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ObjectiveGross motor assessment tools have a critical role in identifying, diagnosing and evaluating motor difficulties in childhood. The objective of this review was to systematically evaluate the psychometric properties and clinical utility of gross motor assessment tools for children aged 2–12 years.MethodA systematic search of MEDLINE, Embase, CINAHL and AMED was performed between May and July 2017. Methodological quality was assessed with the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and an outcome measures rating form was used to evaluate reliability, validity and clinical utility of assessment tools.ResultsSeven assessment tools from 37 studies/manuals met the inclusion criteria: Bayley Scale of Infant and Toddler Development-III (Bayley-III), Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Movement Assessment Battery for Children-2 (MABC-2), McCarron Assessment of Neuromuscular Development (MAND), Neurological Sensory Motor Developmental Assessment (NSMDA), Peabody Developmental Motor Scales-2 (PDMS-2) and Test of Gross Motor Development-2 (TGMD-2). Methodological quality varied from poor to excellent. Validity and internal consistency varied from fair to excellent (α=0.5–0.99). The Bayley-III, NSMDA and MABC-2 have evidence of predictive validity. Test–retest reliability is excellent in the BOT-2 (intraclass correlation coefficient (ICC)=0.80–0.99), PDMS-2 (ICC=0.97), MABC-2 (ICC=0.83–0.96) and TGMD-2 (ICC=0.81–0.92). TGMD-2 has the highest inter-rater (ICC=0.88–0.93) and intrarater reliability (ICC=0.92–0.99).ConclusionsThe majority of gross motor assessments for children have good-excellent validity. Test–retest reliability is highest in the BOT-2, MABC-2, PDMS-2 and TGMD-2. The Bayley-III has the best predictive validity at 2 years of age for later motor outcome. None of the assessment tools demonstrate good evaluative validity. Further research on evaluative gross motor assessment tools are urgently needed.

Background To explore the lived experience of chronic pain and dyskinesia in children and adolescents with cerebral palsy. Methods A convergent parallel mixed methods design was undertaken. First, a quantitative cross-sectional study of participants able to self-report their quality of life was undertaken. This study characterised pain chronicity, intensity, body locations, and quality of life. Second, semi-structured interviews were undertaken with a subset of children and adolescents experiencing chronic pain. Results Twenty-five children and adolescents took part in the cross-sectional study, 23 of whom experienced chronic pain and 13 of moderate intensity. Pain was often located in multiple bodily regions (6/21), with no trends in quality of life outcomes detected. Eight participated in semi-structured interviews, which identified three key themes including ‘lives embedded with dyskinesia’, ‘real world challenges of chronic pain’, and ‘still learning strategies to manage their pain and dyskinesia’. Conclusions A high proportion of children and adolescents with cerebral palsy and dyskinesia who were able to self-report experienced chronic pain. The physical and emotional impacts of living with chronic pain and dyskinesia existed along a spectrum, from those with lesser to greater extent of their impacts. Children and adolescents may benefit from targeted chronic pain education and management within bio-psychosocial models.

Background Despite an increasing number of studies examining the profile of falls and mobility decline in adults with cerebral palsy (CP), little is known about its impact on an individual’s life quality. The aim of this preliminary study was to assess the wellbeing and health status aspects of health-related quality of life (HRQOL) in ambulant adults with CP and explore the relationship of falls and mobility decline with HRQOL. Method Ambulant adults with CP completed postal surveys which sought demographic data, mobility (Gross Motor Function Classification System; GMFCS-E&R), presence of mobility decline, falls history, and HRQOL (Personal Wellbeing Index (PWI), Short Form-36 Health Survey (SF-36)). Results Thirty-four community-dwelling ambulant adults with CP with a mean age of 44.2 years (SD; 8.6; range 26–65) participated. Twenty-eight (82%) participants reported mobility decline since reaching adulthood, and a similar proportion of individuals (82%) reported having had more than two falls in the previous year. The health status and wellbeing of this sample of ambulant adults with CP were generally lower compared with the Australian normative population. Mobility decline was found by univariate regression analysis to be associated with mental health status (β = 0.52; p  = 0.002), but not when other predictor variables were included in the multivariate model (β = 0.27; p  = 0.072). In contrast, self-reported history of falls was found to be a significant contributing factor for both physical health status (β = −0.55; p  = 0.002) and personal wellbeing (β = −0.43; p  = 0.006). Conclusions This sample of ambulant adults with CP perceived their HRQOL to be poor, with some health status and wellbeing domains below that of population wide comparisons. A majority of these individuals also experienced a fall in the last year and a decline in their mobility since reaching adulthood. While further research is required, this preliminary study has highlighted the potential implications of falls and mobility decline on HRQOL in adults with CP.

