Biomedical subjects

Doreen Bartlett

Publications and source records attributed to Doreen Bartlett.

6 recordsLinked to original sources

PubMed2006

Exploring assessment tools and the target of intervention for children with Developmental Coordination Disorder.

PURPOSE: We reviewed current practice for children with Developmental Coordination Disorder (DCD) using research evidence and the International Classification of Functioning, Disability and Health (ICF). Characteristics of children with DCD can be described at the levels of body function (impairments), whole body movements (activities) and involvement in life situations (participation). SUMMARY OF KEY POINTS: Descriptive instruments measuring the extent of motor impairments or activity limitations can be used to: (1) identify children who might benefit from intervention; and (2) determine the optimal type of intervention and model of service delivery. Evaluative tools that measure activities or participation, but not primary impairments, should be used to determine change over time. Commonly used measures for describing children with DCD and evaluating outcomes are reviewed and discussed in the context of the ICF framework. Intervention approaches are then outlined for children with DCD that are targeted to the levels of activity, participation, and prevention of secondary impairments. CONCLUSIONS: Outcomes of children with DCD will be optimized with the use of current research evidence and the appropriate ICF level guiding both assessment and intervention.

Child↗

PubMed2005

Testing of the spinal alignment and range of motion measure: a discriminative measure of posture and flexibility for children with cerebral palsy.

In this study we describe the development and preliminary psychometric testing of the Spinal Alignment and Range of Motion Measure (SAROMM). Through consultation with pediatric physiotherapists, the items were refined. Subsequently 25 children and adolescents with cerebral palsy (CP; 17 males, 8 females) with a mean age of 9 years 8 months (SD 4y 4mo), stratified by the Gross Motor Function Classification System (GMFCS, n=5 in each group), were recruited. Twenty-two children had spastic CP, and one each was also diagnosed with hypotonic, athetoid, and mixed CP. Three children had hemiplegia, 12 had diplegia, and 10 had quadriplegia. These participants were examined by two physiotherapists on one occasion and by the primary physiotherapist again two weeks later. The intraclass correlation coefficients reflecting interrater and test-retest reliabilities for the spine and range of motion subscales and the total scores were all above 0.80. Validity was supported by a significant contribution of GMFCS level and age to the SAROMM score (r2=0.44). The SAROMM has sufficient reliability and validity for use with children with CP in clinical and research settings by rehabilitation therapists.

Adolescent↗

PubMed2004

Gross Motor Function Classification System: impact and utility.

In summary, the GMFCS has had, and continues to have, a major effect on the health care of children with CP. The number of citations of the GMFCS has been increasing every year, and the classification system has had good uptake internationally and across the spectrum of health professionals for use in research design and clinical practice by providing a system for clearly communicating about children's gross motor function. The utility of diagnostic labels such as diplegia has been questioned. However, although by definition CP is a disorder of posture and movement, the movement disability is often only one of the neurodevelopmental problems for many children with CP. When a complete description of a child's clinical presentation is required we recommend that the GMFCS be used together with the Surveillance of Cerebral Palsy in Europe classification indicating the type and topography of movement impairment. When appropriate the clinical profile will similarly be enhanced with details of other impairments and disabilities such as epilepsy or sensory, learning, feeding, or emotional disturbance. The observations in this annotation are constrained by the amount of information in the public domain. Although these sources adequately represent the effect of the GMFCS on research design, they are less likely to inform us of how the GMFCS is being used in administration, clinical practice, or education. It is not yet clear whether information is being used for these purposes or in assisting with case load management, as intended by the developers. By its localized nature, such information might remain difficult to gauge. We would therefore be interested to hear from others who are using the system for these or any other purposes.

Cerebral Palsy↗

PubMed2003

Early identification and risk management of children with developmental coordination disorder.

PURPOSE: The purpose of this study was to determine the motor control issues, motor learning differences, and secondary impairments of children with developmental coordination disorder (DCD) and to explore physical therapists' contribution to their early management. SUMMARY OF KEY POINTS: DCD is a condition involving limitations in gross motor, postural, and/or fine motor performance that is not attributable to other neurological disorders. Manifestation is varied across children and depends, in part, on their level of anticipatory motor control, response to specific task demands, and ability to attend to feedback to obtain flexible, adaptive movement solutions. Children with DCD rely primarily on vision for feedback, frequently use "fixing" strategies, and exhibit limited motor repertoires. As a result of their movement problems, they tend to avoid physical activity and are prone to secondary impairments, including decreased strength and power. CLINICAL IMPLICATIONS AND RECOMMENDATIONS: Physical therapists can 1) use their keen observational skills to identify children with DCD earlier in life and 2) use their knowledge of the secondary impairments and movement difficulties to work with families to engage children in continuous movement activities to maintain strength and power and thus obtain the physical, social, and psychosocial benefits of physical activity.

Journal Article↗

PubMed2003

Validity and reliability of a pediatric reach test.

PURPOSE: The purpose of this study was to develop and evaluate the validity and reliability of a Pediatric Reach Test (PRT). METHODS: The Functional Reach Test was modified to incorporate side reaching in addition to forward reaching in both sitting and standing. Nineteen children developing typically (age 3.0 to 12.5 years) completed the standing section of the PRT as well as laboratory force platform tests of standing balance. On two separate occasions, two different raters evaluated 10 children with cerebral palsy (age 2.6 to 14.1 years) in both the sitting and standing sections of the PRT. RESULTS: Concurrent validity was supported with the observation of moderate-to-high correlations between the standing section of the PRT and laboratory tests of limits of stability (r = 0.42 to 0.77). Construct validity was supported with the observation of high correlations between the standing section of the PRT and a laboratory test of steadiness in quiet stance (r = -0.79) and age (r = 0.83). Construct validity was also supported with a high correlation between the total PRT score and Gross Motor Function Classification System level (rs = -0.88) among the sample of children with cerebral palsy. Test-retest reliability and inter-tester reliability with children with cerebral palsy ranged from intraclass correlation coefficients of 0.54 to 0.88 and 0.50 to 0.93, respectively. CONCLUSIONS: This study provides evidence that the PRT is a simple, valid, and reliable measure with potential for use with children.

Journal Article↗

PubMed2002

Health status of school-aged children with cerebral palsy: information from a population-based sample.

In this study parents' systematic accounts of the health status of 408 school-aged children with cerebral palsy (CP) are reported (221 males, 187 females; mean age 8 years 5 months, SD 1 year 11 months; range 5 to 13 years), as are relations between severity of functional motor impairment and eight functional health status domains. Data were collected as part of a longitudinal study of the motor development of a population-based, stratified, random sample of children with CP from across Ontario, Canada. The Gross Motor Function Classification System (GMFCS) was used to classify severity of CP and functional health status was described with the eight-level Health Utilities Index-Mark 3. Rates of functional limitations in Mobility, Dexterity, Speech, and Vision were statistically significantly associated with GMFCS levels (all p<0.01), with correlation values (tau-b) of 0.82, 0.58, 0.46, and 0.36, respectively. Functional limitations in hearing (tau-b=0.16; p=0.04) and cognition (tau-b=0.27; p<0.01) were both statistically significantly associated with GMFCS levels, though correlations were low. Neither emotion (tau-b=0.03; p=0.24) nor pain (tau-b=0.07; p=0.37) was associated with degree of functional limitation as described by the GMFCS. Clinical and epidemiological implications of findings are discussed.

Activities of Daily Living↗