Episode 30 (Dr Michelle Jackman)
from The ResearchWorks Podcast Hosted by Dr Michelle Jackman
Interventions to improve physical function for children and young people with cerebral palsy: international clinical practice guideline Michelle Jackman, Leanne Sakzewski, Catherine Morgan, Roslyn N Boyd, Sue E Brennan, Katherine Langdon, Rachel A M Toovey, Susan Greaves, Megan Thorley, Iona Novak, First published: 21 September 2021 https://doi.org/10.1111/dmcn.15055 Abstract Aim To provide recommendations for interventions to improve physical function for children and young people with cerebral palsy. Method An expert panel prioritized questions and patient-important outcomes. Using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods, the panel assessed the certainty of evidence and made recommendations, with international expert and consumer consultation. Results The guideline comprises 13 recommendations (informed by three systematic reviews, 30 randomized trials, and five before–after studies). To achieve functional goals, it is recommended that intervention includes client-chosen goals, whole-task practice within real-life settings, support to empower families, and a team approach. Age, ability, and child/family preferences need to be considered. To improve walking ability, overground walking is recommended and can be supplemented with treadmill training. Various approaches can facilitate hand use goals: bimanual therapy, constraint-induced movement therapy, goal-directed training, and cognitive approaches. For self-care, whole-task practice combined with assistive devices can increase independence and reduce caregiver burden. Participation in leisure goals can combine whole-task practice with strategies to address environmental, personal, and social barriers. Interpretation Intervention to improve function for children and young people with cerebral palsy needs to include client-chosen goals and whole-task practice of goals. Clinicians should consider child/family preferences, age, and ability when selecting specific interventions.
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What this episode covers
Interventions to improve physical function for children and young people with cerebral palsy: international clinical practice guidelineMichelle Jackman, Leanne Sakzewski, Catherine Morgan, Roslyn N Boyd, Sue E Brennan, Katherine Langdon, Rachel A M Toovey, Susan Greaves, Megan Thorley, Iona Novak, First published: 21 September 2021 https://doi.org/10.1111/dmcn.15055 Abstract Aim To provide recommendations for interventions to improve physical function for children and young people wit...
Chapters
- 0:00 Intro
- 3:26 Icebreaker question!
- 8:03 Paper introduction
- 9:27 What an international clinical guideline is and why is it important?
- 13:33 A team effort - from all around the world
- 16:00 Physical functioning focus
- 17:59 What is an evidence based recommendation?
- 22:07 1. Client chosen goals should be set
- 24:55 2. Clinicians should determine the factors that are limiting goal achievement
- 28:27 3. Interventions should DIRECTLY target the child's set goal/s.
- 31:22 "Whose brain is working?" Professor Iona Novak
- 32:17 4. Interventions should be motivating and enjoyable for the child (Cortisol and Stress)
- 33:55 5. Practice of goals should occur within the child's home or community environments where possible
- 35:03 6. Parent delivered intervention can be used to supplement face to face therapy when appropriate education is provided.
- 36:47 7. Children/young people and parents should remain the decision makers
- 39:00 "Coaching, motivational interviewing, communication and relational skills - invest into these skills" Dr Dayna Pool
- 39:47 8. A high enough dose of practice needs to be undertaken to achieve functional goals (The Magic Number!)
- 42:35 9. A team approach should be used to set goals and intervention regime.
- 44:24 10. Mobility training using a goal directed approach with a focus of practice within a real life context compared to no intervention (is a STRONG recommendation…
- 47:19 11. Hand use in functional activities. (Algorithms that help the clinician)
- 49:46 12. Self care (CO-OP, HABIT, HABIT-ILE)
- 53:17 13. Leisure (What are the recommendations to improve performance of a leisure activity?)
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