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1.
Phys Occup Ther Pediatr ; 41(1): 1-17, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33023352

RESUMO

AIMS: Telehealth is being rapidly adopted by physical and occupational therapists in pediatrics as a strategy to maintain services during the COVID-19 crisis. This perspective presents a mix of theoretical and practice perspectives to support the implementation of telehealth. Although research evidence is just emerging, there is sufficient indication to believe telehealth is effective. However, which telehealth strategies are best for which children and families, and which intervention goals, are not yet clear. METHODS: We discuss how different telehealth strategies (e.g. videoconferencing, emails, phone calls, online programs) are being used to address specific intervention goals. Comments from therapists using telehealth and examples of practices in different context and with different populations are provided. We discuss how newly adopted telehealth practices could be included in future hybrid service delivery models and programs, as well as factors influencing the decision to offer face-to-face or online interventions. CONCLUSION: Although telehealth has been implemented quickly as a response to a health care crisis, and is not a one-size-fits-all intervention, we believe it offers great opportunities to increase the accessibility, cost-effectiveness and family-centredness of our services, to best support families of children with disabilities.


Assuntos
Assistência à Saúde/métodos , Crianças com Deficiência/reabilitação , Terapia Ocupacional , Modalidades de Fisioterapia , Telemedicina , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Telemedicina/métodos
2.
Rev. neurol. (Ed. impr.) ; 71(1): 1-10, 1 jul., 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195438

RESUMO

INTRODUCCIÓN: La parálisis braquial obstétrica cursa con afectación del miembro superior y da lugar a secuelas estructurales y de la función permanentes que limitan el rango articular de movimiento y reducen la independencia en las actividades cotidianas, así como la participación del niño dentro de su entorno natural. OBJETIVO: Describir los tratamientos de fisioterapia empleados en la actualidad para incrementar la funcionalidad de la extremidad superior afectada en niños de 0 a 10 años diagnosticados de parálisis braquial obstétrica. PACIENTES Y MÉTODOS: Se realizó una búsqueda bibliográfica de los trabajos publicados entre 2009 y 2018 en las bases de datos PubMed, PEDro, ScienceDirect y Cochrane Library. RESULTADOS: Tras aplicar los criterios de inclusión/exclusión, se obtuvieron diez estudios con resultados favorables para la funcionalidad de la extremidad superior afectada y la densidad de mineralización ósea, independientemente de la técnica de elección utilizada durante la intervención. Se analizaron los programas de fisioterapia empleados en los diferentes estudios, como la terapia de movimiento inducido por restricción, el kinesiotape, la electroterapia, la realidad virtual y el uso de férulas u ortesis. CONCLUSIÓN: Todas las técnicas descritas sugieren resultados favorables para la funcionalidad del miembro superior en niños de 0 a 10 años con parálisis braquial obstétrica


INTRODUCTION: Obstetric brachial palsy is involved with affected upper limb, resulting in permanent structural and function sequelae that limit the motion articular range and reduce independence in daily activities, as well as the children participation in their natural environment. AIM: To describe the physiotherapy treatments currently used to increase the affected upper limb functionality in children from 0 to 10 years diagnosed with obstetric brachial palsy. PATIENTS AND METHODS: A bibliographic search of published studies between 2009 and 2018 was carried out in the PubMed, PEDro, ScienceDirect and The Cochrane Library databases. RESULTS: After applying the inclusion/exclusion criteria, ten studies were obtained with favorable results for the affected upper limb functionality and bone mineralization density, regardless of the technique of choice used during the intervention. The used physiotherapy programs in the different studies such as Constraint Induced movement therapy, kinesiotape, electrotherapy, virtual reality and use of splints or orthotics were analyzed. CONCLUSION: All the described techniques suggest favorable results for the affected upper limb functionality in obstetric brachial palsy from 0 to 10 years


Assuntos
Humanos , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Neuropatias do Plexo Braquial/complicações , Neuropatias do Plexo Braquial/terapia , Paralisia do Plexo Braquial Neonatal/complicações , Paralisia do Plexo Braquial Neonatal/terapia , Modalidades de Fisioterapia , Extremidade Superior/patologia , Crianças com Deficiência/reabilitação , Terapia por Estimulação Elétrica , Densidade Óssea/fisiologia , Densitometria , Realidade Virtual
3.
PLoS One ; 15(7): e0235439, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614867

