Changes in the Content of Pediatric Physical Therapy for Infants: A Quantitative, Observational Study

• Published in: Physical & occupational therapy in pediatrics 2018-10, Vol.38 (5), p.457-488
• Main Authors: Hielkema, Tjitske, Toonen, Rivka F., Hooijsma, Siebrigje J., Dirks, Tineke, Reinders-Messelink, Heleen A., Maathuis, Carel G. B., Geertzen, Jan H. B., Hadders-Algra, Mijna
• Format: Article
• Language: English
• Subjects: Early intervention; infancy; neurodevelopmental disorder; pediatrics; physical therapy; rehabilitation
• ISSN: 0194-2638; 1541-3144
• DOI: 10.1080/01942638.2017.1405863

Aims: The aim of our observational longitudinal study is to evaluate changes over time in standard pediatric physical therapy (PPT) for infants at risk of neurodevelopmental disorders. Methods: Treatment sessions in two time periods (2003-2005 [n = 22] and 2008-2014 [n = 16]) were video recorded and analyzed quantitatively in five categories: neuromotor actions, educational actions, communication, position, and situation of treatment session. Differences in percentages of time spent on therapeutic actions between periods were tested with Mann-Whitney U and Hodges Lehmann's tests. Results: No significant changes appeared in the main categories of neuromotor actions. Time spent on not-specified educational actions toward caregivers (median from 99% to 81%, p = .042) and not-specified communication (median from 72% to 52%, p = .002) decreased. Consequently, time spent on specific educational actions (caregiver training and coaching; median from 1% to 19%, p = .042) and specific communication (information exchange, instruct, provide feedback; median from 21% to 38%, p = .007) increased. Infant position changed only minimally: time spent on transitions-that is, change of position-decreased slightly over time (median from 7% to 6%, p = .042). Situation of treatment session did not change significantly over time. Conclusions: Neuromotor actions in PPT remained largely stable over time. Specific educational actions and communication increased, indicating larger family involvement during treatment sessions.