Study designCross-sectional survey.ObjectivesThe objective of this study is to compare self-reported satisfaction with life, and self-reported health and well-being of people with NTSCD, to that of people with TSCI, and with Australian population.SettingVictoria, Australia.MethodsParticipants completed surveys by post or email. The Satisfaction with Life Scale (SWLS) and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were used to assess self-reported satisfaction with life, and health and well-being. Descriptive statistics are reported including median and interquartile range (IQR). The Mann–Whitney U-test was used to investigate differences between groups.ResultsThere were 41 participants: NTSCD (n = 14) and TSCI (n = 27). There were no significant differences in the median scores on the SWLS for NTSCD and TSCI, but both groups scored lower than the Australian non-disabled sample mean. There were significant differences between NTSCD and TSCI for SF-36 domains physical functioning, role limitations physical and vitality (p < 0.05). Median scores for both groups in all eight domains were lower than the means of the comparative Australian sample, except for role limitations emotional.ConclusionsThere were more apparent difficulties for people with NTSCD in completing desired functional tasks than those with TSCI. Both groups had lower self-reported satisfaction with life, and lower reported health and well-being in comparison to samples of non-disabled Australians.

To identify, appraise and synthesize evidence regarding efficacy of conservative interventions (physiotherapeutic, pharmacological) to improve walking in ambulant adults with cerebral palsy (CP). Standard search and extraction methods were utilised. A descriptive synthesis was performed with additional limited meta-analysis where the same outcome measurements were used and clinical heterogeneity was low. Interventions were considered according to target domain (International Classification of Functioning, Disability and Health). From 1571 papers identified, 10 met inclusion criteria. Study exclusion was predominantly due to gait not being a target of the intervention, or non-adult age range. Five randomised controlled trials were identified. Interventions were diverse and included strength training, sensory cueing, neurodevelopmental training, whole body vibration and spasticity medication. A small between-group effect on gait speed was found, weighted mean difference 0.09 (95 % CI 0.03 to 0.16). Evidence to support efficacy of one physiotherapeutic or pharmacological intervention over another to improve gait in adults with CP is currently limited. Further research is required using standardised gait outcome measures, longer follow up periods and higher quality trial designs.

Purpose: Walking is a major target in childhood physiotherapy for children with cerebral palsy (CP). Little information exists on the importance or value of walking when these children grow up. The aim of this study was to explore personal reflections on daily walking by adults with CP. Method: Semi-structured individual interviews were conducted and analysed with systematic text condensation, a four-step thematic cross-case analysis. Results: Eight ambulatory adults (26-60 years, four women and four men) with CP were interviewed. Almost all had experienced deteriorated walking ability in adulthood and reported that walking was restricted and affected by intrinsic features, such as pain, fatigue, reduced balance and fear of falling. Extrinsic features such as being looked at due to walking abnormality and environmental factors, such as seasonal changes affected their free walking and was common. Some had accepted using mobility aids for energy conservation. Conclusions: Both intrinsic and extrinsic factors influence walking in adults with CP. Reflections by the adults with CP suggest these features may reduce participation in public spaces and potentially increase acceptance and use of mobility aids.

