School-Based Work Capacity Evaluation in Young People With Intellectual Disabilities: 2 Case Reports.

PURPOSE: These case reports examine the application of a work capacity/work-hardening model to increase work capacity in young people with disabilities. KEY POINTS: Examination, evaluation, interventions, and outcomes are described for 2 teenagers with intellectual disability. This approach is novel in that it uses functional capacity evaluation concepts used in ergonomic/occupational health contexts and applies them to youth with disabilities in educational settings. CONCLUSION: These concepts expand the scope of practice for physical therapists in school settings and potentially increase work opportunities for youth with disabilities.

The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review.

PURPOSE: Adults with bilateral vestibular hypofunction (BVH) experience significant disability. A systematic review assessed evidence for vestibular rehabilitation (VR). NUMBER OF STUDIES: 14 studies. MATERIALS/METHODS: Search identification of studies based on inclusion criteria: (a) population: adults with BVH of peripheral origin; (b) interventions: vestibular exercises, balance training, education, or sensory prosthetics; (c) comparison: single interventions or compared to another psychophysical intervention, placebo, or healthy population; (d) outcomes: based on International Classification of Functioning, Disability and Health (ICF) Body Functions and Structure, Activity, and Participation; (e) study designs: prospective and interventional, Levels of Evidence I to III per Centre of Evidence-based Medicine grading. Coding and appraisal based on ICF framework and strength of evidence synthesis. RESULTS: Five Level II studies and nine Level III studies: All had outcomes on gaze and postural stability, five with outcomes on gait speed and perceptions of oscillopsia and disequilibrium. CONCLUSIONS: (a) Moderate evidence strength on improved gaze and postural stability (ICF-Body Functions) following exercise-based VR; (b) Inadequate number of studies supporting benefit of VR on ICF-Participation outcomes; (c) Sensory prosthetics in early phase of development. CLINICAL RELEVANCE: Moderate evidence strength in support of VR from an impairment level; clinical practice and research needed to explore interventions extending to ICF-Activity and Participation.

Use of diagnosis and prognosis by pediatric physical therapists.

PURPOSE: Diagnosis and prognosis are components of the Patient Client Management Model of the Guide to Physical Therapist Practice. The purpose of this study is to determine how pediatric physical therapists (PPTs) define and use diagnosis and prognosis in their practice. SUBJECTS AND METHODS: This article reports the themes revealed in answers to open-ended questions on diagnosis and prognosis (n = 7 to n = 68) in an electronic survey that was sent to PPTs who are members of the American Physical Therapy Association (APTA) Section on Pediatrics, and non-Section members of the APTA who identify themselves as PPTs. RESULTS: In this sample, PPTs lack consistency in their definition and use of the terms diagnosis and prognosis. Many respondents reported a level of discomfort with the relevance, utility, and usefulness of diagnosis and prognosis. CONCLUSION: Despite literature on diagnosis and prognosis, PPTs continue to struggle with using these concepts in their practice.

Use of the Guide to Physical Therapist Practice by pediatric physical therapists.

PURPOSE: Physical therapists are encouraged to use the Guide to Physical Therapist Practice (Guide) in their practice. The purpose of this study was to determine whether and how pediatric physical therapists (PTs) use the Guide. SUBJECTS AND METHODS: A nationwide electronic survey was sent to pediatric physical therapists. Four hundred seventy-five members returned the survey yielding a 9.6% response rate. RESULTS: Respondents reported that they practice consistently with the Guide's patient/client management model but that they do not find the Guide useful. Respondents made recommendations for a future edition of the Guide. CONCLUSIONS: Pediatric PTs value the Guide as a reference, resource, and teaching tool. When the Guide is revised, the following should be considered: pediatric content, format, and utility of the Guide; educational needs of pediatric PTs about the Guide; and how stakeholders and PTs with other specialties view and use the Guide.

The benefits of physical activity for youth with developmental disabilities: a systematic review.

OBJECTIVE: Analyze evidence of the benefits of physical activity for youth with developmental disabilities. DATA SOURCES: Key word searches for "disability," "physical activity," "exercise," "fitness," and "sport" in major databases. A total of 3263 citations was found. STUDY INCLUSION/EXCLUSION CRITERIA: Systematic reviews and articles about studies quantitatively examining the effects of physical activity in youth with developmental disabilities ages 0 to 20 years were included. Only articles published in English in peer-reviewed journals were included. DATA EXTRACTION: A Measurement Tool to Assess Reviews criteria were used for systematic reviews; Grading of Recommendations, Assessment, Development, Evaluation criteria were used for observational studies; and Population, Intervention, Comparison, Outcome criteria were used for all studies. DATA SYNTHESIS: Data, shown in table format, were synthesized in relation to five research questions. RESULTS: Three systematic reviews and 14 studies were reviewed. Strong evidence indicated that children and adolescents with developmental disabilities derive health benefits from participation in group exercise programs, treadmill training, or therapeutic riding/hippotherapy. Lesser levels of evidence indicated that health benefits might be present for adapted skiing or aquatic programs. Documented benefits of physical activity include improvements in aerobic capacity, improved gross motor function, and high levels of participant/parent satisfaction. CONCLUSIONS: Evidence exists that physical activity is beneficial for youth with developmental disabilities. Further research studies are needed that are of greater scientific rigor including larger sample sizes, control groups, and stringent, replicable methodology.

Cardiac activity and information processing: the effects of stimulus significance, and detection and response requirements.

In two experiments, measures of heart rate and electromyographic activity were obtained from 40 male undergraduates while they performed two series of trials involving a sequential information processing task. Each trial consisted of a warning light, three successive tones, and a responded light, separated by 6-sec intervals. In Experiment 1, subjects responded only if the three tones were of different frequencies. Acclerative heart-rate responses to the last tone increased as a function of the significance of that tone. Subsequent cardiac decelerations were only observed if the subject was preparing to make a response. These results were replicated in Experiment 2, in which subjects responded only if two of the preceding tones were of the same frequency. Electromyographic activity was not significantly affected by stimulus significance or response anticipation. The data indicate that cardiac acceleration and deceleration reflect two independent psychological processes, associated with information-processing and decision-making activity on the one hand, and preparatory activity on the other.