care; (2) the feeling of competence, self-efficacy, satisfaction and empowerment in professionals and families have a positive impact on quality of life; (3) the use of tele-intervention as a tool for prevention and intervention; (4) preparation for telepractice can improve the development of commitment; (5) tele-intervention as a possible solution to contextual barriers. Conclusions: Tele-intervention in pediatrics is presented as a tool inherent to the family-centered model since its implementation involves several common strategies. Future lines of research should explore the use of this tool as a possible solution to contextual barriers. [ABSTRACT FROM AUTHOR]

Trunk control may influence self-care, mobility, and participation, as well as how children living with cerebral palsy (CP) move around. Mobility and Gross Motor performance are described over environmental factors, while locomotion can be understood as the intrinsic ontogenetic automatic postural function of the central nervous system, and could be the underlying element explaining the relationship between these factors. Our goal is to study the correlation among Trunk Control Measurement Scale (TCMS) and Pediatric Evaluation of Disability Inventory (PEDI) domains, as well as Locomotor Stages (LS). Methods: A feasibility observational analysis was designed including 25 children with CP who were assessed with these scales. Results: The strong correlation confirms higher levels of trunk control in children with better self-care, mobility and participation capacities. Strong correlations indicate also that higher LS show better levels of PEDI and TCMS domains. Conclusions: Our results suggest that more mature LS require higher levels of trunk control, benefitting self-care, mobility and social functions. [ABSTRACT FROM AUTHOR]

Aims: To examine the extent to which physical therapy at a local tertiary teaching clinic enables best practice and to identify priority areas for service redesign. Methods: A retrospective file review of clinical records of patients receiving physical therapy (n = 237) from 2011 to 2015 in Manila, Philippines. Data on clinical diagnosis, interventions, parameters of episode of care, goals and outcome measures were extracted and coded by trained researchers using a standardised form. Results: Most patients (n = 229, 97%) had developmental conditions. Active interventions were employed (n = 236, 99%) and self-management plans appeared in 161 (68%) records. The duration of the episode of care was variable (median = 16 months, range = 1–139). Almost all patients (n = 230, 97%) commenced with weekly sessions, with the total number of sessions ranging from 1 to 150 (median = 15). Therapy goals were reported routinely (n = 236, 99%). Objective measures were recorded in 209 (88%) records at baseline and in 136 (57%) records at follow-up. The time point for outcome assessment was inconsistent (range = <1–36 months). Conclusions: Service delivery at the clinic requires more robust longitudinal management procedures, streamlined mechanisms for monitoring and better involvement of the family in decision-making. Some elements of existing practice (active, self-management approaches) suggest the adoption of best practice principles. Results contribute to 'idea generation' for service redesign. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to 1) explore the experiences and perceptions of pediatric physical therapists (PTs) and occupational therapists (OTs) who use FES in their practice, and 2) provide recommendations for overcoming common barriers to FES implementation. Methods: Eight Canadian PTs (n = 6) and OTs (n = 2), who use FES in their pediatric practice, participated in semi-structured interviews. Open-ended questions queried the motivation, goals, perceived benefits and challenges, and facilitators and barriers of FES use. Interviews were audio recorded and transcribed verbatim. Interpretive description was used to analyze the transcripts. Results: One overarching theme emerged: FES is a useful adjunct to therapy for certain pediatric clients. Four sub-themes were identified: Participants described 1) motivation for incorporating FES into clinical practice, which led to 2) experiences with the implementation of FES in clinical practice, including strategies for overcoming implementation barriers. These experiences influenced 3) how FES is used in practice (e.g. for which populations and therapeutic goals), and informed 4) recommendations for pediatric FES practice (e.g. more educational opportunities, research, and access for families). Conclusions: Pediatric PTs and OTs who use FES in clinical practice view FES as a valuable adjunct, especially for motor training to improve functional skills. [ABSTRACT FROM AUTHOR]

