PURPOSE:This study explored special education teachers' (SETs) perceptions of collaboration with school-based physical therapists (SBPTs). METHODS:SETs who taught in the school year 2021 to 2022 completed a survey on participation in and perceived benefit of 7 collaborative activities with SBPTs. RESULTS:Of 238 SETs, 131 collaborated with SBPTs. Instructional and planning activities occurred at similar rates and were both perceived as beneficial. 80.9% of SETs who collaborated with SBPTs reported greater confidence supporting student participation. While SET-SBPT collaboration occurred more often when the SET was a case manager for students with physical therapy (PT) services (89.3%), it also occurred when the SET had no students with PT services (18.8%). CONCLUSIONS:SETs find instructional and planning collaboration with SBPTs beneficial and, importantly, are more confident, increasing participation for students when they collaborate with SBPTs. Enhancing engagement in instructional and planning activities may improve teacher confidence and student participation.
Purpose: To develop a core set of relevant patient-reported outcomes (PROs) and corresponding measures (PROMs) for pediatric physical therapy, suitable for daily practice, research, and quality assessment. Methods: The research group defined the core set’s scope. Relevant PROs were identified through focus groups and interviews with adolescents, parents, and pediatric physical therapists, and supplemented by a scoping review. Findings were assessed by an expert panel. PROs were prioritized via a survey among pediatric physical therapists and selected for the core set. Valid PROMs were selected for each PRO. Results: Nine PROs were selected, grouped into 3 domains: functioning (physical functioning, participation, social functioning), symptoms (pain and fatigue intensity/interference), and overarching (quality of life, perceived overall health). Suitable PROMs were identified for all except “participation.” Conclusions: A core PRO(M) set for pediatric physical therapy is presented, with recommendations for use and implementation. Further research should develop a feasible generic PROM for participation.
PURPOSE:This study aims to investigate participation levels, predictors, and environmental factors that influence the participation of Brazilian children and adolescents with Autism Spectrum Disorder (ASD) in recreational and community activities. It also explores barriers, facilitators, and family strategies to promote participation. METHODS:A cross-sectional study will include 500 children and adolescents with ASD from Brazil's five regions. Using a Patient and Public Involvement approach, families collaborate in research decisions. Data will be collected through validated instruments: Children's Assessment of Participation and Enjoyment, Preferences for Activities of Children, Participation and Environment Measure-Children and Youth, and the mobility domain of Pediatric Evaluation of Disability Inventory-Computer Adaptive Test. A multimode data collection approach, combining online and in-person data collection, will be applied. Analyses will include descriptive statistics and linear regression. RESULTS:The study will describe participation patterns, preferences, barriers, facilitators, and predictors such as mobility and socioeconomic factors. CONCLUSION:Results will provide evidence to inform public policies and develop culturally relevant interventions that enhance participation, inclusion, and quality of life for Brazilian children with ASD.
AIM:To establish reference values for standing balance in typically developing children. METHODS:A cross-sectional study was conducted in 12 primary schools and 8 preschools, including 2,261 children aged 3 to 12 years old. Static (One-Legged Stance Test) and dynamic (Step Test) standing balance were measured for both legs. Stepwise regression examined the predictive roles of age, sex, weight, and height. RESULTS:One-Legged Stance Test increased from a mean of 9 seconds (standard deviation [SD] 6) for 3-year-olds to 30 seconds (SD 0) for 12-year-olds. Step Test increased from a mean of 0.8 steps/s (SD 0.1) for 3-year-olds to 1.4 steps/s (SD 0.2) for 12-year-olds. Predictors explained 44% of the variance in the One-Legged Stance Test (age 41%) and 59% in the Step Test (age 57%). CONCLUSIONS:Age was the strongest predictor of standing balance. Most children by 7 years old already perform similarly to adults in both static and dynamic standing balance.
PURPOSE:Independent locomotion has cascading impacts on overall infant development. Although infants with Down syndrome (DS) attain locomotor milestones later, it is unknown how they use emerging skills (e.g., creeping and walking) in everyday play. METHODS:This longitudinal observational study used behavioral coding to investigate locomotion quantity and type during play in infants with DS (n = 13), and changes with the acquisition of new motor skills. The amount of time locomoting was compared with 25 typically developing infants. RESULTS:Infants with DS spent less time locomoting than typically developing infants, and their locomotion time changed less with age and motor skill level. Infants with DS also continued to rely on floor mobility skills even after attaining upright locomotor skills. CONCLUSIONS:Detailed behavioral coding identified differences in real-world locomotion used by infants with DS with potential implications for motor skill learning and development.
