ABSTRACT
The purpose of this special report is to present recommendations for the clinical management of children with cerebral palsy, spastic diplegia when increased functional mobility is the identified outcome. These recommendations provide a framework that allows physical therapists to increase their accountability and promote effective interventions for improved patient outcomes. The key components of this special report on clinical management are: a) the Major Recommendations that provide the background and evidence for clinical management; b) a flow chart to assist in clinical decision-making; and c) a Table of Tests and Measures for information on useful tools in the management of children with spastic diplegia. These recommendations are suggestions for clinical management, not an all-inclusive document on physical therapy for children with cerebral palsy. These recommendations may help therapists develop systematic approaches to service delivery and documentation.
Subject(s)
Cerebral Palsy/rehabilitation , Physical Therapy Modalities , Practice Guidelines as Topic , Adolescent , Adolescent Development , Adult , Advisory Committees , Child , Child Development , Child, Preschool , Decision Making , Humans , Infant , Infant, Newborn , Muscle Spasticity/therapyABSTRACT
PURPOSE: The purpose of this special interest report is to describe the outcomes of a research round table discussion regarding the physical therapy management of mobility for children with spastic diplegia. DESCRIPTION: Sixty-two pediatric physical therapists and physical therapists assistants participated in focus groups during the Research Round Table at the American Physical Therapy Association (APTA) 1999 Combined Sections Meeting. A case description of a child with spastic diplegia and guiding questions were used to facilitate discussion. SUMMARY OF EXPERIENCE: Common practices in patient management across the child's life-span emerged from the discussion. Practices in examination, evaluation and prognosis, and intervention differed depending on the age and function of the child and the family's needs. In general, therapists reported that younger children receive examinations that include standardized tests of development and ongoing intervention with a frequency of one to five times per week. In contrast, older children receive therapy services on an episodic basis that address their specific needs. The elements of patient management served as a useful framework for exploring decision making. IMPORTANCE TO PEDIATRIC PHYSICAL THERAPY: The information compiled from this project needs to be validated through systematic inquiry. Therapists may, however, use the practices reported here to reflect on their clinical decision making and to identify questions for further exploration. This descriptive document is the first step in the development of a guideline for evidence-based practice. The development of such a clinical guideline could serve as an education tool for novice therapists, a program evaluation tool to ensure quality care, and a foundation for future research to promote evidence-based practice.
Subject(s)
Cerebral Palsy/rehabilitation , Clinical Competence , Focus Groups , Physical Therapy Modalities/standards , Adolescent , Adult , Age Factors , Attitude of Health Personnel , Cerebral Palsy/diagnosis , Child , Child, Preschool , Decision Making , Female , Health Care Surveys , Humans , Male , Middle Aged , Pediatrics , Physical Therapy Modalities/trends , Quality Control , Risk Assessment , Severity of Illness Index , Sex Factors , Treatment Outcome , United StatesABSTRACT
PURPOSE: The responsiveness of the Test of Infant Motor Performance (TIMP) was examined in infants born preterm. Infant variables predictive of changes in TIMP scores were also identified. METHODS: Twenty-five infants born Subject(s)
Developmental Disabilities/diagnosis
, Infant, Premature/physiology
, Motor Skills Disorders/diagnosis
, Motor Skills/physiology
, Physical Therapy Modalities
, Psychomotor Performance/physiology
, Risk Assessment
, Female
, Humans
, Infant
, Infant, Newborn
, Male
, Motor Skills/classification
, Prospective Studies
, Risk Factors