This qualitative study explored therapists' use of instructions and feedback when teaching motor tasks to children with developmental coordination disorder (DCD) as a first step in developing practical recommendations. A conventional content analysis approach was used to analyze videotaped treatment sessions of physical therapists using a newly developed analysis plan. Inductive coding was used to code purposively selected video segments. The codes were sorted into categories to identify key themes. Analyses were performed independently by two researchers until data saturation was reached. Ten video-taped sessions were analyzed and 61 segments were coded. Three key themes were identified: (1) therapists' intention with the instructions and feedback was to motivate or to provide information; (2) the preferred therapists' teaching style was either direct or indirect; and (3) parameters to shape specific instructions and feedback were the focus of attention, modality, information content, timing and frequency. Therapists used numerous instructions and feedback with different information content, often shaped by multiple focuses and/or modalities to motivate children or to provide specific information about task performance. Although therapists adapted instructions and feedback to child and task, future research should explore how characteristics of child and task can guide therapists' clinical decision-making. [ABSTRACT FROM AUTHOR]

Background and Purpose: To identify the paediatric curriculum content covered in entry‐level physiotherapy programs within the United Kingdom (UK), and report faculties perceived importance. Strengths, weaknesses, barriers and facilitators, to the implementation of paediatric content were explored. Methods: A cross‐sectional online questionnaire captured entry‐level physiotherapy programme leaders' perceptions of paediatric programs. Results: Fifty‐five responses were submitted, providing a 67% completion rate. Faculty perceived that students' felt the inclusion of paediatric content within the curricula was 'Important' (Mean 3.60 ± SD 0.74). Of 30 diagnoses surveyed, only two were covered 'Well' within curriculums, despite 23 rated at least 'Important' by respondents. Of the 18 assessment/examination components, 13 were covered 'Well' with five 'Somewhat'. All were considered to be at least 'Important'. Perceived strengths were grouped into three main categories (1) integrated/lifespan approach, (2) links to clinical specialists, and (3) a broad/detailed curriculum. Perceived weaknesses included curriculum time pressures and paediatric placement availability. Discussion: The majority of paediatric conditions were only somewhat covered by UK curriculums, despite respondents in the main believing they should be an important element of the entry‐level syllabus. Some UK physiotherapy entry‐level students may not be exposed to any paediatric teaching or clinical placements. [ABSTRACT FROM AUTHOR]

