Ankle-Foot  Orthotics Are Not Always Suitable for Children with Cerebral Palsy

Kristie Bjornson, from the University of Washington  in Seattle and the Seattle Children’s Research Institute, discusses findings  about using orthotics in a community setting from a randomised study of  children with cerebral palsy 
  
  
“Guided  Discovery” through Collaborative Choice Helps Children with Downs Syndrome and  Intellectual Impairment Learn to Ride Bikes
  
  
Joyce  McGill Evans, Professor Emerita from University of Alberta, talks about a study  in which the “CO-OP” (Cognitive Orientation to daily Occupational Performance) method was used to help adolescents with cerebral  palsy learn how to ride bikes. 


Childhood  Toe-Walking Explored by Measuring Vibration Perception 


Claire Behnke from Phoenix Arizona reports  findings from an investigation of distal vibration perception among children  who “toe walk” 
  
  
Teenager’s  Obesity Was Associated with Carpal Tunnel Syndrome
  
Kathleen Galloway from Belmont University in  Nashville Tennessee voices her concerns raised by a case of carpal tunnel  syndrome found in an obese teenager.  
  
  
Study Finds  Timed Up and Go Test Found Fit for Purpose 
  
 Adina  Itzkowitz, senior physical therapist and co-ordinator of clinical education at  the New York City Department of Education discusses an investigation of the TUG  test to help monitor childhood development.
  
  
Weight Gain  Prevention Success in School Age African-American Children
  
Peggy Pope, from Tallahassee, a County Schools  Clinical Physical Therapist and Adjunct Professor at Florida A & M  University describes the dietary and activity training methods they used to  help 222 school-age children avoid gaining weight.

Volume 28, Issue 2, Summer

Pediatric Physical Therapy is the first and only peer-reviewed journal devoted to this discipline.  The Journal provides a forum for scientific and professional exchange among researchers and practitioners throughout the world that represent subspecialties of the discipline, including early intervention, neonatology, pediatric sports and fitness, school physical therapy, acute care for seriously ill children, and the prevention of primary and secondary conditions that lead to disabling conditions. 

Official Journal of APTA Pediatrics, an Academy of the American Physical Therapy Association, The Dutch Association for Pediatric Physical Therapy, Physiotherapia Paediatrica, The New Zealand Society of Physiotherapists Pediatric Special Interest Group, and The Pediatric Division of the Canadian Physiotherapy Association.

Science & Medicine

Natural Sciences

Social Sciences

Medicine

The Pediatric Physical Therapy Podcast
March, 2024 Edition:




AN INTERVIEW WITH: 




Eilish M Byrne PT, DSc, PCS, CNT, Assistant Professor, Camino Hospital and Stanford Children's Hospital, California, Visiting Professor University of St Augustine, San Marcos, California. 
In conversation with Peter Goodwin, Editor, The Pediatric Physical Therapy Podcast (March, 2024 Edition)




DESCRIPTION:
Dr. Byrne discusses the research her ream has published in Pediatric Physical Therapy, Volume 36, Number 2, 2024 on:
“Introducing the i-Rainbow- An evidence-based, parent-friendly care pathway designed for even the most critically ill infant in the Neonatal Intensive Care setting.”




AUTHORS:
Eilish M. Byrne, Katherine Hunt and Melissa Scala




SUMMARY:
This study investigated the feasibility and effectiveness of a novel, evidence-based developmental care pathway to be used by healthcare providers and parents in the neonatal intensive care setting. 




PURPOSE: 
This study investigated the feasibility and effectiveness of a novel, evidence-based developmental care pathway to be used by healthcare providers and parents in the neonatal intensive care setting (NICU). The iRainbow is based on current evidence and responds to individual infant health status. It is not base on infant age.




METHODS: 
After development and implementation of the iRainbow, pre-and post- implementation nurse and parent survey data were collected, and pre- and post-developmental care rates were compared.




RESULTS: 
After iRainbow implementation, disagreement among providers on appropriate developmental care interventions significantly decreased, total minutes of daily developmental care and swaddled holding increased significantly, and parents reported that they would recommend the tool.




CONCLUSION: The iRainbow is a unique, parent-friendly, infant-based tool that guides sensory interventions in the NICU by staging infants based on cardiorespiratory status and physiologic maturity, not age. The iRainbow improved the delivery of developmental care activities in our unit and was well received by parents and nurses.




