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探讨物理治疗师在基于步态的脑瘫儿童干预中使用运动学习策略的情况。

Exploring Physiotherapists' Use of Motor Learning Strategies in Gait-Based Interventions for Children with Cerebral Palsy.

机构信息

Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.

Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.

出版信息

Phys Occup Ther Pediatr. 2020;40(1):79-92. doi: 10.1080/01942638.2019.1622623. Epub 2019 Jun 3.

Abstract

This study investigated physiotherapists' experiences using motor learning strategies (MLS) in gait-based interventions for children with cerebral palsy (CP). The objectives were to explore how child characteristics, physiotherapist decision-making, and treatment approach influenced intentional MLS use. Semi-structured interviews were conducted with eight physiotherapists who provided gym- and/or Lokomat-based treatment to children with CP. Interviews were analyzed using directed content analysis and a modified constant comparison method. Three themes described their experiences: (1) MLS use is driven by the unique aspects of the child, physiotherapist, and intervention; (2) The use and description of motor learning content varies among physiotherapists; and (3) The Lokomat is "the same but different." Child characteristics were at the forefront of MLS selection in both interventions. The terminology used to describe MLS use varied considerably among therapists. They used similar clinical decision-making in gym- and Lokomat-based interventions. Conscious reflection on the factors affecting MLS use could facilitate related clinical decision-making in physiotherapy interventions for children with CP. Increased awareness of MLS and use of a structured framework for reporting MLS are required to promote intentional MLS use and generate CP-specific evidence-based MLS research.

摘要

本研究调查了物理治疗师在基于步态的脑瘫儿童干预中使用运动学习策略(MLS)的经验。目的是探讨儿童特征、物理治疗师决策和治疗方法如何影响有意 MLS 使用。对 8 名为脑瘫儿童提供健身房和/或 Lokomat 治疗的物理治疗师进行了半结构化访谈。使用定向内容分析和修改后的恒定比较方法对访谈进行了分析。三个主题描述了他们的经验:(1)MLS 的使用是由儿童、物理治疗师和干预的独特方面驱动的;(2)运动学习内容的使用和描述在物理治疗师之间存在差异;(3)Lokomat“相同但不同”。在两种干预中,儿童特征都是 MLS 选择的首要因素。治疗师使用的 MLS 描述术语差异很大。他们在健身房和 Lokomat 基础干预中使用类似的临床决策。对影响 MLS 使用的因素进行有意识的反思,可以促进脑瘫儿童物理治疗干预中的相关临床决策。提高对 MLS 的认识和使用结构化框架报告 MLS 是促进有意 MLS 使用和产生基于 CP 的循证 MLS 研究的必要条件。

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