RESUMO

While access to support for individuals with disabilities has attracted international attention, children with disabilities and their families continue to face a range of barriers that limit their timely access to the needed support, including health service. This is even worse for children with disabilities living in resource poor settings like Bangladesh. The objective of this study was to determine the extent to which families of children with disabilities have knowledge about and access to government support for their children with disabilities in Bangladesh. We employed a cross-sectional study among 393 families of children with disabilities who sought services from the Centre for the Rehabilitation of the Paralysed for their children with disabilities in Bangladesh. We used chi-square test to measure the association between categorical variables and, Mann-Whitney U-test to compare mean across different sub-groups. Overall, family members of children with disabilities have limited knowledge about and access to government support. We found a significant association between knowledge and access to government support (p<0.001). Family members with children with disabilities aged younger than six years had less access to government support (p<0.001). We thus concluded with an urgent call on government agencies and service providers to provide relevant and timely information to families of children with disabilities to enable them to access the needed support.


Assuntos
Cuidado da Criança , Crianças com Deficiência/reabilitação , Programas Governamentais , Acesso aos Serviços de Saúde , Serviços de Saúde para Pessoas com Deficiência , Adulto , Bangladesh , Criança , Pré-Escolar , Estudos Transversais , Família , Feminino , Humanos , Masculino , Assistência Individualizada de Saúde , Inquéritos e Questionários , Apoio ao Desenvolvimento de Recursos Humanos
6.
Pediatr Phys Ther ; 32(2): 98-105, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32218069

RESUMO

PURPOSE: To ascertain the variables predicting the gap between ideal and actual practice in embedding school-based physical therapy services. METHODS: School-based physical therapists completed an online survey estimating ideal and actual practice of embedding physical therapy services. Predictive modeling was used to determine whether disability, interventions, goals, families, teachers, workload, billing, and/or contracts predicted the gap between estimated ideal and actual practice. RESULTS: Data from 410 participants revealed that severity of students' disability, billing, written contracts, and families' preferences predicted the gap between estimated ideal and actual services. Actual practice varied based on region, APTA membership, and Academy of Pediatric Physical Therapy membership. CONCLUSIONS: Our model predicts the gap between estimates of ideally and actually embedding school-based physical therapy services. While 4 variables predicted the gap, further research is needed to develop a predictive model of actual practice to inform school-based physical therapy practice.


Assuntos
Crianças com Deficiência/reabilitação , Crianças com Deficiência/estatística & dados numéricos , Fisioterapeutas/estatística & dados numéricos , Modalidades de Fisioterapia/estatística & dados numéricos , Serviços de Saúde Escolar/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
7.
Value Health ; 23(2): 164-170, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32113621

RESUMO

OBJECTIVES: To examine health-related quality of life (HRQoL) in young children with low language or congenital hearing loss and to explore the value of assessing HRQoL by concurrently administering 2 HRQoL instruments in populations of children. METHODS: Data were from 2 Australian community-based studies: Language for Learning (children with typical and low language at age 4 years, n = 1012) and the Statewide Comparison of Outcomes study (children with hearing loss, n = 108). HRQoL was measured using the parent-reported Health Utilities Index Mark 3 (HUI3) and the Pediatrics Quality of Life Inventory 4.0 (PedsQL) generic core scale. Agreement between the HRQoL instruments was assessed using intraclass correlation and Bland-Altman plots. RESULTS: Children with low language and with hearing loss had lower HRQoL than children with normal language; the worst HRQoL was experienced by children with both. The lower HRQoL was mainly due to impaired school functioning (PedsQL) and speech and cognition (HUI3). Children with hearing loss also had impaired physical and social functioning (PedsQL), vision, hearing, dexterity, and ambulation (HUI3). Correlations between instruments were poor to moderate, with low agreement. CONCLUSIONS: Children with low language and congenital hearing loss might benefit from interventions targeting overall health and well-being, not just their impairments. The HUI3 and PedsQL each seemed to provide unique information and thus may supplement each other in assessing HRQoL of young children, including those with low language or congenital hearing loss.


