Search

Background. Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL). Objective. The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects. Design. This was a cross-sectional study. Methods. In both a clinical sample of children diagnosed with DCD (n=25 [21 male, 4 female], age range=5-8 years) and a group of peers with typical development (25 matched controls), the children's parents completed the DCDDaily-Q. Differences in scores between the groups were investigated using t tests for performance and participation and Pearson chi-square analysis for learning. Multiple regression analyses were performed to explore the predictive values of performance, learning, and participation. Results. Compared with their peers, children with DCD showed poor performance of ADL and less frequent participation in some ADL. Children with DCD demonstrated heterogeneous patterns of performance (poor in 10%-80% of the items) and learning (delayed in 0%-100% of the items). In the DCD group, delays in learning of ADL were a predictor for poor performance of ADL, and poor performance of ADL was a predictor for less frequent participation in ADL compared with the control group. Limitations. A limited number of children with DCD were addressed in this study. Conclusions. This study highlights the impact of DCD on children's daily lives and the need for tailored intervention., Developmental coordination disorder (DCD) is associated with impairments in the coordination of voluntary movements, timing, force control, and motor learning. (1) These impairments will affect all kinds of motor activities, [...]

Background. In improvement of clinical practice, unidirectional approaches of translating evidence into clinical practice have been pinpointed as main obstacles. The concept of engaged scholarship has been introduced to guide [...]

Background and Purpose. There is growing awareness that the poor uptake of evidence in health care is not a knowledge-transfer problem but rather one of knowledge production. This issue calls for re-examination of the evidence produced and assumptions that underpin existing knowledge-to-action (KTA) activities. Accordingly, it has been advocated that KTA studies should treat research knowledge and local practical knowledge with analytical impartiality. The purpose of this case report is to illustrate the complexities in an evidence-informed improvement process of organized stroke care in a local rehabilitation setting. Case Description. A participatory action approach was used to co-create knowledge and engage local therapists in a 2-way knowledge translation and multidirectional learning process. Evidence regarding rehabilitation stroke units was applied in a straightforward manner, as the setting met the criteria articulated in stroke unit reviews. Evidence on early supported discharge (ESD) could not be directly applied because of differences in target group and implementation environment between the local and reviewed settings. Early supported discharge was tailored to the needs of patients severely affected by stroke admitted to the local rehabilitation stroke unit by combining clinical and home rehabilitation (CCHR). Outcomes. Local therapists welcomed CCHR because it helped them make their task-specific training truly context specific. Key barriers to implementation were travel time, logistical problems, partitioning walls between financing streams, and legislative procedures. Discussion. Improving local settings with available evidence is not a straightforward application process but rather a matter of searching, logical reasoning, and creatively working with heterogeneous knowledge sources in partnership with different stakeholders. Multiple organizational levels need to be addressed rather than focusing on therapists as sole site of change., Physical therapy subscribes to the ideal of evidence-based practice, but how do we achieve that ideal? The health care sector, including physical therapy, has difficulty in applying and achieving widespread [...]

Background. Goniometric measurements of hemiplegic arm joints must be reliable to draw proper clinical and scientific conclusions. Previous reliability studies were cross-sectional and based on small samples. Knowledge about the contributions of sources of variation to these measurement results is lacking. Objective. The aims of this study were to determine the interobserver reliability of measurements of passive range of motion (PROM) over time, explore sources of variation associated with these measurement results, and generate smallest detectable differences for clinical decision making. Design. This investigation was a measurement-focused study with a longitudinal design, nested within a 2-arm randomized controlled trial. Methods. Two trained physical therapists assessed 7 arm movements at baseline and after 4, 8, and 20 weeks in 48 people with subacute stroke using a standardized protocol. One physical therapist performed the passive movement, and the other read the hydrogoniometer. The therapists then switched roles. The relative contributions of several sources of variation to error variance were explored with analysis of variance. Results. Interobserver reliability coefficients ranged from .89 to .97. The PROM measurements were influenced by error variance ranging from 31% to 50%. The participant x time interaction made the largest contribution to error variance, ranging from 59% to 81%. Smallest detectable differences were 6 to 22 degrees and were largest for shoulder movements. Limitations. Verification of shoulder pain and hypertonia as sources of error variance led to a substantial number of unstable variance components, necessitating a simpler analysis. Conclusions. The assessment of PROM with a standardized protocol, a hydrogoniometer, and 2 trained physical therapists yielded high interobserver reliability indexes for all arm movements. Error variance made a large contribution to the variation in measurement results. The resulting smallest detectable differences can be used to interpret future hemiplegic arm PROM measurements with more confidence., Of the 15 million people who b have a stroke each year worldwide, between 77% and 81% of the survivors have a motor deficit in the extremities. (1) The affected [...]