The Scope of Pediatric Physical Therapy Practice in Health Promotion and Fitness for Youth With Disabilities

Rowland, Jennifer; Fragala-Pinkham, Maria; Miles, Charles P.; O’Neil, Margaret E.

doi:10.1097/pep.0000000000000098

Cited by 45 publications

(37 citation statements)

References 163 publications

(84 reference statements)

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“…In recent years, strategies and goals for physical therapy and rehabilitation services for youth with CP have shifted from a focus on developmental motor skills and quality of movement to activity-based interventions for improved fitness, functional mobility and habitual PA (7,27,35). This shift is partially due to evidence suggesting that ambulant youth with CP experience decreased fitness and PA participation compared to age matched peers, which places them at increased risk for poor health outcomes later in life (35,36).…”

Section: Introductionmentioning

confidence: 99%

Decision Trees for Detection of Activity Intensity in Youth with Cerebral Palsy

Trost

Fragala-Pinkham

Lennon

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose To develop and test decision tree (DT) models to classify physical activity (PA) intensity from accelerometer output and Gross Motor Function Classification System (GMFCS) classification level in ambulatory youth with cerebral palsy (CP); and 2) compare the classification accuracy of the new DT models to that achieved by previously published cut-points for youth with CP. Methods Youth with CP (GMFCS Levels I - III) (N=51) completed seven activity trials with increasing PA intensity while wearing a portable metabolic system and ActiGraph GT3X accelerometers. DT models were used to identify vertical axis (VA) and vector magnitude (VM) count thresholds corresponding to sedentary (SED) (< 1.5 METs), light PA (LPA) (≥1.5 and <3 METs) and moderate-to-vigorous PA (MVPA) (≥ 3 METs). Models were trained and cross-validated using the “rpart” and “caret” packages within R. Results For the VA (VA_DT) and VM decision trees (VM_DT), a single threshold differentiated LPA from SED, while the threshold for differentiating MVPA from LPA decreased as the level of impairment increased. The average cross-validation accuracy for the VC_DT was 81.1%, 76.7%, and 82.9% for GMFCS levels I, II, and III, respectively. The corresponding cross-validation accuracy for the VM_DT was 80.5%, 75.6%, and 84.2%, respectively. Within each GMFCS level, the DT models achieved better PA intensity recognition than previously published cut-points. The accuracy differential was greatest among GMFCS level III participants, in whom the previously published cut-points misclassified 40% of the MVPA activity trials. Conclusion GMFCS-specific cut-points provide more accurate assessments of MVPA levels in youth with CP across the full spectrum of ambulatory ability.

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Section: Introductionmentioning

confidence: 99%

Decision Trees for Detection of Activity Intensity in Youth with Cerebral Palsy

Trost

Fragala-Pinkham

Lennon

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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“…[2][3][4][5] Few studies have investigated HPA in young children with CP aged less than 5 years. 5,20 Interventions for young children with CP have focused on improving developmental motor abilities, as children with CP will reach the highest motor capacity at approximately 5 years. 21 Although motor capacity is directly associated with HPA, 5 there are many other factors associated with HPA including both personal and environmental factors.…”

mentioning

confidence: 99%

Longitudinal physical activity and sedentary behaviour in preschool‐aged children with cerebral palsy across all functional levels

Keawutan

Bell

Oftedal

et al. 2017

Develop Med Child Neuro

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“…Factors associated with physical activity in children and adolescents with disabilities, such as self‐efficacy and the presence of adaptive equipment, should ideally be incorporated into interventions aimed at increasing physical activity . A recent paper has described the unique position of paediatric physical therapists in implementing interventions to achieve healthy, active lifestyles in children and adolescents …”

mentioning

confidence: 99%

“…[24][25][26] A recent paper has described the unique position of paediatric physical therapists in implementing interventions to achieve healthy, active lifestyles in children and adolescents. 27 Although the evidence for the effectiveness of interventions aimed at improving physical activity is still limited in typically developing children, 28,29 the knowledge about children with physical disabilities seems even more limited and an overview of effective interventions is lacking. Therefore, the aim of this systematic review is to summarize the best evidence of interventions for increasing physical activity in children with physical disabilities.…”

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confidence: 99%

Evidence for increasing physical activity in children with physical disabilities: a systematic review

Bloemen

Wely

Mollema

et al. 2017

Develop Med Child Neuro

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Aim To summarize the best evidence of interventions for increasing physical activity in children with physical disabilities. Method A systematic review was conducted using an electronic search executed in Academic Search Elite, Academic Search Premier, CINAHL, Embase, MEDLINE, PEDro, PsychINFO, and SPORTDiscus up to February 2016. The selection of articles was performed independently by two researchers according to predetermined eligibility criteria. Data extraction, methodological quality, and levels of evidence were independently assessed by two researchers using a data‐collection form from the Cochrane Collaboration and according to the guidelines of the American Academy for Cerebral Palsy and Developmental Medicine. Results Seven studies were included. Five randomized controlled trials ranged from strong level I to weak level II studies, and two pre–post design studies were classified as level IV. There is level I evidence for no effect of physical training on objectively measured physical activity, conflicting level II evidence for interventions with a behavioural component on the increase of objectively measured physical activity directly after the intervention, and level II evidence for no effect during follow‐up. Results are limited to children with cerebral palsy as no other diagnoses were included. Interpretation Increasing physical activity in children with physical disabilities is very complex and demands further development and research.

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The Scope of Pediatric Physical Therapy Practice in Health Promotion and Fitness for Youth With Disabilities

Abstract: Pediatric physical therapists should incorporate health promotion and fitness strategies into practice.

Cited by 45 publications

References 163 publications

Decision Trees for Detection of Activity Intensity in Youth with Cerebral Palsy

Decision Trees for Detection of Activity Intensity in Youth with Cerebral Palsy

Longitudinal physical activity and sedentary behaviour in preschool‐aged children with cerebral palsy across all functional levels

Evidence for increasing physical activity in children with physical disabilities: a systematic review

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