Assuntos
Percepção Auditiva , Comportamento Infantil , Linguagem Infantil , Crianças com Deficiência/psicologia , Perda Auditiva/diagnóstico , Audição , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Pessoas com Deficiência Auditiva/psicologia , Qualidade de Vida , Inquéritos e Questionários , Fatores Etários , Austrália , Estudos de Casos e Controles , Pré-Escolar , Pesquisa Comparativa da Efetividade , Efeitos Psicossociais da Doença , Crianças com Deficiência/reabilitação , Educação de Pessoas com Deficiência Auditiva , Feminino , Perda Auditiva/congênito , Perda Auditiva/psicologia , Perda Auditiva/reabilitação , Humanos , Transtornos do Desenvolvimento da Linguagem/psicologia , Transtornos do Desenvolvimento da Linguagem/reabilitação , Inclusão Escolar , Masculino , Pessoas com Deficiência Auditiva/reabilitação , Valor Preditivo dos Testes , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes
8.
BMC Health Serv Res ; 20(1): 134, 2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32087730

RESUMO

BACKGROUND: Immigrants and their Norwegian-born children make up approximately 18% of the total population in Norway. While several studies have been conducted on immigrants' utilization of healthcare services, immigrant families are systematically underrepresented in international studies of children with disabilities. By focusing on experiences of immigrant parents of children with disabilities navigating health and rehabilitation services in Norway, this study generated knowledge of how accessible and tailored the services were from their point of view. METHODS: This study took a qualitative approach, using semi-structured interviews to explore the experiences of immigrant parents of children with disabilities from non-Western countries. The interviews were transcribed, coded, and analyzed via an inductive thematic analytic approach. RESULTS: The findings show how the "immigrant experience" influenced the way the parents looked at, experienced, and even praised the services. The parents appreciated the follow-up services provided by the pediatric rehabilitation centers, which they experienced as predictable and well-organized. While navigating the services, they experienced several challenges, including the need for information, support, and timely help. They felt exhausted because of years of struggle in the healthcare system to access the help and services they needed. They expressed how this struggle had affected their own health. The feeling of being treated differently from the majority was another challenge they experienced while navigating the services. The findings also show how parents' experiences of communication with healthcare providers were influenced not only by their own language and communication skills but also by the healthcare providers' intercultural communication skills and dominant organizational culture. CONCLUSIONS: The parents' experiences show that there is still a gap between the public ideal of equal healthcare services and the reality of the everyday lives of immigrant families of children with disabilities. By exploring immigrant parents' experiences, this study highlights the importance of mobilization at both the individual and systemic levels to fill the current gap and provide tailored and accessible services to the entire population.


Assuntos
Atitude Frente a Saúde , Serviços de Saúde da Criança/organização & administração , Crianças com Deficiência/reabilitação , Crianças com Deficiência/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Grupos Minoritários/psicologia , Pais/psicologia , Adulto , Criança , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Noruega , Navegação de Pacientes , Gravidez , Pesquisa Qualitativa
9.
An Acad Bras Cienc ; 92(1): e20190273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32074180

RESUMO

The characteristic of immersion, involvement and motivation have made serious games an important tool to be used in the medical field. However, there are people that, having some sort of physical disability, are not able to, or do not feel motivated to play. This work presents a strategy to support human- computer interactions for children with a disability in their upper limbs through a wearable device, with the objective of improving access to digital games for the target audience. For the development of this work, the wearable device Myo was used to control a puzzle game as a means of providing the interaction between the individual and the game. In this context, the game is controlled with the movement of the user's upper limb that presents the disability, through the Myo device. For the validation of this research, the game developed was made available for individuals presenting a disability in the upper limbs, from an age range between five and fifteen years old, of the Association of Assistance to the Disabled Child (AACD). Soon, it was noticed that the participants of the research soon could play while utilizing the deficient limb with Myo's support and felt more motivated to play. On the long run, it is expected to contribute to the motivation of patients through technological innovation, so that the process of body consciousness is made more interactive.


Assuntos
Crianças com Deficiência/reabilitação , Transtornos dos Movimentos/reabilitação , Jogos de Vídeo , Adolescente , Criança , Desenho de Equipamento , Feminino , Humanos , Masculino , Motivação , Inquéritos e Questionários , Interface Usuário-Computador
10.
Dev Med Child Neurol ; 62(4): 483-488, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31984500

