Pediatric Rehabilitation Therapies Differ in Intensity

Ambuehl, Maria; Hedel, Hubertus J. A. van; Labruyère, Rob

doi:10.1097/phm.0000000000001323

Cited by 5 publications

(17 citation statements)

References 37 publications

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“…It is challenging to formulate one currency to define how much effort the body requires for a variety of physical rehabilitation interventions. Therefore, intensity should be defined by a scale that fits the type of intervention and the intended goal 24 …”

Section: Discussionmentioning

confidence: 99%

“…Intensity is often equated with duration of therapy intervention 39,42 . However, duration is not a valid proxy for the intensity of an intervention and therefore cannot be used to establish a dose–response relationship 24 . It is challenging to formulate one currency to define how much effort the body requires for a variety of physical rehabilitation interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Dosage consists of the factors frequency, intensity, time, and type (FITT) of an intervention 22 and relates both to the ability and speed in the recovery process which, in turn, is associated with the degree of restoration of functional performance 17,20 . The FITT factors are recommended as a useful framework in reporting dosage of physical rehabilitation interventions 23,24 …”

mentioning

confidence: 99%

“…17,20 The FITT factors are recommended as a useful framework in reporting dosage of physical rehabilitation interventions. 23,24 In adults, several systematic reviews have explored whether increased intensity of physical rehabilitation intervention improves functional outcomes after stroke. [25][26][27] Although there are no clear guidelines for best level of practice, the principle that increased intensity of intervention is helpful is widely accepted.…”

mentioning

confidence: 99%

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Physical rehabilitation interventions in children with acquired brain injury: a scoping review

Meyling

Verschuren

Rentinck

et al. 2021

Develop Med Child Neuro

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Aim To synthesize the evidence about the characteristics (frequency, intensity, time, type) and effects of physical rehabilitation interventions on functional recovery and performance in daily functioning in children and young people with acquired brain injury (ABI), including traumatic brain injuries (TBI) and non‐TBI, during the subacute rehabilitation phase. Method Using scoping review methodology, a systematic literature search was performed using four databases. Articles were screened by title and abstract and data from eligible studies were extracted for synthesis. Results Nine of 3009 studies were included. The results demonstrated a variety of intervention characteristics: frequency varied between 1 and 7 days per week; time of intervention varied between 25 minutes and 6 hours a day; intervention types were specified in seven studies; and none of the included studies reported details of intensity of intervention. All studies reported positive results on the International Classification of Functioning, Disability and Health: Children and Youth (ICF‐CY) levels of body function and activities after the intervention period, with study designs of included studies being cohort studies without concurrent controls (n=7) or case reports (n=2). Interpretation Inconsistency in results hampers generalizability to guide clinical practice. Physical interventions during subacute rehabilitation have potential to improve functional recovery with intervention characteristics as an important factor influencing its effectiveness. Future well‐designed studies are indicated to gain knowledge and optimize rehabilitation practice in paediatric ABI and high‐quality research including outcomes across all ICF‐CY domains is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Physical rehabilitation interventions in children with acquired brain injury: a scoping review

Meyling

Verschuren

Rentinck

et al. 2021

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“… Perhaps these devices are simply not yet at a good enough technological level to outperform conventional therapy, and another big leap in development is necessary to produce the according positive scientific results. This is reflected in the fact that current devices usually do not enable patients to reach a sufficient cardiovascular training intensity [ 15 – 17 ]. Training at high gait speeds is not possible with sufficient quality due to the weight and the associated inertia of these devices.…”

mentioning

confidence: 99%

Robot-assisted gait training: more randomized controlled trials are needed! Or maybe not?

Labruyère

2022

J NeuroEngineering Rehabil

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I was encouraged by the recent article by Kuo et al. entitled “Prediction of robotic neurorehabilitation functional ambulatory outcome in patients with neurological disorders” to write an opinion piece on the possible further development of stationary robot-assisted gait training research. Randomized clinical trials investigating stationary gait robots have not shown the superiority of these devices over comparable interventions regarding clinical effectiveness, and there are clinical practice guidelines that even recommend against their use. Nevertheless, these devices are still widely used, and our field needs to find ways to apply these devices more effectively. The authors of the article mentioned above feed different machine learning algorithms with patients’ data from the beginning of a robot-assisted gait training intervention using the robot Lokomat. The output of these algorithms allows predictions of the clinical outcome (i.e., functional ambulation categories) while the patients are still participating in the intervention. Such an analysis based on the collection of the device’s data could optimize the application of these devices. The article provides an example of how our field of research could make progress as we advance, and in this opinion piece, I would like to present my view on the prioritization of upcoming research on robot-assisted gait training. Furthermore, I briefly speculate on some drawbacks of randomized clinical trials in the field of robot-assisted gait training and how the quality and thus the effectiveness of robot-assisted gait training could potentially be improved based on the collection and analysis of clinical training data, a better patient selection and by giving greater weight to the motivational aspects for the participants.

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Individual and contextual factors influencing children's effort in pediatric rehabilitation interventions

Levac

2023

Develop Med Child Neuro

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Rehabilitation clinicians strive to encourage children's sustained effort within challenging practice conditions. Effort influences intervention success, yet it is rarely defined or measured. Effort can be conflated with individual factors, such as motivation and engagement, that might influence it. Contextual factors that likely impact children's effort, such as practice conditions and therapeutic interactions, are generally under‐described. Defining, describing, and measuring effort and its influencers is necessary to enhance understanding of differences in rehabilitation intervention outcomes across individuals and contexts and to support the development of personalized precision rehabilitation approaches. This narrative review describes effort conceptualization in rehabilitation, particularly in relation to intensity, engagement, and participation nomenclature. The review outlines individual and contextual factors that may influence children's effort in rehabilitation and describes potential next steps for effort description and measurement. Subsequent work should aim to identify factors that can be targeted in clinical practice to promote and sustain children's effort in the rehabilitation process, thereby individualizing interventions and potentially improving their effectiveness.

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Pediatric Rehabilitation Therapies Differ in Intensity

Cited by 5 publications

References 37 publications

Physical rehabilitation interventions in children with acquired brain injury: a scoping review

Physical rehabilitation interventions in children with acquired brain injury: a scoping review

Robot-assisted gait training: more randomized controlled trials are needed! Or maybe not?

Individual and contextual factors influencing children's effort in pediatric rehabilitation interventions

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