Larson Sophia C, Smith Alyssa E, Aravamuthan Bhooma R, Moore Hunter G, Antonoff Kaylin A, Ramey Sharon, Hoyt Catherine R
Washington University School of Medicine, St. Louis, MO, USA.
Virginia Polytechnic Institute and State University, Blacksburg, USA.
OTJR (Thorofare N J). 2024 Dec 11:15394492241300607. doi: 10.1177/15394492241300607.
Hemiplegic Cerebral Palsy (CP) is the most common pediatric motor disability, characterized by unilateral motor weakness. Pediatric Constraint-Induced Movement Therapy (pCIMT) improves affected extremity function but faces variable clinical integration. This study assessed U.S. providers' awareness and use of pCIMT, educational practices, and barriers to broader implementation for more eligible children. Overall, 148 providers specializing in pediatric stroke or hemiplegic CP completed surveys on pCIMT familiarity, implementation challenges, and support for evidence-based practices (EBP). Participants indicated high pCIMT competency. Although 75% reported regional pCIMT availability, only 14% indicated that pCIMT is accessible to all children who could benefit. Reported barriers included therapist and family availability, cost, and institutional limitations. Despite valuing EBP, participants reported minimal workplace support for its use. The study revealed significant barriers to pCIMT accessibility and implementation. Further research is needed to address these challenges and improve clinical adoption of EBP, such as pCIMT.
偏瘫型脑瘫(CP)是最常见的儿童运动障碍,其特征为单侧运动无力。儿童强制性诱导运动疗法(pCIMT)可改善患侧肢体功能,但在临床应用中存在差异。本研究评估了美国医疗服务提供者对pCIMT的认知与使用情况、教育实践以及更广泛应用于更多符合条件儿童的障碍。总体而言,148名专门从事儿童中风或偏瘫型CP治疗的医疗服务提供者完成了关于pCIMT熟悉程度、实施挑战以及对循证实践(EBP)支持情况的调查。参与者表示具备较高的pCIMT能力。尽管75%的人报告称当地有pCIMT服务,但只有14%的人表示所有可能受益的儿童都能获得pCIMT治疗。报告的障碍包括治疗师和家庭的可及性、成本以及机构限制。尽管重视循证实践,但参与者报告称工作场所对其使用的支持极少。该研究揭示了pCIMT可及性和实施方面的重大障碍。需要进一步研究以应对这些挑战并改善循证实践(如pCIMT)在临床中的应用。