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物理治疗师使用评估工具为脑瘫儿童开具踝足矫形器处方的情况。

Physical Therapists' Use of Evaluation Measures to Inform the Prescription of Ankle-Foot Orthoses for Children with Cerebral Palsy.

机构信息

a School of Rehabilitation Science, College of Medicine, University of Saskatchewan , Saskatoon , Canada.

b Saskatchewan Health Authority, Children's Program , Regina , Canada.

出版信息

Phys Occup Ther Pediatr. 2019;39(3):237-253. doi: 10.1080/01942638.2018.1463586. Epub 2018 Apr 27.

Abstract

: To examine how physical therapists (PTs) use evaluation measures to guide prescription and re-assessment of ankle-foot orthoses (AFOs) for children with CP. : PTs in Canada who work with children with CP were invited to complete an online survey. Survey questions examined PT evaluation and interpretation of findings at initial AFO prescription and re-assessment. Closed-ended responses were analyzed using descriptive statistics, and a conventional content analysis examined responses to open-ended questions. : Sixty responses from ten provinces were analyzed. Three themes emerged from the open-ended responses, which were supported by closed-ended responses. (1) Focus on impairment-level measures. Although evaluation primarily involved observational, non-standardized measures of impairments and gait pattern, most respondents also considered participation-level constructs. (2) Lack of confidence/knowledge. Respondents reported a moderate level of confidence concerning decision-making about AFO type and characteristics. 3) Inconsistent practices between therapists, possibly reflecting the paucity of available evidence or individualization of the prescription. : Non-standardized, observational assessment methods, and impairment-level constructs appear to guide AFO prescription decisions. Integrating current knowledge into practice, developing best practice guidelines, and developing standardized tools to assess the effects of AFOs on participation may promote confidence, consistency, and improved outcomes.

摘要

目的

探讨物理治疗师(PT)如何使用评估工具来指导儿童脑瘫踝足矫形器(AFO)的处方和重新评估。方法:邀请加拿大从事脑瘫儿童工作的 PT 完成在线调查。调查问题考察了初始 AFO 处方和重新评估时 PT 的评估和发现的解释。使用描述性统计对封闭式回答进行分析,并对开放式回答进行常规内容分析。结果:分析了来自 10 个省的 60 份回复。开放式回答中出现了 3 个主题,这些主题得到了封闭式回答的支持。(1)关注损伤水平的评估。尽管评估主要涉及损伤和步态模式的观察性、非标准化测量,但大多数受访者还考虑了参与水平的结构。(2)缺乏信心/知识。受访者报告说,他们对 AFO 类型和特征的决策有一定程度的信心。(3)治疗师之间的做法不一致,可能反映出可用证据的缺乏或处方的个体化。结论:非标准化、观察性评估方法和损伤水平结构似乎指导着 AFO 处方决策。将现有知识整合到实践中,制定最佳实践指南,并开发标准化工具来评估 AFO 对参与的影响,可能会提高信心、一致性和改善结果。

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