Current Trends for Children With Spina Bifida: A Survey of Pediatric Physical Therapists.

PURPOSE: To describe contemporary physical therapy practice and management of children with spina bifida (SB) in the context of the International Classification of Functioning, Disability, and Health (ICF) framework. METHODS: A descriptive, cross-sectional electronic survey was sent to US pediatric physical therapy clinics and posted in the American Physical Therapy Association Pediatrics newsletter. Data were analyzed using content analysis. Codes were compared, refined, and condensed into categories. RESULTS: A total of 163 participants were included. Most assessments evaluated the ICF Activity component. Most frequently reported ICF components: impairments = decreased strength (17.9%), activity limitations = limited walking (22.5%), and participation restrictions = restricted socializing/playing with peers or siblings (22.6%). The most prevalent intervention was strength training. CONCLUSIONS: Physical therapists (PTs) in the United States are performing assessments and interventions supported by available evidence; however, knowledge translation and more research are needed to support best practices in PT management of children with SB.

Movement as a Gateway to Participation for Individuals With Neuromotor Conditions: A Scoping Review.

PURPOSE: The purpose of this scoping review was to examine and analyze the developmental and rehabilitation literature related to movement and participation at key points of transition for individuals with neuromotor conditions. METHODS: Arksey and O'Malley's scoping review protocol was applied, and 37 articles were included. Extracted data included population, developmental transition points, movement opportunity, type of participation, and outcome measures. RESULTS: Most studies covered developmental transition points; none examined transitions as a variable for participation outcomes. Physical activity/exercise was the most common movement opportunity. Most publications used formal outcome measures of participation; others used observation or interviews. CONCLUSION: No publications adequately addressed the effect of movement opportunities on participation during developmental transition points.

Relationship between Movement Quality, Functional Ambulation Status, and Spatiotemporal Gait Parameters in Children with Myelomeningocele.

AIMS: We investigated relationships among the Pediatric Neuromuscular Recovery Scale (Peds NRS), modified Hoffer Scale, and spatiotemporal gait parameters in children with myelomeningocele (MMC). METHODS: 21 children with MMC, age 5.3 years (SD = 2.6), were assessed by three clinicians using the Peds NRS and modified Hoffer Scale. In eight children, gait parameters were also measured. RESULTS: The Peds NRS summary score demonstrated good correlation with modified Hoffer Scale score (r = -0.64, p = 0.002) that accounted for 41% of variation in summary score. Six Peds NRS seated/standing items exhibited good relationships with modified Hoffer Scale (r = -0.51 to -0.70, p ≤ 0.023), and the sit-to-stand item demonstrated an excellent relationship (r = -0.85, p < 0.001). Sit-to-stand and three standing/walking items exhibited excellent associations with cadence (Rs = 0.81 to 0.88, p ≤ 0.014), and swing and stance time (both Rs = -0.83 to -0.90, p ≤ 0.01). Two Peds NRS standing items and modified Hoffer Scale score demonstrated good correlations with velocity (Rs = 0.71, p = 0.047; Rs = -0.73, p = 0.04, respectively). CONCLUSIONS: Our findings suggest that children with MMC who exhibit greater movement quality and trunk control are likely to be functional ambulators with more optimal spatiotemporal gait parameters.

Psychometric Properties of Segmental Assessment of Trunk Control in Infants and Toddlers With Down Syndrome.

PURPOSE: This study investigated infants and toddlers with Down syndrome (DS) to determine: reliability of the Segmental Assessment of Trunk Control (SATCo), concurrent validity of the SATCo with the Gross Motor Function Measure (GMFM), and whether age and SATCo score predict GMFM score. METHODS: Eighteen infants and toddlers with DS were tested on the SATCo by 2 physical therapist (PT) raters. One PT rater administered the GMFM. After 2 weeks, PT raters rescored their recorded SATCo sessions. A third PT rater also scored the SATCo videos. RESULTS: Interrater reliability of the SATCo was moderate to good and intrarater reliability was good to excellent. The SATCo and the GMFM had good to excellent significant correlations. Age and SATCo score were significant predictors of the GMFM. CONCLUSIONS: Trunk control appears to play a central role in gross motor function of infants and toddlers with DS. The SATCo has good psychometric properties in this population. WHAT THIS ADDS TO THE EVIDENCE: This study contributes to the literature on the psychometric properties of the SATCo and supports its use to measure trunk control in infants and toddlers with DS between the ages of 6 and 24 months.

Gross Motor Outcomes After Dynamic Weight-Bearing in 2 Children With Trunk Hypotonia: A Case Series.