Background and Objective: An abnormality in muscular tone, lack of postural control, and a lack of coordination are all linked to the retention of primitive and immature postural reflexes. The Purpose of this study aimed of detecting which therapeutic approach is more effective in integrating retained primitive reflexes, either Masgutova neuro‐sensorimotor reflex integration or Sensory integration (SI) program. Methods: Forty children with spastic diplegic cerebral palsy (CP) (11 girls and 29 boys), involved in the current study and their ages ranged from 3 to 6 years old. They were divided at random into two groups (A and B), patients in the study group (A) (n = 20) were treated by Masgutova neuro‐sensorimotor reflex integration program (MNRI) while those of study group (B) (n = 20), were subjected to Sensory integration program (SIP), A standardized physical treatment regimen was provided to both groups (Stretching exercise, Strengthening exercise, and facilitation of developing motor milestones) All children were evaluated by using GMFM‐88 and (PDMS‐2) reflexes subtest before and after treatment that lasted for three successive months at a frequency of three sessions per week. Results: There was a statistically substantial increase in GMFM scores and control of primitive reflexes post treatment in each group compared to those of the pretreatment mean values (p > 0.05). There was also a statistically non‐significance difference between group A and group B regarding post treatment results (p > 0.05). Implications on Physiotherapy Practice: SI and MNRI programs can equally be used in the treatment of children with spastic CP who suffer from retained primitive reflexes and delayed gross motor function. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to understand the Neonatal Intensive Care Unit (NICU) healthcare providers' (HCPs) experiences and needs during their own past, present and desired pregnancies. It has been reported that HCPs' personal and professional lives are mutually interconnected. Given the NICU HCPs' knowledge of the risks and potential adverse outcomes of newborns admitted to the NICU, their pregnancy experience may be more challenging than that of the general population. However, to date, these aspects are still little studied. Design: A qualitative descriptive study design was adopted. Methods: Semi‐structured interviews were conducted between January and April 2021 in a single third‐level NICU in northeastern Italy. Transcripts were analysed using inductive content analysis. Findings are reported according to the COREQ guidelines. Results: Nineteen HCPs participated in this study. Participants included 12 nurses, 6 medical doctors, and 1 paediatric physical therapist. All participants reported that their professional knowledge and experience influenced their pregnancy‐related experiences, emotions and behaviours. Some participants employed adaptive coping strategies, while others were likely to experience post‐traumatic stress reactions. The narratives of the men and women were similar. Three themes were identified: 'Feeling different'; 'Influence of work experience on decision‐making'; 'Coping with difficulties'. Conclusion: To reduce the potential impact of NICU HCPs' work experience on pregnancy, family functioning and infant health, management of parental emotions should be considered for this population. Impact: Hospital managers could prevent the potential distress of vulnerable NICU healthcare workers during pregnancy by tailoring interventions aimed at supporting them in becoming aware and making sense of their work experiences or sensitizing individual psychological support. Moreover, university students should be offered self‐help strategies to face potential dual role conflicts in their future careers. Patient and Public Involvement: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: Parental involvement in pediatric physiotherapy is a fundamental component of the family-centered paradigm and falls within the contemporary interdisciplinary model of early intervention. The active participation of parents in the therapy process augments its efficacy. The personal trait of resilience significantly increases the likelihood of parental involvement. This study aims to examine the correlation between resilience and the extent of carer involvement in a child's physiotherapy. Material and methods: We conducted a survey involving 41 carers of children with developmental disabilities who were undergoing the physiotherapy process. Diagnostic survey methods were employed to gather data, utilizing the following instruments: Resilience Scale 25, the Author's Survey Questionnaire for Child Carers, and the Author's Survey Questionnaire for Physiotherapists. Results: The findings indicated a relationship between resilience and the level of involvement in the child's physiotherapy process. Resilience-enhancing factors such as openness to experience, a sense of humour, proactive coping strategies, and perseverance were identified as significant contributors. Conclusions: Resilience can play a pivotal role in determining the degree of carer involvement in a child's physiotherapy. Parents should actively participate in the therapeutic process. Workshops to cultivate resilience should be included in the support offer, as they can enhance the prospects of therapeutic success. Trust-based, empathetic communication with the physiotherapist is vital during the rehabilitation process, fostering parental competence and instilling a sense of parental empowerment. [ABSTRACT FROM AUTHOR]

The inclusion of families in intervention programs for infants may be more effective in ensuring adherence and positive outcomes. Approaches that include natural and enriched environments that provide communication and family interaction are important in the rehabilitation of high-risk infants. To compare the effectiveness of Family Collaborative Approach (FCA) and Neurodevelopmental Therapy (NDT)-based family training. High-risk infants (n = 63) with a mean age of 32.60 ± 4.53 months received early intervention for 12 weeks. Prechtl's General movements (GMs) assessment, Hammersmith Neonatal Neurological Examination (HNNE), Hammersmith Infant Neurological Examination (HINE), BAYLEY-III Scales of Infant and Toddler Development, and Third Addition (BSID-III) were performed. Significant differences between groups were found in HINE scores at the 3rd, 6th, and 12th months (p ≤.028), and in BSID-III scores at the 6th month (cognitive, language, and motor) (p <.001) and the 12th month (language) (p =.031). There was significant difference between NDT and control group in 3rd month HINE scores and Reflex&Reactions scores (p ≤.021). FCA group and NDT group was significantly different from control group in 6th month HINE (p =.032) and 12th month HINE scores (p =.007). FCA group significantly different from NDT group (p ≤.002) and control group (p <.001) in 6th month BSID-III cognitive, language, and motor scores. There was significant difference between FCA and control group in 12 month BSID-III language scores (p =.024). Early physiotherapy interventions were effective in high-risk infants and FCA program was superior to NDT. [ABSTRACT FROM AUTHOR]

