School of Physical and Occupation Therapy, McGill University, Montreal, QC, Canada.
CRIR - Lethbridge-Layton-Mackay Rehabilitation Centre of the CIUSSS West-Central Montreal, QC, Canada.
Dev Med Child Neurol. 2020 May;62(5):640-646. doi: 10.1111/dmcn.14382. Epub 2019 Oct 31.
To examine the impact of engagement in a self-chosen community-based activity on three relevant body functions (motor, cognitive, and affective) as well as on the performance of the selected activity.
An individual-based interrupted time series design with multiple baselines was used. Seven young people (four males, three females) aged 15 to 25 years (median 18y; interquartile range 17-20y) with physical disabilities participated in an 8-week community activity of choice (e.g. swimming, playing piano). Change in three relevant body functions, underpinning the specific chosen activity, including motor (e.g. Functional Reach Test, Trunk Impairment Scale, dynamometers), cognitive and affective (Behavior Assessment System for Children), as well as activity performance (Canadian Occupational Performance Measure) were measured repeatedly, providing individual outcome trajectories. Linear and mixed-effects models were used.
Significant improvements in at least one aspect of motor function (6 out of 6), cognition (3 out of 3), affect (5 out of 7), and performance (7 out of 7) were observed. Specifically, the intervention had a moderate to large effect on hyperactivity (1.45, 95% confidence interval [CI] 1.0-1.9) with a smaller effect on anxiety (0.21, 95% CI 0.10-0.32) and inadequacy (0.21, 95% CI 0.02-0.39). Concurrently, a notable effect size for activity performance (4.61, 95% CI 0.76-8.46) was observed. Average change across motor outcomes was substantial (3.7 SDs from baseline), yet non-significant.
Findings provide initial evidence of the benefits resulting from participation-based interventions, emphasizing the merit of meaningful 'real-life' young people-engaging therapy.
Participation-based interventions can impact body-function level outcomes. Significant improvements in the performance of chosen activities were observed. Significant improvements were also seen in cognitive and affective body functions. Improvements in motor-related outcomes were substantial but not statistically significant.
研究参与自选社区活动对三个相关身体功能(运动、认知和情感)以及所选活动表现的影响。
采用个体基础的中断时间序列设计和多个基线。7 名 15 至 25 岁(中位数 18 岁;四分位距 17-20 岁)的身体残疾年轻人参与了他们自选的 8 周社区活动(例如游泳、弹钢琴)。反复测量三个相关身体功能(支撑特定所选活动的功能)的变化,包括运动(例如功能伸展测试、躯干损伤量表、测力计)、认知和情感(儿童行为评估系统),以及活动表现(加拿大职业表现量表),提供个体结果轨迹。使用线性和混合效应模型。
观察到运动功能(6 项中有 6 项)、认知(3 项中有 3 项)、情感(7 项中有 5 项)和表现(7 项中有 7 项)至少有一个方面得到显著改善。具体而言,干预对多动(1.45,95%置信区间 [CI] 1.0-1.9)有中度至较大影响,对焦虑(0.21,95%CI 0.10-0.32)和不足(0.21,95%CI 0.02-0.39)有较小影响。同时,活动表现的显著效果大小(4.61,95%CI 0.76-8.46)也被观察到。运动结果的平均变化幅度较大(从基线开始 3.7 个标准差),但无统计学意义。
研究结果提供了基于参与的干预措施的益处的初步证据,强调了有意义的“现实生活”年轻人参与治疗的优点。
基于参与的干预措施可以影响身体功能水平的结果。观察到所选活动表现的显著改善。在认知和情感身体功能方面也观察到了显著的改善。与运动相关的结果的改善幅度较大,但无统计学意义。