KEYWORDS: 
iRainbow, Neonatal Intensive Care Unit, Neonatal Therapy, Developmental Care, Neonatal Sensory Interventions, Neonatal Care Path, Family Education




WHAT THIS EVIDENCE ADDS:
Current evidence: There are many studies and programs demonstrating the benefits of providing evidence-based developmental interventions for both neonates and caregivers.1-4
   Gap in the evidence: There is less agreement regarding the safety and timing of developmental interventions7-9, and what does exist tends to rely on gestational age, while recommending performing activities per infant tolerance.5,6 However, this approach can be problematic because preterm infants progress at variable rates, and infant tolerance is not objectively defined.
     How does this study fill this gap? This study provides objective clinical criteria to define neonate tolerance for intervention guided by the cardiorespiratory stability of the infant, and in later stages, behavior cues of the infant, not gestational age.
   Implication of all the evidence: Optimal timing of and tolerance to evidence-based developmental interventions in the NICU is still being described. Relying solely on gestational ages may not be ideal for many infants. The iRainbow serves as a valuable tool to objectively identify an infant’s readiness to participate in a developmental care program.

Volume 36, Issue 2

INTERVIEWS IN THIS EDITION:
Studio Guest: 
Linda Fetters PhD, PT, FAPTA
University of Southern California, Los Angeles, Pediatric Physical Therapy Editor-in-Chief, adds her comments and reflections on clinical implications arising from the research discussed in the podcast by Pediatric Physical Therapy authors.





Author Interviews:





1. Catie Christensen PT DPT PCS, Evidence Based Practice Coordinator, Nationwide Children’s Hospital, Columbus, Ohio, USA 
“2022 APTA Pediatrics Knowledge Translation Lecture: Clinicians and Researchers Collaborate to Implement a Segmental Approach to Trunk Control”
Christensen discusses her team’s detailed investigation of how collaboration between clinicians and researchers can help implement the “segmental approach” to trunk control in patients with cerebral palsy.





2. Kate L. McLeod, Queensland Cerebral Palsy & Rehabilitation Research Centre, University of Queensland, Brisbane, Australia.
“Effect of Active Motor Learning Interventions on Gross Motor Function and Mobility in Children Aged 2 to 6 Years With Bilateral Cerebral Palsy: A Systematic Review and Meta-analysis “
McLeod tells the podcast about her group’s meta-analysis of studies investigating active-motor learning interventions among children with bilateral cerebral palsy. 





3. Stacey C. Dusing PT PhD FAPTA PCS, Sykes Family Chair of Pediatric Physical Therapy, Health, and Development, Division of Biokinesiology & Physical Therapy, University of Southern California, Los Angeles, California, USA. 
“Impact of the COVID-19 Pandemic on a Clinical Trial: A Quantitative Report on Study Engagement and Strategies”
Research on physical therapy practice during the COVID pandemic suggests that lessons have been learned and that clinicians will be better prepared for a future pandemic.  Dusing tells the podcast about her group’s report in Pediatric Physical Therapy on a study of infants in a rehabilitation clinical trial, that took place before and during COVID. 





4. Kelly E. Rock PT, DPT, PhD, PCS, currently Postdoctoral Fellow, Department of Physical Therapy, University of Florida, Gainesville, Florida, USA and former PhD student at the Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, Maryland, USA, discusses: “Muscle Properties, Gross Motor Performance, and Quality of Life in Children With Sickle Cell Disease”. The group looked at muscle properties and motor performance as metrics to guide and individualize physical therapy plans for children with sickle-cell disease. Rock explains how these outcome measures can provide an evidence-base for therapy planning.





5. Kimberley S. Scott PT DPT PhD, Assistant Professor, Department of Physical Therapy, Creighton University, Omaha, Nebraska, USA.
“Fidelity of Delivery in a Multisite Randomized Clinical Trial of Intervention Efficacy for Infants With Unilateral Cerebral Palsy”
For children with unilateral cerebral palsy, the consistency of interventions between centers and between individual clinicians has been checked in a new study. Scott tells the podcast about her group’s investigation of the fidelity of therapy delivery in a multi-site randomized clinical trial. 





6. Jodi Thomas DHSc, School of Physical Therapy, Texas Woman’s University, Dallas, Texas, USA 
“The Head Control Scale: Responsiveness and Concurrent Validity With the Alberta Infant Motor Scale” 
Although head control holds the key to a number of developmental issues it’s not easy to measure objectively in a new-born infant. Thomas talks about the validation of her group’s recently developed “Head Control Scale” as an accurate measure of head control in young children.