RESUMO

AIM: To develop a detailed priority list of family-centred rehabilitation goals on the activity level within the International Classification of Functioning, Disability and Health (ICF) chapters d4 'Mobility' and d5 'Self-care' in a paediatric population with a broad range of health conditions. METHOD: Twenty-two months after implementing a systematic, family-centred, goal-setting process, the rehabilitation goals of 212 inpatients were retrospectively allocated to the most detailed level of ICF categories by two independent researchers. The overall frequencies of these goals were calculated and stratified by health condition, functional independence, and age. RESULTS: Ninety-three females and 119 males were included in the study (mean age 10y 9mo, SD 4y 5mo, range 2y 1mo-21y 5mo). The five most frequent rehabilitation goals were ICF codes d4500 'Walking short distances' (11%), d4200 'Transferring oneself while sitting' (9%), d5400 'Putting on clothes' (7%), d451 'Going up and down stairs' (6%), and d4153 'Maintaining a sitting position' (5%). These top goals varied in the subgroups with regard to the underlying health condition, functional independence, and age. INTERPRETATION: The findings of this study are not generalizable due to the large heterogeneity in priorities. However, they can be used to incorporate families' needs into future research designs and the development of new technologies. WHAT THIS PAPER ADDS: Walking short distances is the most frequent mobility/self-care goal of paediatric rehabilitation. The top goals depend on health condition, functional independence, and age. Priorities vary considerably between children undergoing rehabilitation. Rehabilitation goals need to be assessed individually for each child.


Assuntos
Atividades Cotidianas , Crianças com Deficiência/reabilitação , Planejamento de Assistência ao Paciente , Centros de Reabilitação , Autocuidado , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Pacientes Internados , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Masculino , Estudos Retrospectivos , Adulto Jovem
11.
Dev Neurorehabil ; 23(3): 145-159, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30987518

RESUMO

Children with complex disabilities sometimes have difficulty communicating with their parents, caregivers, and teachers. For these children, eye gaze assistive technology can be used to facilitate communication. Eye gaze assistive technology outcomes for children and youth were analyzed in this systematic review. Database and hand-searches yielded 4412 unduplicated results, of which 11 articles were eligible for this review. Outcome measures, as well as environmental and personal factors, were mapped to the World Health Organization's International Classification of Functioning, Disability and Health framework. Communication outcomes were most prevalent and co-occurred with outcomes in all reported activities and participation domains. Environmental and personal factors were classified as either facilitators or as barriers in relation to device uptake and success. Although comprehensive professional and caregiver support was the primary facilitator for success, barriers could lead to rejection of the technology even when children were successful using the system.


Assuntos
Crianças com Deficiência/reabilitação , Fixação Ocular , Reabilitação Neurológica/métodos , Equipamentos de Autoajuda , Adolescente , Criança , Humanos , Reabilitação Neurológica/instrumentação , Avaliação de Resultados em Cuidados de Saúde
12.
Scand J Occup Ther ; 27(5): 385-393, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30734615

RESUMO

Background: Many bimanual activities are challenging for children with unilateral spastic cerebral palsy (USCP).Aims: To investigate hand use by children with USCP in daily activities of their interest.Material e methods: Sample included twenty children with USCP, aged 8 to 14 years old. Participants identified bimanual activities of their interest and no interest. Children's performance on these activities were videotaped. Videos were coded according to the affected extremity's forms and effectiveness of use, caregiver provision and types of assistance, and child's satisfaction. The relative proportions of each parameter were compared using the signed-rank test, considering the time spent in activities of interest and no interest.Results: We analyzed 116 activities. We found effects of interest in children's satisfaction (p = 0.003) and on the type of assistance (p = 0.03). Specifically, children demonstrated longer periods of satisfaction performing activities of their interest and caregiver physical assistance was provided for longer periods of time in activities of no interest. There were no effects on the other parameters.Conclusions: A model that illustrates the impact of a child's interest on the performance of daily bimanual activities is presented, grounded in our results and in the literature.


Assuntos
Atividades Cotidianas/psicologia , Cuidadores/psicologia , Paralisia Cerebral/psicologia , Paralisia Cerebral/reabilitação , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Manipulações Musculoesqueléticas/métodos , Adolescente , Criança , Feminino , Humanos , Masculino
13.
Disabil Rehabil Assist Technol ; 15(2): 183-194, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30735067

