Evidence Based Practice Don’t Skimp on Good Design and Quality January 30, 2018 by Lori Potts, PT
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...
Evidence Based Practice Evidence Update: Adding Resistance to BWSTT November 27, 2017 by Elena Noble, MPT
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...
Evidence Based Practice Evidence Update: Dynamic Gait Training for Child with SCI October 17, 2017 by Elena Noble, MPT
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...
Evidence Based Practice Evidence Update: Children with CP and Home-based Treadmill Programs September 25, 2017 by Elena Noble, MPT
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...
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...
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