7. Melissa McIntyre PT DPT, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
“Daily Quantity and Kinematic Characteristics of Leg Movement in a Child With SMA Type I” 
The rare genetic condition: Spinal Muscular Atrophy, or SMA, can now be treated with specific molecular drugs or gene therapy. These treatments alter disease progression, resulting in improved motor function and development. In the best of cases, infants who previously had dismal outlooks and very short survivals can demonstrate near-typical motor development. McIntyre talks about her case study, giving insights into physical therapy for neonates and young children with SMA who demonstrate previously unseen development trajectories and motor achievements.

Volume 35, Issue 4

INTERVIEWS IN THIS EDITION:
Studio Guest: 
Linda Fetters PhD, PT, FAPTA
University of Southern California, Los Angeles, Pediatric Physical Therapy Editor-in-Chief. 
Linda begins this special edition of the podcast by talking about our inspiring former leader, the late Cindy Miles, President of the Academy of Pediatric Physical Therapy at the American Physical Therapy Association.


Author Interviews:
1. Hércules Ribeiro Leite PhD, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
I Would Like to Do It Very Much! Leisure Participation Patterns and Determinants of Brazilian Children and Adolescents With Physical Disabilities 
Hércules tells us how the needs of youngsters with physical impairments are often overlooked, especially in low- and middle-income countries. His group’s new program increases their participation in leisure activities such as sports providing new opportunities to improve outcomes.


2: Jeanette M Cadieux PT DPT, Cadieux Physical Therapy, Cooper Landing, Alaska, USA
Pediatric Walking Speed Normal Reference Values in a Local Population 
In a new research study, Janette has been calibrating pediatric walking speed in typical children as a comparator to help assess performance in children with impairments.


3 Joseph Schreiber PT PhD FAPTA, Physical Therapy Learning for Practice, Pittsburg PA, USA 
Clinical Outcomes of an Intensity Program for Children With Movement Challenges
Joe tells the podcast about his group’s high intensity program of physical therapy for children with movement challenges: a massive initiative developed by his co-authors at the Children’s Institute, in Pittsburgh, bringing clinically important improvements in outcomes.


4: Adriaan Louw PT PhD, Evidence in Motion, Story City, Iowa, USA
Pain Neuroscience Education in Elementary and Middle Schools
Adriaan explains how our attitudes towards pain influences our experiences of pain. He discusses his research findings on the role of pain neuroscience education among children, and explains how physical therapists are pivotal to implementing this.


5. Deanne Fay PT, DPT, PhD, Professor & Director of Curriculum, Physical Therapy Program, AT Still University, Mesa, Arizona, USA
Influence of Modified Instructions on Locomotion Subtest Scores Using the Peabody Developmental Motor Scales, Second Edition
Deanne explains how departing from the published scripts for instructing children and asking them questions while you are conducting motor function scores can markedly affect the score and should be discouraged.


6. Tanochni Mohanty, MPT, JSS College of Physiotherapy, Mysuru, Karnataka, India
Predictors of Risk for Cerebral Palsy: A Review
Tanochni gives the podcast some of the key findings from her group’s big new survey reviewing data on predictive risk factors for cerebral palsy. In particular she highlights the significance of absent fidgety movements among infants and of prenatal general movements.


7. Kara Boynewicz, PT, PhD, DPT, East Tennessee State University, Johnson City, Tennessee
Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure
Coping with new-born babies heavily exposed to opiates in utero became a key specialist activity for Kara who has been studying how best to give these infant as good a start in life as possible by setting up a carefully controlled investigation of motor performance in new-born infants with: Neonatal Opiate Withdrawal Syndrome, NOWS.

Volume 35, Issue 3

INTERVIEWS IN THIS EDITION:


Studio Guest: 


Linda Fetters PhD, PT, FAPTA
University of Southern California, Los Angeles, Pediatric Physical Therapy Editor in Chief


Dr. Fetters adds her comments about clinical implications of the new data and insights discussed by authors interviewed in the podcast. 


Author Interviews:


1. Jamie B Hall PT, DPT, PhD, PCS, 
Assistant Teaching Professor, Department of Physical Therapy, University of Missouri, Columbia MO, USA


“Caregiver Perceptions of an Interdisciplinary Intensive Therapy Program: A Qualitative Study”
Caregivers are at the center of a study using interdisciplinary intensive therapy for children with cerebral palsy and other neurodevelopmental impairments. 


2:   Roberto M. Benzo PhD, Assistant Professor, Ohio State University College of Medicine, Columbus OH, USA, formerly: Department of Psychology, University of Miami FL, USA.


“Physical Fitness Among Adolescents who are Hispanic with Overweight or Obesity”
New research on physical fitness in overweight and obese young people shows that it can—and should—be accurately monitored in adolescence to help spot those at risk.  The study looked at 280 youngsters who were Hispanic with overweight or obesity.


