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重度运动障碍幼儿熟练动力移动能力预测因素的回顾性分析

Retrospective Analysis of Predictors of Proficient Power Mobility in Young Children With Severe Motor Impairments.

作者信息

Mockler Shelley R, McEwen Irene R, Jones Maria A

机构信息

Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, IA.

Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

出版信息

Arch Phys Med Rehabil. 2017 Oct;98(10):2034-2041. doi: 10.1016/j.apmr.2017.05.028. Epub 2017 Jul 5.

Abstract

OBJECTIVES

To determine if child characteristics, maternal education, intervention parameters, type of wheelchair control mechanism, or a combination of these variables were associated with proficient power mobility skills in children with severe motor impairments aged 14 to 30 months; and to determine if performance on the Wheelchair Skills Checklist (WSC) was associated with performance on the Powered Mobility Program (PMP).

DESIGN

Secondary data analyses on data collected from 2 previously completed randomized controlled trials (RCTs).

SETTING

Intervention and outcomes measurements took place in natural environments.

PARTICIPANTS

Participants included children who were assigned to the intervention groups in 2 RCTs (N=31).

INTERVENTION

Children practiced maneuvering individually customized power wheelchairs for 12 months in natural environments.

MAIN OUTCOME MEASURES

Proficiency was assessed using the WSC and the PMP. The Battelle Developmental Inventory and Merrill-Palmer-Revised were used to assess baseline cognition and motor skills. Baseline mobility was assessed using the Pediatric Evaluation of Disability Inventory.

RESULTS

Cognition, fine motor skills, and wheelchair control mechanism were associated with proficiency. Cognition, type of wheelchair control, and diagnosis all predicted proficiency while controlling for other covariates using multiple regression analysis. Agreement between the WSC and PMP was 94.7%.

CONCLUSIONS

Cognition, type of wheelchair control, and diagnosis might predict power mobility proficiency in young children with severe motor impairments. These factors however should not be used to determine whether a child has the opportunity to participate in a training program. Agreement between the WSC and PMP could help researchers and clinicians compare results across studies that use only one of these outcome measures.

摘要

目的

确定儿童特征、母亲教育程度、干预参数、轮椅控制机制类型或这些变量的组合是否与14至30个月大的重度运动障碍儿童熟练的电动移动技能相关;并确定轮椅技能检查表(WSC)的表现是否与电动移动计划(PMP)的表现相关。

设计

对从2项先前完成的随机对照试验(RCT)收集的数据进行二次数据分析。

设置

在自然环境中进行干预和结果测量。

参与者

参与者包括在2项RCT中被分配到干预组的儿童(N = 31)。

干预

儿童在自然环境中练习操纵单独定制的电动轮椅12个月。

主要结局指标

使用WSC和PMP评估熟练程度。使用巴特尔发育量表和修订版梅里尔-帕尔默量表评估基线认知和运动技能。使用儿童残疾评估量表评估基线移动能力。

结果

认知、精细运动技能和轮椅控制机制与熟练程度相关。在使用多元回归分析控制其他协变量时,认知、轮椅控制类型和诊断均预测了熟练程度。WSC和PMP之间的一致性为94.7%。

结论

认知、轮椅控制类型和诊断可能预测重度运动障碍幼儿的电动移动熟练程度。然而,这些因素不应被用于确定儿童是否有机会参加培训计划。WSC和PMP之间的一致性有助于研究人员和临床医生比较仅使用其中一项结局指标的研究结果。

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