How to Prepare Interprofessional Teams in Two Weeks: An Innovative Education Program Nested in Telehealth

PROBLEM: Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult. APPROACH: A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space. OUTCOMES: To date, 594 students have participated demonstrating capacity to: 1.effectively engage in interprofessional care,  2. utilize Telehealth to impact care and break down barriers of isolation, and 3. implement skills to advance healthcare. CONCLUSION: IPE combined with Telehealth technology provides future providers with knowledge and skills for interprofessional care regardless of geographic barriers. Next Step: Integrate more technology using mobile devices and enhance the evaluation process

Effects of orthoses on upright functional skills of children and adolescents with cerebral palsy

Purpose: Most research details the influence of orthoses on impairments in children with cerebral palsy. The purpose of this study was to determine the effect of orthoses on multiple tests of function. Methods: The researchers used the Standardized Walking Obstacle Course (SWOC), Pediatric Balance Scale (PBS), performance on individualized goals related upright function, and self-reports of comfort and stability with and without orthoses to examine 28 children (5.4-19.1 years of age) with cerebral palsy. Results: No significant differences were found in performance on the SWOC and PBS with and without orthoses. Only 18% of the children performed better on an individualized goal with their orthoses, but 48% of the children reported more feelings of comfort and stability while wearing orthoses. Conclusions: Results of this study bring into question the use of orthoses to improve functional balance and ambulation in children with cerebral palsy

Standardized Walking Obstacle Course (SWOC): Reliability and validity of a new functional measurement tool for children

PURPOSE: This study reports reliability of the Standardized Walking Obstacle Course (SWOC) and concurrent validity with the Timed Up and Go (TUG) for use in children with and without developmental disabilities. METHODS: Seventy-three children completed the SWOC and TUG during each of two sessions scheduled one week apart. Two raters took measures of time and number of steps on the SWOC to correlate with the same measures on the TUG. RESULTS: Very high interrater reliabilities for time (intercorrelation coefficient [ICC] 0.99) and number of steps (ICC 0.94-0.99) noted. High intrarater reliabilities recorded for time (ICC 0.83-0.97) and number of steps (ICC 0.84-0.96). Significant correlations (p \u3c 0.05) between the TUG and SWOC were moderate to very high for time (r = 0.72-0.90) and number of steps (r = 0.63-0.92). CONCLUSION: The SWOC demonstrates good reliability within and between raters and concurrent validity with the TUG for use with children to establish their functional ambulation capability. The SWOC could easily be used in any setting for any child who can follow the directions and walk without an assistive device. Further testing is needed of the use of the SWOC to detect change and measure the extent of the environment\u27s influence on activity and participation for different populations of children. Copyright © 2006 Lippincott Williams & Wilkins, Inc. and Section on Pediatrics of the American Physical Therapy Association

Predictors of standardized walking obstacle course outcome measures in children with and without developmental disabilities

Purpose: This study was designed to determine which characteristics of children predict measures on the Standardized Walking Obstacle Course (SWOC). Methods: SWOC testing was performed under 3 conditions: (1) walk, (2) walk with a tray, and (3) walk wearing shaded glasses. Trials consisted of standing up, walking the course in 1 direction, and sitting down. Children (n = 440) completed 2 trials per condition. Trial measures included time, and numbers of steps, stumbles, and steps off the path. Relationships were evaluated using Chi-square analyses and significant predictors were determined by multiple logistic regression analyses. Sensitivity and specificity were calculated to determine the accuracy of disability as a predictor. Results: Age, weight, and disability were the strongest predictors (P \u3c .05). Increased age and weight predicted shorter time and fewest steps. Disability predicts longer time and most steps. Conclusion: The SWOC is appropriate to screen children for disabilities in functional ambulation. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Promotion of physical fitness and prevention of secondary conditions for children with cerebral palsy: Section on pediatrics research summit proceedings

Inadequate physical fitness is a major problem affecting the function and health of children with cerebral palsy (CP). Lack of optimal physical activity may contribute to the development of secondary conditions associated with CP such as chronic pain, fatigue, and osteoporosis. The purpose of this article is to highlight the content and recommendations of a Pediatrics Research Summit developed to foster collaborative research in this area. Two components of physical fitness - muscle strength and cardiorespiratory fitness - were emphasized. Although there is evidence to support the use of physical fitness interventions, there are many gaps in our current knowledge. Additional research of higher quality and rigor is needed in order to make definitive recommendations regarding the mode, intensity, frequency, and duration of exercise. Outcome measurements have focused on the body functions and structures level of the International Classification of Functioning, Disability and Health (ICF), and much less is known about effects at the activities and participation levels. Additionally, the influence of nutritional and growth factors on physical fitness has not been studied in this population, in which poor growth and skeletal fragility have been identified as serious health issues. Current intervention protocols and outcome measurements were critically evaluated, and recommendations were made for future research. © 2007 American Physical Therapy Association