3: Bethany M.  Sloane PT, DPT, Pediatric Physical Therapist, Oregon Health and Science University, Portland OR, USA 

  
“Modified Ride-on Car Intervention for Children With Profound Intellectual and Multiple Disabilities: A Case Series”
A research study looked at using power mobility devices to help children with profound intellectual and multiple disabilities achieve independent mobility.  


4: Julie Orlando DPT, Biomechanics & Movement Science Program, University of Delaware, Newark DE, USA
“Development and Initial Evaluation of a Soft Ankle Support for 
Children With Ankle Impairments”


A soft ankle support for children with ankle impairments has been trialed to provide a comfortable and attractive alternative to conventional ankle-foot orthoses.  


5. Marisa Birkmeier PT, DPT, DHSc, Assistant Professor, Director of Clinical Education, George Washington University, Washington, DC

 
“Excellence in Pediatric Physical Therapy Education: Recommendations and Action Items”
An assessment of the current guideline recommendations for the pursuit of excellence in education for pediatric physical therapy students.

Volume 35, Issue 2

INTERVIEWS IN    THIS EDITION
      1. Amy Bailes,    PT PhD

        Director of    Physical Therapy Research, Cincinnati Children's Hospital Medical Center,    Cincinnati, OH

        “Inpatient    Physical Therapy After Orthopedic Lower Extremity Surgery in Children With    Cerebral Palsy”

A new study in    Pediatric Physical Therapy reveals the proportion of children with cerebral    palsy having physical therapy during inpatient stay after their orthopedic    lower extremity surgery. The value of such therapy to inpatient care is    discussed by lead author Amy Bailes.  
      2. Rachel    Bican, PT, DPT, PhD

        Assistant    Professor, Division of Physical Therapy, Ohio University, Athens, Ohio

        “Comparison of    Gross Motor Outcomes Between Children With Cerebral Palsy From Appalachian    and Non-Appalachian Counties”

        Pediatric    Physical Therapy researcher Rachel Bican talks about her investigation of    cerebral palsy outcomes in the US Appalachian area compared to nearby    non-Apalachian regions.  
      3. Nancy    Lennon, PT DPT MS

        Department of    Orthopedics, Division of Therapeutic and Rehabilitation Services, Nemours    Children’s Health, Wilmington, Delaware, USA 

        “Factors    Associated With Short-Term Recovery Following Single-Event Multilevel Surgery    for Children With Cerebral Palsy.”

        Nancy Lennon    talks about her group’s research findings of the effect of physical therapy    on the outcome of single event multilevel surgery performed to improve motor    function in children with cerebral palsy.
      4. Natalie    Fairbairn, MPH/MHM, OT

        Grace Centre    for Newborn Intensive Care, The Children’s Hospital, Westmead, Sydney, New    South Wales, Australia. 

        “Risk of    Developmental Coordination Disorder in 8- and 9-Year-Olds Following Newborn    Cardiac and Non–Cardiac Surgery”

        Natalie    Fairbairn discusses the risks her group found of cardiac and non-cardiac    surgery on newborn babies—in particular its effect on developmental    co-ordination disorder.
      5. James E    Gehringer, PhD

        Research    Assistant Professor Munroe-Meyer Institute, University of Nebraska Medical    Center, Omaha, Nebraska  

        “Hand-Arm    Bimanual Intensive Training in Virtual Reality: A Feasibility Study”

        James    Gehringer explains how his group integrated virtual reality with Hand-Arm    Bimanual Intensive Training (HABIT) for treating unilateral cerebral palsy.    The research appeared to overcome some of the frequently encountered barriers    to progress.
      6. Johannes J    Noordstar, PhD MSc, 

        Assistant    Professor, Center for Child Development, Exercise & Physical Literacy,    Wilhelmina Children’s Hospital, University Medical Centre, Utrecht University,    Netherlands.  

        “Is Measuring    Physical Literacy in School-Aged Children With Cystic Fibrosis or Congenital    Heart Disease Needed?”

        Physical    therapy researcher Johannes Noordstar talks about his group’s research on    whether “physical literacy” should be assessed in school-age children with    cystic fibrosis or congenital heart disease. 
      7. Helen    Carey, PT DHSc PCS 

        College of    Health Sciences, University of Indianapolis, Indiana USA

        “Early    Developmental Trends in High-Risk Neonates Later Diagnosed With Autism    Spectrum Disorder”

        Helen Carey    talks about her findings (published in Pediatric Physical Therapy) from a    study of high-risk neonates showing how autism spectrum disorder can be    detected very early in life.

Volume 28, Issue 2, Summer

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