INTRODUCTION: Children with trunk hypotonia may have limited ability to maintain an upright weight-bearing position, resulting in decreased postural control and a delay in achieving gross motor milestones. PURPOSE: The purpose of this case series is to report the effect of a home-based dynamic standing program on postural control and gross motor activity in 2 children with trunk hypotonia. DESCRIPTIONS: Child 1 (aged 24 months, Gross Motor Function Classification Scale Level IV) and Child 2 (aged 21 months, Gross Motor Function Classification Scale Level V) participated in a standing program using the Upsee harness at home 3 days per week for 12 weeks. OUTCOMES: Both children improved their gross motor function, and Child 1 demonstrated improved trunk control in sitting. WHAT THIS CASE ADDS: The use of the Upsee harness was an effective intervention for these children with trunk hypotonia to achieve weight-bearing and improve gross motor abilities.

Work-Life Balance of Faculty in Professional Physical Therapist Education: A Mixed-Methods Study.

INTRODUCTION: The purpose of this mixed-methods study was to explore perceptions of work-life balance (WLB) of full-time faculty in professional physical therapist (PT) education programs. REVIEW OF LITERATURE: Studies show that faculty are at risk of diminution of WLB and subsequent burnout due to job expectations and changing educational landscapes. Limited evidence exists to describe perceived WLB of faculty in professional PT education. SUBJECTS: Full-time faculty in professional PT education programs (n = 239) responded to an online survey and 16 participated in focus group discussions. METHODS: The Work/Nonwork Interference and Enhancement Survey (W/NW Scale), faculty characteristic prompts, and open-ended questions were disseminated electronically to all accredited professional PT education programs within the United States. Focus groups were conducted to further explore nuances of WLB. Frequencies and percentages were calculated for survey categorical variables with means and standard deviations for continuous variables. Differences in W/NW Scale and faculty characteristics were analyzed using independent-samples Mann-Whitney U tests. Open coding and an iterative process of thematic analysis was used to analyze the qualitative data. RESULTS: Medians for all W/NW Scale dimensions were between 2 and 3 out of 5. W/NW Scale dimension scores differed significantly in each of the faculty characteristics of gender, defined workload, and faculty job searching (Z = -2.399 to -3.517, P ≤ .016). Qualitative data yielded 3 main themes: 1) implicit and explicit job duties; 2) leadership; and 3) individual boundaries. Ebb and flow of WLB emerged as an overarching theme. DISCUSSION AND CONCLUSION: This study offers a portrayal of the lived experience of faculty regarding WLB. Results offer useful information about faculty demographics, work-related factors, and personal responsibilities. One limitation was that cultural, community, and religious demands were not explored. Findings may facilitate improved understanding of faculty WLB perceptions and can guide leadership to optimize the balance between faculty's paid work and personal life.

Psychometric properties of 3-meter backward walk test (3MBWT) in people with Parkinson disease.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the 3-meter backward walk test (3MBWT) in individuals with Parkinson Disease (PD) to determine the following: (1) concurrent validity with other gait velocity measures and (2) interrater and intrarater reliability of in-person and video assessment. METHODS: A convenience sample of 25 people with PD participated. Forward gait velocity was measured using a computerized walkway (Zeno Walkway System), the 10-meter walk test (10MWT), and 4-meter walk test (4MWT). Backward gait velocity was measured using the 3MBWT. Concurrent validity was assessed using Pearson's correlations. Reliability was assessed using intra-class correlation coefficients (ICC(2,1)). RESULTS: All relationships between the 3MBWT and gait outcome measures were significant. The 3MBWT demonstrated strong correlations with the 4MWT dual task (r = .795, p=<.001) and moderate correlations with 4MWT comfortable walking speed (r = .658, p < .001), 4MWT fast walking speed (r = .601,p=.002), 10MWT comfortable walking speed (r = .512, p = .009), and 10MWT dual task (r = .535, p = .006). A low yet significant correlation was noted with the 10MWT fast walking speed (r = .398, p = .049). Association between the 3MBWT and the Zeno Walkway System revealed moderate correlations. All reliability tests were significant at p < .001. Interrater reliability ICC(2,1) values were very high for 3MBWT (ICC(2,1) = 0.93, [0.83-0.91]). Intrarater reliability was also very high (ICC(2,1) = 0.96 [0.90-0.98]). CONCLUSION: The 3MBWT demonstrates validity and reliability as a tool for assessing gait speed in the posterior direction in people with PD.

An open pilot trial of a behavioural intervention to reduce violence by young adults with early psychosis receiving treatment in an early intervention services setting: A protocol.

