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脑瘫幼儿踝足矫形器处方及监测临床考量的制定:一项德尔菲研究

Development of clinical considerations for ankle-foot orthosis prescription and monitoring in young children with cerebral palsy: a Delphi study.

作者信息

Firouzeh Pegah, Morris Christopher, Sonnenberg Lyn K, Manns Patricia, Pritchard Lesley

机构信息

Faculty of Rehabilitation Medicine, College of Health Sciences, University of Alberta, Edmonton, Canada.

PenCRU, University of Exeter Medical School, University of Exeter, Exeter, UK.

出版信息

Disabil Rehabil. 2025 Jul;47(15):3989-4001. doi: 10.1080/09638288.2024.2435516. Epub 2024 Dec 4.

Abstract

PURPOSE

To seek agreement on evidence-based, family-centered, clinical considerations for Ankle Foot Orthosis (AFO) prescription and monitoring for young, ambulatory children with cerebral palsy.

MATERIALS AND METHODS

An online Delphi survey focusing on parent, clinician, and researcher perspectives on specific processes and outcomes concerning AFO prescription and monitoring practices was conducted over two rounds. Participants rated each survey item as critical, important but not critical, or less important. Items were included in Round 2 if >70% of participants in all three groups scored critical and <15% scored less important. A subgroup of survey respondents participated in a meeting to ratify the survey results.

RESULTS

Twenty-two pediatric clinicians, seven researchers, and ten parents of young children with cerebral palsy participated in Round 1. Two clinicians and two parents dropped out in the second round. A total of 36 clinical considerations were deemed to be critically important for inclusion across contributor groups.

CONCLUSIONS

The proposed clinical considerations for AFO prescription and monitoring that embeds the perspectives of families is a valuable contribution to clinical practice. They can be used by clinicians as a guide when prescribing and introducing AFOs to families of young, ambulatory children with cerebral palsy.

摘要

目的

就基于证据、以家庭为中心的临床考量达成共识,这些考量适用于为患有脑瘫的能行走幼儿开具踝足矫形器(AFO)处方及进行监测。

材料与方法

开展了两轮在线德尔菲调查,重点关注家长、临床医生和研究人员对AFO处方及监测实践中特定流程和结果的看法。参与者将每个调查项目评为关键、重要但非关键或不太重要。如果所有三个组中超过70%的参与者将某一项目评为关键,且不到15%的参与者将其评为不太重要,则该项目将被纳入第二轮调查。一部分参与调查的受访者参加了一次会议,以批准调查结果。

结果

22名儿科临床医生、7名研究人员和10名患有脑瘫幼儿的家长参与了第一轮调查。第二轮有两名临床医生和两名家长退出。共有36项临床考量被认为对所有参与群体都至关重要,应予以纳入。

结论

所提出的结合了家庭观点的AFO处方及监测临床考量对临床实践具有重要价值。临床医生在为患有脑瘫的能行走幼儿家庭开具和介绍AFO时,可将其作为指导。

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