Novice physical therapists\u27 use of family-centered practices in physical therapy services

The Individuals with Disabilities Education Act (IDEA) recognizes the role of the family in the lives of children with special needs, and supports families in their natural care-giving and decision-making roles. This legislation guides physical therapy practice in early intervention and school settings. Family-centered functional therapy has emerged as a practice model that integrates families in therapy programming (Darrah, Law, & Pollock, 2001). Few published studies have considered physical therapists\u27, especially novice therapists\u27, value and use of family-centered practices. The purpose of this exploratory study was to: (1) describe novice physical therapists who practice in early intervention and schools; (2) investigate novice physical therapists\u27 value and use of family-centered practices; (3) compare therapists\u27 and families\u27 perceptions of family-centered practice; and (4) identify factors that may contribute to therapists\u27 use of family-centered practices. ^ Twenty five novice early intervention and school physical therapists from across the country and 27 parents of children receiving physical therapy services completed the Family-Centered Program Rating Scale and responded to a researcher-designed survey designed to quantify factors that potentially influence delivery of care. Analysis of participants\u27 responses indicated that most therapists chose to practice in early intervention and schools because they wanted to work with children. Their preservice classroom and field training relating to young children varied in number of hours, with less than half of the sample\u27s training programs having mandatory field experiences with young children. Preparation programs were more likely to provide information about medical conditions than topics relating to family-centered care. ^ Both therapists and parents highly valued indicators of family-centered care and positively rated therapists\u27 performance. Therapists\u27 ratings of the importance of family-centered practices tended to be higher than those of parents. Therapists\u27 ratings of importance consistently exceeded their rating of their implementation of family-centered activities. Parents consistently rated therapists\u27 delivery of services higher than the therapists rated their own performance. ^ Factors that significantly influenced therapists\u27 delivery of family-centered care included: the time at which therapists\u27 identified interest in becoming a physical therapist; the number of classroom hours relating to young children; the type of employment setting; and the number of family needs.

Deterministic and stochastic postural processes: effects of task, environment, and age.

International audienceUpright standing is always environmentally embedded and typically co-occurs with another (suprapostural) activity. In the present study, the authors investigate how these facts affect postural dynamics in an experiment in which younger (M age = 20.23 years, SD = 2.02 years) and older (M age = 75.26 years, SD = 4.87 years) participants performed a task of detecting letters in text or maintaining gaze within a target while standing upright in a structured or nonstructured stationary environment. They extracted the coefficients of drift (indexing attractor strength) and diffusion (indexing noise strength) from the center of pressure (COP) time series in anteroposterior (AP) and mediolateral (ML) axes. COP standard deviation decreased with drift and increased with diffusion. The authors found that structure reduced AP diffusion for both groups and that letter detection reduced younger SDAP (primarily by diffusion decrease) and increased older SDML (primarily by drift decrease). For older and younger participants, ML drift was lower during letter detection. Further, in older letter detection, larger visual contrast sensitivity was associated with larger ML drift and smaller SDML, raising the hypotheses that ML sway helps information detection and reflects neurophysiological age

Motor assessment using the NIH Toolbox

Motor function involves complex physiologic processes and requires the integration of multiple systems, including neuromuscular, musculoskeletal, and cardiopulmonary, and neural motor and sensory-perceptual systems. Motor-functional status is indicative of current physical health status, burden of disease, and long-term health outcomes, and is integrally related to daily functioning and quality of life. Given its importance to overall neurologic health and function, motor function was identified as a key domain for inclusion in the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox). We engaged in a 3-stage developmental process to: 1) identify key subdomains and candidate measures for inclusion in the NIH Toolbox, 2) pretest candidate measures for feasibility across the age span of people aged 3 to 85 years, and 3) validate candidate measures against criterion measures in a sample of healthy individuals aged 3 to 85 years (n = 340). Based on extensive literature review and input from content experts, the 5 subdomains of dexterity, strength, balance, locomotion, and endurance were recommended for inclusion in the NIH Toolbox motor battery. Based on our validation testing, valid and reliable measures that are simultaneously low-cost and portable have been recommended to assess each subdomain, including the 9-hole peg board for dexterity, grip dynamometry for upper-extremity strength, standing balance test, 4-m walk test for gait speed, and a 2-minute walk test for endurance