PURPOSE:Research on gross motor proficiency (GMP) in people with hemophilia is inconsistent, limiting treatment and wellness recommendations. This exploratory study used a norm-referenced assessment to measure GMP and explore relationships with hemophilia-specific parameters. METHODS:Investigators collected demographic data, hemophilia type, severity, current management, and history of target joint(s) on 45 males with hemophilia, aged 4 to 21. Measurements included range of motion and subtests from the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), which were compared with age- and sex-matched normative data using scale and standard scores. RESULTS:The cohort scored at normative values or higher for BOT-2 subtests. Odds of scoring below average were increased in participants with obesity or target joints. No statistical associations were found between hemophilia type, severity, or current management and GMP. CONCLUSIONS:A diagnosis of hemophilia did not affect GMP, though patients with elevated body mass index or a target joint may be at greater risk of impaired motor proficiency.
PURPOSE:To examine factors related to early access and adherence to physiotherapy services among children with cerebral palsy (CP) in Cameroon. METHODS:A cross-sectional mixed retrospective and prospective study was conducted in Douala, Cameroon. Children aged 3 to 60 months diagnosed with CP from a tertiary referral center were included. Data were collected through structured caregiver interviews and medical record reviews. Early access was defined as initiating physiotherapy before 5 months of age, and good adherence was defined as completing ≥50% of prescribed sessions. RESULTS:Out of 94 children, 36 (38.3%) accessed physiotherapy early, and 36 (38.3%) showed good adherence. Factors significantly linked to early access included CP subtype, neonatal jaundice, and having more than 7 risk factors. Poor adherence was significantly associated with parental discouragement due to lack of improvement and canceled appointments due to the physiotherapist's unavailability. CONCLUSIONS:Early physiotherapy access and adherence remain inadequate in this Cameroonian setting, with clinical severity prompting earlier referrals.
PURPOSE:To assess the effects of wheelchair (WC) delivery and WC training on mobility of children with disabilities (CWD) and identify potential solutions for improving WC access in Ugandan CWD through experiential learning opportunities involving physical therapy students and residents. METHODS:Using a pre and posttest cohort design, 35 nonambulatory Ugandan children participated in a seating and mobility clinic through the Ugandan Wheelchair Project. Functional mobility and caregiver burden were the primary outcomes assessed in this study utilizing the mobility domain of the Pediatric Evaluation of Disability Inventory. Secondary outcome measures captured happiness, quality of life, and participation using the Smiley Faces Assessment Scale, Quality of Life survey modified from the Pediatric Quality of Life survey, and Picture My Participation, respectively. RESULTS:Scores from the Pediatric Evaluation of Disability Inventory and Smiley Faces Assessment demonstrated statistically significant improvements in mobility for CWD, caregiver burden, and children's happiness. Summary data collected from the Quality of Life survey and Picture My Participation offered suggestions to improve and guide future efforts around WC delivery in Uganda. CONCLUSIONS:Improved mobility and happiness for Ugandan CWD can be created through global experiential learning opportunities involving WC delivery.
PURPOSE:This second article in a series examines the contextual factors influencing the selection and use of standardized pediatric outcome measures (OMs) in physical therapist (PT) education and practice. METHODS:Four focus groups were conducted with 32 participants, including pediatric PT faculty and clinicians. Data were analyzed using a constant comparative method and thematic analysis. RESULTS:Three major themes emerged: (1) curriculum selection, (2) practice selection, and (3) expectations of students. These themes were further divided into 11 categories and 32 subcategories, reflecting varied contextual influences such as institutional priorities, clinical demands, and perceptions of student readiness. CONCLUSIONS:Findings reveal the complex, context-dependent nature of OM decision-making and a persistent disconnect between academic and clinical practices. Understanding decision influencers is essential to improving alignment between educational preparation and clinical expectations, and to advancing evidence-based pediatric physical therapy practice.
BACKGROUND:Developmental coordination disorder (DCD) affects 5% of school-age children and is characterized by impaired motor coordination and planning, not better explained by other conditions. Motor difficulties negatively impact school performance, activities of daily living, and participation with family and peers and may persist into adulthood. The 2020 DCD Clinical Practice Guideline (2020 DCD CPG) set standards for the physical therapy management of children with DCD. PURPOSE:This 2026 DCD CPG provides an updated reference for physical therapists, families, healthcare professionals, educators, and researchers to improve clinical outcomes and inform future research. RESULTS AND CONCLUSIONS:The 2026 DCD CPG addresses: physical therapy contributions to the diagnostic process, examination/evaluation including recommended outcome measures; collaborative plans of care including referral to other providers and dosage considerations; shared decision-making to establish meaningful goals and home programs; evidence-based interventions including task-oriented approaches and community physical activities; progress monitoring; implementation and compliance recommendations; and research recommendations.
BACKGROUND AND PURPOSE:This study aimed to analyze the relationship between physical literacy and habitual physical activity in children with cerebral palsy who can walk and to compare these aspects between them. METHODS:This was a cross-sectional study that included 43 children with cerebral palsy aged 6 to 12 years at Gross Motor Classification System (GMFCS) levels I and II. Participants wore Actigraph wGT3X-BT accelerometers for 1 week to assess physical activity levels and completed the Physical Literacy Profile Questionnaire (PLP-Quest) to assess physical literacy. RESULTS:No significant correlation was found between physical literacy and habitual physical activity. Seventy-eight percent of the participants met the World Health Organization's physical activity recommendations. Children at GMFCS level II showed higher sedentary behavior and lower light physical activity levels than those at level I, besides their similar physical literacy scores. CONCLUSIONS:More efforts are needed to reduce sedentary behavior, especially for children at GMFCS level II, and to encourage physical literacy development.