The literature is lacking in studies about what specific types of learning activities are most effective for adult learners. To examine the effectiveness of a learning activity with patient interactions as compared to a learning activity without patient interactions. A convenience sample of third year Doctor of Physical Therapy students participated in this retrospective cross-sectional study (n = 47). Data were a clinical reasoning assignment, the Andragogy in Practice Inventory (API) and Intent to Use Scale, and the Behavioral Engagement Related to Instruction (BERI) protocol. Data analysis included descriptive frequencies, paired t-tests, Wilcoxon Signed Rank Tests and Multivariate Analysis of Variance. Significant differences were noted between the learning activity with and the learning activity without patient interaction on several API subscales: prepare the learner, climate setting, setting of objectives and learning activities as well as in the conceptual reasoning area of the clinical reasoning assignment (p =.005, p =.036, p =.002, p =.047, and p =.038, respectively). No other significant differences were noted in other outcome variables. No significant influence of age or gender was found. This study demonstrated that, overall, both the with and without patient interaction learning activities were compatible with the preferences of the adult learner. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep bruxism has been associated with temporomandibular dysfunction, pain, fatigue, and poor sleep quality. OBJECTIVE: The aim of this study was to determine the gender and age distribution of sleep and oral habits of children with sleep bruxism and to examine the effect of a sleep hygiene and physiotherapy program. METHODS: In this cross-sectional study, 82 children aged 6–13 years with sleep bruxism were initially screened between March 2020 and June 2021, from which 37 of them voluntarily attended an 8-week sleep hygiene and physiotherapy program. Evaluations were made using a Visual Analogue Scale (VAS), the Children's Sleep Habits Questionnaire (CSHQ), and the Oral Habits Questionnaire (OHQ) at the beginning and at the end of the 8-week program. RESULTS: Statistically significant differences were determined between the 6–9 years and 10–13-year age groups in respect of the sleep habits subcategories of resistance to bedtime (p = 0.001), sleep anxiety (p = 0.043), parasomnia (p = 0.040), and sleep respiratory disorder (p = 0.041). Following the 8-week treatment program, a significant reduction was obtained in the VAS value (p < 0.05), CSHQ subcategories of resistance to bedtime (p = 0.001), sleep duration (p = 0.008), parasomnia (p = 0.000), and in the OHQ score (p = 0.000). CONCLUSION: There was no relationship between sleep bruxism and gender, but a relationship was found with age. The rate of bruxism was seen to decrease with an increase in age. It was determined that oral, sleep habits, and bruxism are closely related, and the rates at which bruxism is seen are affected by the oral habits. Sleep hygiene and physiotherapy have been effective in children with sleep bruxism. [ABSTRACT FROM AUTHOR]

The aims of this study were to explore perceptions of school-based physical therapists (SBPTs) about professional development and effective practice and to create a conceptual framework to help understand how SBPTs become effective practitioners who continue to learn and grow professionally as clinicians in an educational setting. Twenty school-based physical therapists completed a demographic questionnaire and a semi-structured interview. Guiding interview questions focused on SBPTs' perceptions of roles and responsibilities, professional development, barriers, and recommendations. Participants identified roles and personal qualities of effective SBPTs. Three concepts for the process of professional development were developed: educational context and culture, barriers to effective practice, and strategies for professional development. The development of effective practice for SBPTs is a multifaceted, iterative process involving a unique set of knowledge, skills, and behaviors that allow them to fulfill their roles. The process takes time and effort to understand the self within the educational context and culture, recognize barriers to effective practice, and develop strategies for success. A conceptual framework was developed to assist SBPTs in implementing a plan for professional development that leads to effectively providing services to students and functioning as essential members of the educational team. [ABSTRACT FROM AUTHOR]

