Inclination, hip abduction, orientation, and tone affect weight-bearing in standing devices.

PURPOSE: With children who are unable to stand or walk independently in the community, therapists commonly use standing devices to assist lower-extremity weight-bearing which is important for bone and muscle health. In addition, positioning in hip abduction may improve hip stability and range of motion. This is the first study to explore the effect of angle of inclination, hip abduction, body orientation, and tone on weight-bearing in pediatric standing devices. METHODS: This descriptive exploratory study used a convenience sample of 15 participants (2 with normal tone, 5 with generalized hypotonia, and 8 with hypertonia) (mean age of 5 years and 10 months, range of 3 years 4 months to 9 years 7 months); 13 of whom used standing devices at home, as well as 2 typically developing siblings (normal tone). Each child stood in 36 positions to measure the amount of weight-bearing through footplates. RESULTS: Weight-bearing was highest with 60 degrees of abduction and no inclination (upright) in supine positioning for children with low and normal tone. Children with high muscle tone bore most weight through their feet with no abduction (feet together) and no inclination (upright) in prone positioning. Overall, supine positioning resulted in more weight-bearing in all positions for children with low and normal tone. Prone positioning resulted in slightly more weight-bearing in all positions for children with high tone. CONCLUSIONS: Weight-bearing was affected by all three of the variables (inclination, abduction, and orientation) for participants with high, normal, and low tone. To determine optimal positioning, all standers should include a system to measure where and how much weight-bearing is occurring in the device.

Limb length discrepancies among 8- to 12-year-old children who are developing typically.

PURPOSE: The prevalence of lower extremity limb length discrepancy (LLD) in the general pediatric population has not been clearly defined. The goal of this study was to identify the prevalence of LLD in children aged 8 to 12 years, who are developing typically. METHODS: A convenience sample of 43 girls and 62 boys was tested. Participants' gender, age, height, and weight were recorded. Limb length measurements were taken from the anterior superior iliac spine to the medial malleolus and umbilicus to medial malleolus using the direct method. RESULTS: Descriptive statistics revealed an average age of 9.88 years (SD = 1.2), height of 55.7 inches (SD = 4.6), and weight of 82.5 pounds (SD = 24.6). Seven of 105 children demonstrated an LLD of 2 cm or greater. CONCLUSION: Approximately 7% of the children present with an LLD of 2 cm or greater. This study contributes to the understanding of the prevalence of LLD in prepubescent children.

A description of professional pediatric physical therapy education.

PURPOSE: The purpose of this work was to reexamine the status of professional pediatric physical therapy education in the United States. METHODS: A task force designed a 16-item survey and contacted representatives from all professional physical therapy programs. RESULTS: Surveys were gathered from 151 programs for a return rate of 75%. Much variability exists across programs in total number of hours devoted to pediatrics (range, 35-210 hours). In addition, almost 60% of respondents indicated that the individual responsible for delivering the pediatric content will be retiring within the next 15 years. CONCLUSION: These results describe current pediatric professional education and provide numerous opportunities and challenges for the development of optimal professional pediatric education.

The effects of a 5-week therapeutic horseback riding program on gross motor function in a child with cerebral palsy: a case study.

PURPOSE: The purpose of this study was to determine the outcome of a short-term therapeutic horseback riding intervention on the gross motor function in a child with cerebral palsy. DESIGN: This study employed a repeated-measures design with a pretest, a post-test, and a post post-test conducted 5 weeks apart using the Gross Motor Function Measure (GMFM) as an outcome measure. The three sets of test scores from the GMFM were compared upon completion of the intervention. INTERVENTION: The subject participated in a 5-week therapeutic horseback riding program consisting of 1 hour of riding per week. Each riding session consisted of stretching, strengthening, and balance activities. The child's level of motor function was tested prior to the intervention, upon completion of the intervention, and 5 weeks postintervention. The GMFM, a criterion-referenced observational measure designed to measure change in the gross motor function in children with cerebral palsy, was chosen as the assessment tool. RESULTS: Upon completion of the 5-week intervention, the child was observed to have improved scores on the GMFM in two of the five dimensions measured and scored for a total of eight items. The post post-test was completed 5 weeks after the final riding session and the results demonstrated successful maintenance of the improved scores in seven of eight items. CONCLUSIONS: The result of this case study suggest that 5 weeks of therapeutic riding are sufficient to produce positive changes in the gross motor function of a child with cerebral palsy.