PURPOSE:To determine the sustained impact of physical therapy (PT) intervention during cancer treatment on long-term physical function in children and adolescents treated for noncentral nervous system cancers. METHODS:In a posttest-only nonequivalent groups observational design, 74 survivors over 5 years postcancer treatment (37 PT, 37 control) completed physical function testing. Differences in group means and relationships between demographics, ankle impairments, and activity limitations were analyzed. RESULTS:The PT group exhibited significantly greater dorsiflexion strength Z scores (P =.008) and plantarflexion strength Z scores (P =.003) than controls. Ankle range of motion and activity limitations were not significantly different. PT and age at diagnosis explained 24% of the variance in the 6-minute walk test. CONCLUSIONS:Our study suggests that PT during treatment in survivors of childhood cancer offers a sustained strength benefit. Future research should examine the dosing and adherence to PT in relation to impairments to optimize outcomes.
PURPOSE:The relation between motivation to move (MTM) and motor development has been explored in typically developing children, but not those with disabilities. METHODS:We conducted a secondary analysis of data from 37 toddlers with cerebral palsy (age: 11.0-33.4 months, Gross Motor Function Classification System I-IV) enrolled in a clinical trial. We measured MTM's stability over time and its relations to gross motor function, cognition, sex, and age. RESULTS:At baseline, greater MTM was related to higher gross motor function and cognition. Despite improvements in motor function over the trial period, MTM remained stable. Initial MTM and cognition, but not sex, were significant predictors of later motor function. CONCLUSIONS:We hypothesize that MTM is learned from successful movement experiences at very young ages. Understanding the evolution of MTM in children with cerebral palsy may be useful to develop strategies to facilitate motivation and optimize motor development. Further study in other age groups and populations is needed.
Purpose: Intrauterine constraint factors such as multiparity and breech presentation at birth have been associated with congenital muscular torticollis (CMT). The literature lacks evidence linking these factors to CMT severity. The purpose of this study is to determine how birth weight, length, presentation, sex, and delivery factors associate with CMT severity. A secondary purpose is to correlate severity with CMT direction and age at physical therapy evaluation. Methods: Researchers relied on a clinical outcome database of 1239 infants <= 6 months diagnosed with CMT to examine how birth weight, length, breech positioning, sex, multiparity, and delivery method relate to CMT severity. Results: Breech presentation was the only factor associated with torticollis severity. Infants with >30 degrees of cervical tightness were more likely to be younger at evaluation and have a right torticollis. Conclusions: The increased likelihood of CMT severity with breech presentation at birth can guide pediatric physical therapists in prognostics.
Purpose: Low back and neck pain are increasing worldwide, even in children. However, Italy lacks validated tools for the assessment of children and adolescents with spine disorders. The Young Spine Questionnaire (YSQ) seems to be an appropriate option. The aim of this study was to translate, adapt, and validate the YSQ to develop an Italian version of it. Methods: One hundred thirty-three participants were recruited in the area of Trieste, aged between 9 and 12 years old. The YSQ and the KIDSCREEN-10 were assessed with regard to their reliability, test-retest reliability from 3 to 4 days, and construct validity. Results: The mean age of the sample was 10.25 (+/- 1.5), with a slight prevalence of females (62.7%). The internal consistency was high, with an alpha score ranging from 0.62 to 0.92 and a total score of 0.82. The test-retest showed good reproducibility. The total score of the YSQ showed a Spearman correlation coefficient of 0.87. For the dimensions and the items of the questionnaire, the scores ranged from 0.52 to 0.79. Construct validity showed a strong correlation between the questionnaires, with a score of 0.61. Conclusions: The YSQ seems to be a valid and reliable questionnaire to assess spinal pain in Italian children. According to the results of the psychometric proprieties, the use of this questionnaire is recommended.
Purpose: To determine the level of burnout and investigate the relationship between effort-reward imbalance and burnout among early intervention (EI) physical therapists. Method: Study participants included EI physical therapists from 1 state within the United States. Participants completed an online survey that included demographic questions, the Oldenburg Burnout Inventory, and the Effort-Reward Imbalance Scale. Linear regression examined the relationship between effort-reward imbalance and burnout. Results: A total of 127 participants were included. Effort, reward, and overcommitment explained 49% (R-2 = .490) of the variance in exhaustion (F-4,F-118 = 28.38; P < .001) and 29.7% of the variance in disengagement (F-4,F-118 = 12.48; P < .001) components of burnout. Conclusion: Physical therapists practicing in EI report high levels of emotional exhaustion, disengagement, and burnout. The results suggest that strategies to manage job demands, rewards, and overcommitment may help EI organizations decrease burnout among EI physical therapists.