The aim of the review was to evaluate the evidence regarding the effectiveness of aquatic rehabilitation based on the Halliwick concept (HC) in psychomotor development, gross motor function and aquatic skills of children with cerebral palsy. We followed PRISMA recommendations, performing a systematic search in PubMed, Science Direct, LILACS, SciELO, and PEDro database. We identified 474 studies; five met the eligibility criteria and were included in the review. Four studies demonstrated a significant improvement in gross motor function and aquatic skills. Social interaction skills were also improved. However, the methodological quality of these studies was limited, and then, research that adopt controlled experimental designs are necessary. [ABSTRACT FROM AUTHOR]

This case study explores the use of a personalized, adjustable Kinect exergame in 10 physiotherapy sessions for a 10-year-old girl with incomplete right-sided obstetric brachial plexus palsy (OBPP). The aim was to observe the impact on the patient's upper limb mobility that could be achieved through maximization of the player's motivation, possibly due to continuous game parameter adjustments. It had been achieved that the patient was playing 87% of the total gaming time with a personally challenging setting that increased her arm speed from one to four movements. Strength in abduction and flexion were increased by 8 N and 7 N, respectively. Furthermore, the patient showed better muscular balance and an increase of 50% in speed of the Jebsen-Taylor hand function test (JTHFT). The patient reported high levels of motivation, low perception of fatigue, and just slight discomfort. The study found that the use of personalized video games as a complement to conventional physiotherapy can be successful in OBPP patients when the game allows for the adjustment of the difficulty level as a response to personal performance. Predefined difficulty levels and automatic performance analysis can be helpful. Results are promising; however, further research is needed to confirm the results. [ABSTRACT FROM AUTHOR]

This review aimed to assess the utility of the Peabody Developmental Motor Scale-2 (PDMS-2) as an outcome measure for evaluating the motor performance of children. A comprehensive search strategy was employed, utilizing Google Scholar, PubMed, and PEDro databases from 2010 to April 2021, focusing on studies incorporating PDMS-2 in pediatric physical therapy. Text words and medical subject headings terms guided the search process. Nineteen selected studies underwent evaluation using the PEDro checklist, where scores ranged from 0 to 10. Scores of 0–3 were deemed poor, 4–5 fair, 6–8 good, and 9–10 excellent. Results revealed varying levels of methodological quality among the studies: 3 scored fair (5/10), 3 scored good (6/10), and 8 achieved a good rating (8/10). Furthermore, 4 studies received a high rating (9/10), while 1 study attained an excellent score (10/10). These scores reflected the internal and structural validity of the individual studies. The synthesis of findings suggests that PDMS-2 emerges as a reliable and valid assessment tool for measuring motor proficiency in children. Notably, the test's ease of administration further enhances its broad feasibility. In conclusion, PDMS-2 proves to be an efficient outcome measure, exhibiting potential for evaluating improvements in motor skills and overall developmental progress in children. [ABSTRACT FROM AUTHOR]

Children with Unilateral Spastic Cerebral Palsy (US CP) have motor and somatosensory impairments that affect one side of their body, impacting upper limb functioning. These impairments contribute negatively to children's bimanual performance and quality of life. Intensive home-based therapies have been developed and have demonstrated their feasibility for children with US CP and their parents, especially when therapies are designed with the proper coaching of families. Mirror Therapy (MT) is being studied to become an approachable intensive and home-based therapy suitable for children with US CP. The aim of this study is to analyze the feasibility of a five-week home-based program of MT for children with US CP that includes coaching by the therapist. Six children aged 8–12 years old performed the therapy for five days per week, 30 min per day. A minimum of 80% of compliance was required. The feasibility included compliance evaluations, total dosage, perceived difficulty of the exercises, and losses of follow-ups. All children completed the therapy and were included in the analysis. The total accomplishment was 86.47 ± 7.67. The perceived difficulty of the exercises ranged from 2.37 to 4.51 out of 10. In conclusion, a home-based program of Mirror Therapy is a safe, cost-efficient, and feasible therapy for children with US CP when the therapist is involved as a coach during the entire program. [ABSTRACT FROM AUTHOR]

