Evidence Based Practice

As a pediatric physical therapist working in public schools, I want my students to move, and to move in the same way their peers do. When Rifton came out with the treadmill gait trainer, I was eager to explore increasing exercise intensity for my teenagers with mobility impairments. I was fortunate enough to get funding for one in my school. I went to the literature to look for protocols using gait treadmills for youth with disabilities and did not find much.

The field of pediatric physical therapy has long recognized the difficulty of conducting high level research with the cerebral palsy population. Meeting the qualifications of a randomized controlled trial while implementing interventions with children with multiple physical disabilities – with all their varied daily realities – is extraordinarily difficult. In turn, the systematic review that...

Existing evidence on pediatric therapy dosing is scanty and conflicting, though motor learning theory has long associated increased frequency and repetition of movement and skills with improved outcomes. A new study now appears to bolster this view in the context of school-based intervention. The study comes out of Norway, where almost all children with cerebral palsy are registered in CP-specific follow...

This article was originally written for Medbridge and is shared here with permission. People who suffer brain injuries require extensive medical care to preserve vital organ functions and prevent secondary injury. Physical therapists are in a unique position to positively influence the ultimate outcome for these individuals by simply providing early mobilization. Two studies provide support for early...

Does the quality of an individual’s mobility device influence their participation? Common sense tells us it would, but do we find research to back that up? Thankfully, yes. Today’s post highlights the work of a research team that implemented a two-day assessment with 604 community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke. Of these, 250 people (41%) self...

Although integrated into pediatric clinical practice for the last decade, body weight supported treadmill training (BWSTT) continues to be an area of research interest and an evolving intervention. We can see this reflected in a recent study examining effective motor learning strategies for treadmill training. For children with disabilities, the treadmill is a safe place where they can organize their...

Because good clinical evidence on the benefits of gait training is so scarce, we celebrate every contribution we find. Here’s one that specifically explores the effect of dynamic gait training on a child with a spinal cord injury. After sustaining a complete T10 spinal cord injury (SCI) at 23 months old, this child began a walking program six months later. She initially started with a posterior...

Motor learning suggests that practice, repetition and task specificity are instrumental to task improvement. Sometimes extending the practice of therapeutic activities beyond the clinical environment and into the home is a great way to apply these principles and reinforce the gains made in the clinic. Knowing this, I was interested to read a recent study looking at children with cerebral palsy and the...

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...

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...