Steinhart Shoshana, Raz-Silbiger Shani, Beeri Maurit, Gilboa Yafit
ALYN Hospital - Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel.
School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Phys Occup Ther Pediatr. 2021;41(2):176-191. doi: 10.1080/01942638.2020.1807448. Epub 2020 Aug 28.
This pilot study examined the impact of an occupation based intervention using a telerehabilitation format with adolescents with myelomeningocele (MMC).
We conducted a nonrandomized pilot study including four adolescents ages 14-18 with MMC. The intervention program included 10-12 sessions of the Cognitive Orientation to daily Occupational Performance remotely delivered via videoconferencing. Outcome measures included the Canadian Occupational Performance Measure (COPM), Wee-Functional Independence Measure;(Wee-FIM), and the Pediatric Quality of Life Inventory (PedsQL). Assessments were administered at baseline, post intervention and at three-month follow-up.
Following intervention, participants rated their performance as having improved 2 points on the COPM for 8 out of 12 trained goals and on 2 out of 8 untrained goals. At 3-month follow-up improvement was reported on 9 out of 12 trained goals and 3 out of 8 untrained goals All participants made clinically significant improvements on the Wee-FIM total score following intervention and improvements were maintained at 3-month follow-up. The intervention effect on the PedsQL was inconclusive. Feedback interviews suggested that participants experience high satisfaction from the results and implementation of the intervention.
Our results demonstrate potential efficacy of occupation based teleintervention for adolescents with MMC.
本试点研究探讨了采用远程康复形式对患有脊髓脊膜膨出（MMC）的青少年进行基于职业的干预的影响。
我们进行了一项非随机试点研究，纳入了4名年龄在14 - 18岁的患有MMC的青少年。干预计划包括通过视频会议远程提供的10 - 12节日常职业表现认知导向课程。结果测量包括加拿大职业表现测量量表（COPM）、小儿功能独立性测量量表（Wee - FIM）和儿童生活质量量表（PedsQL）。在基线、干预后和三个月随访时进行评估。
干预后，参与者对12个训练目标中的8个以及8个未训练目标中的2个在COPM上的表现评级提高了2分。在三个月随访时，12个训练目标中的9个以及8个未训练目标中的3个报告有改善。所有参与者在干预后Wee - FIM总分上取得了临床上显著的改善，并且在三个月随访时保持了改善。干预对PedsQL的效果尚无定论。反馈访谈表明，参与者对干预的结果和实施满意度很高。
我们的结果证明了基于职业的远程干预对患有MMC的青少年具有潜在疗效。