Objective of this review was to collate information on the effectiveness of trunk targeted intervention on children with cerebral palsy (CP) on three functional outcomes that are gross motor function, trunk control and balance. A comprehensive search was conducted on online databases from inception to August 2021, using relevant keywords. A total of 15 randomized controlled trials which enrolled children with cerebral palsy under 18 years met the inclusion criteria. A significant improvement was seen in the trunk targeted training groups on applying trunk targeted interventions. Trunk targeted interventions improve gross motor function, trunk control as well as balance, hence should be incorporated in the conventional physical therapy program delivered to children with CP and would help in greater functional recovery. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) technology has seen increasing use in physical rehabilitation and in the management of acute and chronic pain. Functional movement disorders (FMDs) are a source of disability with no known association to neurologic pathology, and patients are generally offered multidisciplinary treatment approaches to improve functional movement. However, patients who are not compliant with rehabilitation may have persistent FMD and long-term disability. Given VR's use in physical rehabilitation, it may serve as a useful adjunct for the management of FMD. Utilizing an application called MovementTM to create a playlist of targeted applications for the restoration of motor function and balance, this case study presents the application of VR as a tool to engage patients in physical therapy for the management of FMD. The VR games were selected to encourage movement while customization of levels within the games facilitated achievement of physical therapy goals. Physical rehabilitation aided by VR, when used in collaboration with a multidisciplinary care team, may be used to facilitate recovery from FMD. [ABSTRACT FROM AUTHOR]

Physiotherapy is an essential component in the management of cystic fibrosis (CF). To explore how parents of infants with CF experience physiotherapy clinic consultations. A qualitative study, informed by hermeneutic phenomenology, utilizing in-depth semi-structured interviews and daily diaries was conducted with 13 parents of infants (aged 0–2 yrs.) receiving physiotherapy care for CF in Australia. Three themes arose from the text. The first was that parents' physiotherapy clinic experience is influenced by the manner in which health professionals communicate to parents about physiotherapy in CF, as well as their own prior experience and knowledge. Secondly, parents receive conflicting messages from the physiotherapy consultation, but perceive the key message to be to prioritize adherence to physiotherapy. The final theme was that parents' expectations of the physiotherapy interaction were often not met, in particular a lack of practical physiotherapy education and training was reported. Parents of infants with CF seek an optimistic, practical and hands on approach during physiotherapy consultations. Exploring options for providing physiotherapy input outside of traditional clinic environments may help accommodate individual needs. Investigation into the manner in which physiotherapy education is communicated to parents is warranted in light of the influence on parents' expectations of physiotherapy. [ABSTRACT FROM AUTHOR]

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Background: Insufficiencies of gluteus medius and maximus muscles in children with unilateral cerebral palsy (CP) may restrict activity and participation by affecting gait, gross motor functions, and balance. Objectives: The present study aimed to elucidate the effect of Kinesio taping (KT) applied to the gluteus medius and maximus muscles on activity and participation in children with CP. Methods: The study was completed with 20 children with unilateral CP who were randomly divided into 2 groups: the KT group received KT and physiotherapy (n = 11), and the control group received only physiotherapy (n = 9). The KT application was administered for 4 weeks. The activity was evaluated with a BTS G-Walk Spatiotemporal Gait Analysis System, Timed Up and Go test (TUG), Functional Mobility Scale (FMS), Gross Motor Function Measure (GMFM), and Pediatric Balance Scale (PBS); in addition, participation was evaluated using the Canadian Occupational Performance Measure (COPM). Results: The KT group showed significant improvements in the gait parameter (cadence; P = 0.009), pelvic tilt symmetry (P= 0.017), pelvic rotation symmetry (P = 0.018), gait symmetry (P < 0.001), FMS (P = 0.07), TUG, GMFM, PBS, and COPM scores (P < 0.001) in the medium-term compared to the control group. It was also found that gait (cadence; P= 0.004)) and functional mobility (P < 0.001) improved in the immediate term than in the KT group. Conclusions: KT combined with conventional physiotherapy can improve cadence and functional mobility in the immediate term, as well as gait and pelvic symmetry, functional mobility, gross motor function, balance, and participation in the medium term in children with unilateral CP. Further randomized controlled studies addressing large samples and long-term effects are warranted. [ABSTRACT FROM AUTHOR]