AIMS: Despite the public health impact of violence among young adults with psychosis, behavioural interventions to reduce the risk of engaging in violence remain rare. For young adults with early psychosis, cognitive behavioural therapy (CBT)-based psychotherapy has efficacy in reducing impairment and improving functioning. However, no CBT-based intervention to reduce violence has been formally adapted for young adults with early psychosis. This protocol outlines the first clinical trial of a behavioural intervention to reduce violence for young adults with early psychosis. This study is set in an early intervention services (EIS) setting and seeks to adapt and pilot Psychological Intervention for Complex PTSD and Schizophrenia-Spectrum Disorder (PICASSO), a CBT-based intervention, through an iterative process utilizing mixed-methods assessments. METHODS: All research will occur at OnTrackNY, the largest EIS program in the United States. This study will consist of an open pilot trial, with four EIS clinicians delivering the intervention to one to two EIS participants per round. In this mixed-methods study, both quantitative measures (acceptability, feasibility and hypothesized mediators of target outcome collected on a weekly basis) and qualitative interviews (with EIS clinicians at weeks 4, 8 and 12) will be conducted. Transcripts will be analyzed using thematic content analysis. Two to three rounds of iterative modifications are anticipated (n = 10-16 EIS participants total). RESULTS: Recruitment began in February 2024 and is expected to continue over a 9-12-month period. CONCLUSIONS: Because violent behaviour causes interpersonal disruptions such as incarceration and increased caregiver burden, an innovative intervention to reduce violence risk could have broader health impact for this vulnerable population. Adapting the PICASSO intervention to the EIS setting will optimize its acceptability and feasibility by the intended target population.

Trunk control and gross motor outcomes after body weight supported treadmill training in young children with severe cerebral palsy: a non-experimental case series.

Objective: To explore the impact of a body weight supported treadmill training (BWSTT) intervention on postural control and gross motor function in three young children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV or V. Method: Children (N = 3) between the ages of 2-3 years who were diagnosed with CP classified as GMFCS levels IV and V participated in BWSTT three times per week. The Segmental Assessment of Trunk Control (SATCo) and the gross motor function measure (GMFM-66) were assessed before and after the 6-week intervention. Results: Final testing revealed that all participants improved on the SATCo and GMFM. Conclusion: BWSTT is a viable intervention that may improve trunk control and gross motor outcomes in young children with severe CP. Further research is needed to explore the impact of BWSTT for young children classified as GMFCS levels IV and V.

Comparing clinical outcomes between two scorpion antivenom dosing strategies in children.

Background and Objectives: The clinical course from scorpion envenomation can range from mild to life threatening, particularly in younger children. The F(ab')2 antivenom currently available in the United States is extremely effective for countering the neurotoxic effects but extremely expensive. This dose comparison study assesses clinical outcomes between two antivenom dosing strategies. Methods: This was a retrospective review of medical records of pediatric patients treated in the pediatric emergency department (PED) with grade 3 or 4 envenomation requiring antivenom. Treatments rendered at two time-periods were assessed: 3-vial first dose (May 2007-August 2011) and single-vial-serial dose (September 2011-June 2016). Primary outcome was the proportion of patients who achieved complete symptom resolution within 4 h post antivenom dose. Results: One hundred and forty-one children met entry criteria, 76 in 3-vial first dose and 65 in single-vial-serial dose. Median age was 4 years (Q1:2-Q3:7), 56.2% males. There were no demographic and differences in clinical severity at presentation between the two dosing groups. All children, irrespective of group assignment, achieved the primary end-point of symptom resolution within 4 h. Median time to complete resolution of symptoms was longer for the single-vial-serial-dosing group vs. the 3-vial-first dose group [90 min (Q1:63-Q3:124) vs. 62 min (Q1:40-Q3:90), p = 0.002]. There were no statistically significant differences between the two groups regarding clinical outcomes including PED discharge, intubation, hospitalization, or death. Conclusion: In this retrospective analysis, children in both single-vial-serial dosing group, and 3-vial-full dosing group, achieved symptom resolution within 4 h of initiating therapy with no additional complications or adverse clinical outcomes.

Enhancing sonochemical activity in aqueous media using power-modulated pulsed ultrasound: an initial study.

Relatively little is known about the effects of pulsed ultrasound on the facilitation of chemical reactivity. Previous studies have indicated that sonochemistry using pulses is generally less effective than continuous ultrasonic irradiation. However, the pulse trains employed were such that the peak power of the pulses was the same as the maximum power used in continuous irradiation. As a result, less acoustic energy was transmitted to the solutions over the same period of time. The effectiveness of ultrasound when the pulse is adjusted so that the same amount of acoustic energy is input compared to continuous irradiation over a given time has not been previously explored. In this study we have embarked on an examination of the efficacy of power-modulated pulsed (PMP) sonochemistry. Specifically, we have explored the effects of pulse type and pulse frequency on the oxidation of potassium iodide and the degradation of acid orange, a common industrial colorant. A rate increase by a factor of three was observed compared with continuous irradiation under conditions of equivalent acoustic input power.