RESUMO

Purpose: Parental perceptions are key to the uptake of augmentative and alternative communication (AAC) devices for their children with complex communication needs. This study aimed to explore the perceptions of parents in a resource poor Global South country on the use of mobile technology as AAC devices.Materials and methods: Sixteen participants (11 female; 5 male) were included in the study. Focus group discussions, face-to-face interviews and telephone interviews were conducted with the aid of an interview guide. The interview data were analysed using the key principles of Framework analysis and through the lens of critical disability studies.Results: Six broad themes emerged. Most participants indicated a penchant for mobile technology, though its current use with their children was mainly as a teaching tool rather than a communication device. Concerns were raised about the cost of mobile technology, which if used within communication, was only as a temporary stop-gap measure with limited knowledge. The power of mainstream technology to challenge prevalent notions of disability was also highlighted by the participants.Conclusions: There is an openness to using mainstream mobile technology by parents with their children with complex communication needs. This use is currently reserved mainly for educational purposes while its power to challenge disability-related stereotypes is acknowledged. More parent training is required to encourage the use of mobile technology as AAC devices for communication.Implications for rehabilitationCurrent parent perspectives on mobile technology as AAC devices must be explored, given its potential impact on the uptake of these devices to support communication in their children with complex communication needs.Mainstream mobile technology could challenge perceptions of disability and therefore, be more acceptable to parents for their children with complex communication needs.Parental training is required to increase knowledge on the use of mobile technology as AAC devices for communication to enable informed choice-making.


Assuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Transtornos da Comunicação/reabilitação , Computadores de Mão , Crianças com Deficiência/reabilitação , Pais/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino
14.
Disabil Rehabil Assist Technol ; 15(1): 92-100, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30652627

RESUMO

Purpose: The study aim was to examine the measurement properties of the Youth Evaluation of Products Scale for Augmentative and Alternative Communication (YEP-AAC) as a means to understand the product attitudes of youth toward their AAC devices.Methods: In study 1, four males and two females between the ages of 8 and 17 years (median age = 14 years) participated in face-to-face interviews. A researcher administered the YEP-AAC and then asked youths to explain the rationale for their item ratings. Two researchers analyzed masked transcripts of the interviews to predict the valence of item ratings assigned by youths. In study 2, 18 families participated in a mailed survey to examine the reliability and validity of the scale domains. Seventeen mothers/one father and their children (9 male/9 female) between the ages of 10 and 20 years participated (median age = 16 years).Results: The level of chance-corrected agreement between valences converted from youth ratings on the YEP-AAC and those assigned by researchers was fair (weighted kappa = 0.38). Internal consistencies of the scale domains were acceptable. Youths who rated their AAC devices more favourably had higher functional communication as hypothesized.Conclusion: The two studies provide support for the face validity, internal consistency and convergent validity of the YEP-AAC as a measure of the product attitudes of youth with complex communication needs.Implications for rehabilitationDeveloping reliable ways to understand the product needs, preferences and values of youth with complex communication needs will help to support the selection, acquisition and use of augmentative and alternative communication (AAC) devices.Consumer socialization helps to explain how youth may acquire the skills, knowledge and experience relevant to their role as AAC consumers.Reliable youth-report questionnaires that are grounded in consumer socialization provide an expedient way to understand the product attitudes of young consumers with complex communication needs.


Assuntos
Atitude Frente a Saúde , Auxiliares de Comunicação para Pessoas com Deficiência , Crianças com Deficiência/reabilitação , Adolescente , Criança , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
15.
Scand J Occup Ther ; 27(5): 364-372, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30661444

RESUMO

Background: The PREP (Pathways and Resources for Engagement and Participation), an innovative 12-week occupational therapy intervention that focuses on changing the environment, was found effective in improving the participation of youth in specific chosen community-based activities.Objective: To complement existing evidence, this study explored changes in overall participation patterns of youth with physical disabilities following the PREP intervention.Methods: Guided by time-geography approach, 13 youth aged 12-17 completed a 24-hr diary using the Aday app during one typical weekday and another day during the weekend, pre- and post-intervention. Data of 50 diaries were plotted and analyzed using the VISUALTimePAcTS program.Results: Following the PREP, youth were engaged in less digital media and more in study-related activities. Number of occurrences and time spent doing activities with friends were greater post-intervention, whereas time spent doing activities at home was quite similar, particularly during the weekdays. During the weekends, however, youth spent slightly less time at home.Conclusions and significance: Findings provide preliminary support for the effectiveness of the PREP, extending beyond the accomplishment of specific targeted activities towards a change in the overall daily patterns of youth. Such knowledge can redirect occupational therapists' attention to environment-focused interventions involving real-life experiences.


