Evidence Based Practice Improving Gait in Chronic TBI with Motor Learning Strategies July 25, 2017 by Elena Noble, MPT
Long-term disability is a frequent sequel of traumatic brain injury (TBI) and takes the form of persisting motor impairments that impact walking and autonomous movement. So to improve environmental negotiation and basic care skills, independent gait is an essential therapy goal for TBI patients.    Literature shows that the best time for independent gait recovery occurs within the first few...
Evidence Based Practice Evidence Update: Rehab Gait Training with BWS June 27, 2017 by Elena Noble, MPT
Gait rehabilitation uses both body weight supported treadmill training and over-ground training to help a client reach their maximum walking potential. With no established clinical indications, choosing between the approaches is a research-based and experience-based decision which factors in the nature of a client’s injury, timing and scope of intervention and projected outcomes. Here are two recent...
Evidence Based Practice Evidence Update: Dynamic Seating for Children with Autism May 30, 2017 by Elena Noble, MPT
Teachers and therapists working in inclusive classrooms continue to work to improve academic outcomes for students with autism spectrum disorder (ASD).  One fascinating area of inquiry is seating modification to improve in-seat performance, as students may need to sit for five hours during a normal school day. In one recent article on the topic, researchers examined how dynamic seating options...
Evidence Based Practice Evidence Update: The Relationship of Trunk Support to Head Stability May 09, 2017 by Lori Potts, PT
Trunk and head control is a challenge for many children with cerebral palsy (CP). This fascinating recent study examines how providing varying levels of biomechanical trunk support affects neural control of head stability, specifically for children with CP in Gross Motor Function Classification System (GMFCS) Levels IV or V. By definition, GMFCS Level IV indicates children whose walking ability is severely...
Evidence Based Practice Evidence Update: Improving Services for Youth with Disabilities April 13, 2017 by Elena Noble, MPT
For a child with disabilities, few transitions are as fraught as the passage from youth to adult, usually around age 21. While the Individuals with Disabilities Education Act (IDEA) makes some provision for transitional services for youth as they prepare to move out of the school system for “further education, employment or independent living,” these services are often poorly defined and...
Evidence Based Practice Evidence Update: Task-Specific Gait Training Improves Gait Speed January 05, 2017 by Elena Noble, MPT
Improving gait parameters is a primary goal of therapy intervention. One of these parameters is gait speed because we know there is a link between how fast we walk and how well we interact with our surroundings. (Just notice how frustrated your aging parents become as their gait slows them down.) Simply put, refining gait through therapy ultimately improves speed and boosts quality of life. There are a...
Evidence Based Practice Evidence Update: Stretch Effectiveness in Children with Disabilities October 17, 2016 by Elena Noble, MPT
In therapy, children with neuromuscular disabilities receive routine stretching interventions for contracture management and the alignment of the hip and spine. Depending on a child’s clinical presentation, stretch interventions range from short-term passive and active stretching to prolonged stretches using adaptive standers, serial casts or orthoses. However, according to four therapists published...
Evidence Based Practice Evidence Update: Selecting Gait Trainer Features September 23, 2016 by Elena Noble, MPT
Once again Ginny Paleg, DScPT, MPT and Roslyn Livingstone, MSc have delivered a valuable literature review, this one on the all-important topic of gait training. In the therapy community we’re well aware of the importance of mobility for the developing mind and body. Because children with cerebral palsy at GMFCS levels IV and V are not independently mobile, supportive gait trainers provide critical...
Evidence Based Practice Evidence Update: Early Intervention with Treadmill Training August 29, 2016 by Elena Noble, MPT
Young children with disabilities respond well to early therapeutic intervention. Literature regarding cortical plasticity in the developing brain points to encouraging therapy results as well. Not surprisingly then, initial research on treadmill training in this population is positive, indicating quicker and more competent acquisition of gait skills. However, for children, access to treadmills and a...
Evidence Based Practice Evidence Update: Positioning for Cognition May 10, 2016 by Elena Noble, MPT
Motor development in children is closely connected to cognitive development. As children learn new postures and mobility skills they’re increasingly able to explore their environment. This, in turn, helps improve cognition. In order to nurture these same motor and cognitive gains in children with disabilities, therapists use supported positioning techniques to facilitate age-appropriate skills and...
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