Background and Purpose: Ensuring access to high quality services in paediatric physiotherapy (PT) is important to respond to the diverse needs of children. The accessibility and quality of paediatric PT services has however never been explored internationally. The purpose of this study is to explore the perceived strengths, weaknesses, opportunities, and threats (SWOT) of paediatric PT services offered around the world. Method: A cross‐sectional survey design method was used with a subsample of physiotherapists (PTs) who had previously participated in an online survey. The survey used for this study included close‐ and open‐ended questions about access to services and the SWOT of PT services within participants' country. Descriptive statistics were used to summarize quantitative data and a content analysis was performed on open‐ended questions. Results: Overall, 47 PTs from 47 countries completed the survey; 36% of participants reported that free access was available to all children in their country while 34% stated that a referral was always required when accessing services. Lack of direct access, insufficient specialized PT, financial and geographical issues were the main perceived barriers to access services. Access also emerged as one of the nine themes following the SWOT analysis. Other themes included education, quality of PT approaches, PT practices, communication and cooperation, teamwork, government, resources, and attitudes of PTs. Discussion: Despite variations in accessing services and how services are delivered across countries, some similar themes influencing PTs practices were found. Future opportunities for PTs working with children should aim at optimizing the initial training and professional development of PTs in paediatrics, increasing access to services for all children and advocating for sustainable and well‐coordinated models of care building on best practices. [ABSTRACT FROM AUTHOR]

Children with hemiplegic cerebral palsy (CP) are at risk of reduced upper limb function and poorer quality of life than their typically developing peers. Although upper limb impairments have potential negative impact on the health-related quality of life (HRQOL) in children with hemiplegic CP, the efficacy of upper limb rehabilitation approaches aiming to improve upper limb impairments on HRQOL has not been adequately investigated. This study compares the efficacy of two modes of activity-based upper limb rehabilitation (modified constraint-induced movement therapy [mCIMT] and bimanual training [BIM]) on HRQOL outcomes in children with hemiplegic CP mainstreamed in regular schools. Thirty children with hemiplegic CP aged between 7 and 11 years (mean age 8.53 ± 1.54 years) who had functional ability levels of I–III according to the Manual Ability Classification System (MACS), Gross Motor Classification System (GMFCS), and Communication Function Classification System (CFCS) were randomly assigned to receive mCIMT or BIM training. Result: Both mCIMT and BIM yielded statistically significant improvements in all HRQOL domains immediately after the 10-week interventions (P <.001), which were retained at 16 weeks. While there were some differences in the intervention effects, both of these upper limb rehabilitation approaches based on intensive unimanual or bimanual activity may be beneficial for improving perceived life satisfaction related to physical activity, general mood, family, friends, and school among children with hemiplegic CP mainstreamed in regular schools. [ABSTRACT FROM AUTHOR]

PURPOSE: Sixty percent of children with bilateral cerebral palsy have impaired hand function. The study's purpose was to examine the benefits of bimanual task practice on the manual ability and hand function of children with bilateral spastic cerebral palsy. METHODS: In this pre-post study design, 18 children with bilateral spastic cerebral palsy with an average age of 11.5 (+/-1.9) years, Manual Ability Classification System levels I-III and Bimanual Fine Motor Function levels I-III participated in bimanual task practice of upper extremities. The task practice included clay activities, paper manipulation and activities of daily needs. The children underwent 45-minute training sessions 3 times a week over 6 weeks. The outcome measures were ABILHAND-Kids, Quality of Upper Extremity Skills Test and grip strength. RESULTS: Post-training, a mean change of 6.44 logits in ABILHAND-Kids, 11 points on the Quality of Upper Extremity Skills Test, and 3.3 and 3.1 kilograms grip strength in the dominant and nondominant hands respectively were observed with a statistical significance (p < 0.05). CONCLUSION: Bimanual task training might be beneficial in improving manual ability, hand function and grip strength in children with bilateral spastic cerebral palsy. [ABSTRACT FROM AUTHOR]