Assuntos
Terapia Comportamental/métodos , Crianças com Deficiência/educação , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Internet , Participação do Paciente/psicologia , Telerreabilitação/métodos , Adolescente , Criança , Feminino , Geografia , Humanos , Masculino , Participação do Paciente/estatística & dados numéricos
16.
Rev Neurol (Paris) ; 176(1-2): 37-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31601451

RESUMO

The transfer of adolescents from paediatric care to adult health facilities is often difficult for the patients and their families and can lead to a breakdown in medical follow-up and therefore serious complications. Existing recommendations for the successful transition of patients with chronic disorders do not specifically address patients with handicap. Preparations for the transfer must be made well in advance. They must aim to achieve the autonomisation of adolescents by making them responsible and providing them with the knowledge that will enable them to manage their care themselves, the know-how to react appropriately if there is any change in their condition, and to move comfortably within the adult health system. This requires the active participation of the patient, his or her family and the paediatric and adult care teams. It involves multidisciplinary management plus the production and maintenance of an educational therapy programme. Finally, the identification of doctors trained in handicap, relevant sub-specialists and even expert patients could enable improvements in the continuum of complete and appropriate care for these patients within adult medicine.


Assuntos
Crianças com Deficiência , Doenças do Sistema Nervoso/terapia , Transição para Assistência do Adulto , Adolescente , Adulto , Criança , Crianças com Deficiência/reabilitação , Crianças com Deficiência/estatística & dados numéricos , Humanos , Comunicação Interdisciplinar , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/epidemiologia , Equipe de Assistência ao Paciente/organização & administração , Transição para Assistência do Adulto/organização & administração , Adulto Jovem
17.
Phys Occup Ther Pediatr ; 40(2): 217-230, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31480881

RESUMO

Aims: The purpose of this study was to obtain the perspectives of occupational and physical therapists working in pediatric rehabilitation about the factors that influence implementation of clinical practice guidelines (CPG) using the case of constraint induced movement therapy (CIMT). We aimed to identify factors that hinder implementation of CPGs and strategies for overcoming barriers when widespread implementation is stalled.Methods: Qualitative case study methodology was bounded within the parameters of CIMT implementation in pediatric rehabilitation in one jurisdiction. Twenty-one occupational and physical therapists participated in one of three focus groups. Data were analyzed using an inductive qualitative approach.Results: Participants viewed CPGs as useful, and emphasized the importance of consistency between guidelines and relevance to practice context. Therapists considered the "art and science" in clinical decision-making. Barriers and facilitators to CPG implementation were identified at the client, clinician, intervention location and systemic level. Potential solutions to help "unstick" guideline implementation were consistent with theories of collective knowledge exchange and mindlines.Conclusion: The presence of CPGs does not ensure evidence uptake; understanding of local barriers is required. This case study highlights the value of a collective knowledge exchange approach and attention to the social structures of knowledge development and evidence use.


Assuntos
Crianças com Deficiência/reabilitação , Medicina Baseada em Evidências , Fidelidade a Diretrizes , Guias de Prática Clínica como Assunto , Pesquisa Médica Translacional , Criança , Humanos , Terapeutas Ocupacionais , Pediatria/métodos , Fisioterapeutas
18.
Aust Occup Ther J ; 67(1): 31-38, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31657029

RESUMO

AIM: Assessment of functional abilities is an essential component in the diagnosis of neurodevelopmental disorders in young children. Functional abilities, assessed using the Pediatric Evaluation of Disability Inventory-Computer Adapted Test (PEDI-CAT), are used to determine eligibility for early intervention funded under the National Disability Insurance Scheme in Australia (NDIS). This study aims to compare the use of the PEDI-CAT with the Vineland-3, a comprehensive parent interview for the determination of support needs, diagnosis, and eligibility for funding. METHOD: Seventy-five preschool aged children referred for formal diagnosis were assessed with the Vineland-3, and subscale scores reviewed for clinical judgement. These children were also assessed on the PEDI-CAT speedy version and the results on the two tests compared. RESULTS: The PEDI-CAT was less sensitive than the Vineland-3 to the functional difficulties being experienced in this population of preschool aged children. The Vineland-3 had floor effects on some scales and deficits masked by skills in other areas in the same domain, but standard subscale scores allowed skills and areas needing support to be defined. Overall 25% of children clinically in need of support were not identified on the Pedi-cat compared to only 4% using Vineland Domain scores and 3% using Vineland-3 subscale scores. The PEDI-CAT also identified significantly lower levels of support required with only 32% of children found to need very substantial support compared to 40% of children on the Vineland Domain scores, and 59% using subscale scores. CONCLUSION: Based on the results of this study, the Vineland-3 comprehensive interview interpreted using subscale scores as well as domain scores is more sensitive than the PEDI-CAT in identifying young children in need of support as well as the areas and degree of support required.


Assuntos
Avaliação da Deficiência , Transtornos do Neurodesenvolvimento/diagnóstico , Terapia Ocupacional/métodos , Criança , Pré-Escolar , Comunicação , Crianças com Deficiência/reabilitação , Feminino , Humanos , Relações Interpessoais , Masculino , Limitação da Mobilidade , Transtornos do Neurodesenvolvimento/reabilitação , Terapia Ocupacional/normas , Reprodutibilidade dos Testes
19.
Scand J Occup Ther ; 27(5): 373-384, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31703170

RESUMO

Background: Play is a right for children; an essential childhood occupation influenced by their family environment. Despite increasing recognition of unstructured outdoor play benefits, children with disabilities experience limited play opportunities.Aim: To apply a capabilities approach lens to understand outdoor play decision-making by mothers of children with disabilities within a culturally and linguistically diverse community.Materials and methods: Data collection for this case study involved semi-structured interviews with five mothers of primary school-aged children with disabilities and a week-long survey that profiled their children's outdoor play. Analysis was thematic and involved identifying barriers and opportunities at each ecocultural layer, aggregating strategies families used to address the barriers, and understanding their overall play decision-making.Findings: Mothers considered the child's interests and abilities, valued play as both a means and ends, planned for play, and facilitated in the moment as required. Multiple factors influenced mothers' outdoor play decisions. Mothers' values were child-centred, positively influencing the child's play opportunities.Conclusion and significance: This study's capabilities lens could inform professions such as occupational therapy to support families of children with disabilities from culturally diverse communities to advocate for play opportunities across settings.


Assuntos
Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Crianças com Deficiência/estatística & dados numéricos , Mães/psicologia , Ludoterapia/métodos , Jogos e Brinquedos/psicologia , Adulto , Criança , Feminino , Humanos , Masculino , Inquéritos e Questionários
20.
Disabil Rehabil Assist Technol ; 15(3): 357-362, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-30806105

RESUMO

Background: Children with cerebral palsy have difficulty to sit, stand, walk, run and jump independently. Therapy is an important factor in improving these aspects, and if applied in early intervention treatments, when the child is growing, it could have many benefits. These therapies require intensive and extended sessions, which in turn demand dedication and effort. New strategies that provide interesting and motivating interventions are often incorporated to improve the participation and performance of the children in the therapies. Therapies using social assistive robots can be alternative and complementary methods to promote the participation and motivation of children with cerebral palsy.Methods: The objective of this work is to validate the effectiveness of a 16-session physical therapy program to improve the participation and fulfillment of therapeutic objectives on an 8 year-old boy with dyskinetic cerebral palsy for motor learning to walk using a social assistive robot. The therapy program was carried out through a methodological proposal that uses SMART objectives (Specific, Measurable, Achievable, Realistic and Timed), Goal-Directed Therapy (GDT) and its evaluation through Goal Attainment Scaling (GAS). Results: A NAO robot was used as a social assistive robot to support a physical therapy for a child with cerebral palsy. In this work, it was observed that the motivation generated by the interaction with the social assistive robot facilitated the persistence in the walking and the fulfillment of the objectives. Conclusion: Using humanoid robots as social assistive robots may benefit therapeutic processes on children with motor disabilities. The methodology developed provides a formal way to achieve objectives in therapeutic processes for children with cerebral palsy.Implications for rehabilitationIt requires researchers to conduct more studies to validate the potential of the use of social robots in therapeutic interventions that promote development in children with motor disabilities, such as cerebral palsy.Promoting the use of new technologies in therapeutic processes such as humanoid robots allows us to create new strategies to know the impact of this technology in the area of rehabilitation.The use of formal methodologies focused on the patient, along with multidisciplinary teams, could increase the possibilities of using social robots to improve cognitive and motor outcomes in children with cerebral palsy.The formulation of SMART objectives and their quantification through the GAS scale can be used as recommendations to improve the formulation of goals in therapeutic interventions for children with cerebral palsy.


Assuntos
Paralisia Cerebral/reabilitação , Crianças com Deficiência/reabilitação , Destreza Motora , Robótica/métodos , Participação Social , Caminhada , Criança , Humanos , Masculino
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