Exercise is an effective intervention for the prevention of falls; however, some forms of exercises have been shown to be more effective than others. There is a need to identify effective and efficient methods for training health professionals in exercise prescription for falls prevention. The objective of our study was to compare two approaches for training clinicians in prescribing exercise to prevent falls. This study was a head-to-head randomized trial design. Participants were physiotherapists, occupational therapists, nurses, and exercise physiologists working in Victoria, Australia. Participants randomly assigned to one group received face-to-face traditional education using a 1-day seminar format with additional video and written support material. The other participants received Web-based delivery of the equivalent educational material over a 4-week period with remote tutor facilitation. Outcomes were measured across levels 1 to 3 of Kirkpatrick's hierarchy of educational outcomes, including attendance, adherence, satisfaction, knowledge, and self-reported change in practice. Of the 166 participants initially recruited, there was gradual attrition from randomization to participation in the trial (n = 67 Web-based, n = 68 face-to-face), to completion of the educational content (n = 44 Web-based, n = 50 face-to-face), to completion of the posteducation examinations (n = 43 Web-based, n = 49 face-to-face). Participant satisfaction was not significantly different between the intervention groups: mean (SD) satisfaction with content and relevance of course material was 25.73 (5.14) in the Web-based and 26.11 (5.41) in the face-to-face group; linear regression P = .75; and mean (SD) satisfaction with course facilitation and support was 11.61 (2.00) in the Web-based and 12.08 (1.54) in the face-to-face group; linear regression P = .25. Knowledge test results were comparable between the Web-based and face-to-face groups: median (interquartile range [IQR]) for the Web-based group was 90.00 (70.89-90.67) and for the face-to-face group was 80.56 (70.67-90.00); rank sum P = .07. The median (IQR) scores for the exercise assignment were also comparable: Web-based, 78.6 (68.5-85.1), and face-to-face, 78.6 (70.8-86.9); rank sum P = .61. No significant difference was identified in Kirkpatrick's hierarchy domain change in practice: mean (SD) Web-based, 21.75 (4.40), and face-to-face, 21.88 (3.24); linear regression P = .89. Web-based and face-to-face approaches to the delivery of education to clinicians on the subject of exercise prescription for falls prevention produced equivalent results in all of the outcome domains. Practical considerations should arguably drive choice of delivery method, which may favor Web-based provision for its ability to overcome access issues for health professionals in regional and remote settings. Australian New Zealand Clinical Trials Registry number: ACTRN12610000135011; http://www.anzctr.org.au/ACTRN12610000135011.aspx (Archived by WebCite at http://www.webcitation.org/63MicDjPV).

Establishing and promoting connections between health researchers and health professional clinicians may help translate research evidence to clinical practice. Social media may have the capacity to enhance these connections. The aim of this study was to explore health researchers' and clinicians' current use of social media and their beliefs and attitudes towards the use of social media for communicating research evidence. This study used a mixed-methods approach to obtain qualitative and quantitative data. Participation was open to health researchers and clinicians. Data regarding demographic details, current use of social media, and beliefs and attitudes towards the use of social media for professional purposes were obtained through an anonymous Web-based survey. The survey was distributed via email to research centers, educational and clinical institutions, and health professional associations in Australia, India, and Malaysia. Consenting participants were stratified by country and role and selected at random for semistructured telephone interviews to explore themes arising from the survey. A total of 856 participants completed the questionnaire with 125 participants declining to participate, resulting in a response rate of 87.3%. 69 interviews were conducted with participants from Australia, India, and Malaysia. Social media was used for recreation by 89.2% (749/840) of participants and for professional purposes by 80.0% (682/852) of participants. Significant associations were found between frequency of professional social media use and age, gender, country of residence, and graduate status. Over a quarter (26.9%, 229/852) of participants used social media for obtaining research evidence, and 15.0% (128/852) of participants used social media for disseminating research evidence. Most participants (95.9%, 810/845) felt there was a role for social media in disseminating or obtaining research evidence. Over half of the participants (449/842, 53.3%) felt they had a need for training in the use of social media for professional development. A key barrier to the professional use of social media was concerns regarding trustworthiness of information. A large majority of health researchers and clinicians use social media in recreational and professional contexts. Social media is less frequently used for communication of research evidence. Training in the use of social media for professional development and methods to improve the trustworthiness of information obtained via social media may enhance the utility of social media for communicating research evidence. Future studies should investigate the efficacy of social media in translating research evidence to clinical practice.

The position statement represents COSA's first step in instigating change in cancer care in Australia, acknowledging that although there is still more to be learned, the extant evidence supports moving forward with incorporating exercise into routine cancer care.3–6 Cumulative findings from physical activity and exercise trials support the promotion of physical activity and use of exercise science principles to gain and maintain physiological, functional, and quality-of-life benefits during and after treatment for cancer.3–6 This evidence provides sound justification for including exercise as part of routine cancer care, independently of any potential protective effects against survival outcomes that are still to be determined. [...]it is COSA's position that there is sufficient evidence, capacity, and need to support promotion of physical activity and exercise guidelines through their incorporation into standard cancer care. Next on COSA's agenda is the development of an implementation plan, which will capitalise on the skills and experiences of the multidisciplinary team (including psychologists, social workers, nurses, occupational therapists, dietitians, physical therapists and trainers, clinicians, general practitioners, and their patients) in the widespread and multifaceted promotion of physical activity at all phases of the cancer care trajectory.

Approximately 80% of research evidence relevant to clinical practice never reaches the clinicians delivering patient care. A key barrier for the translation of evidence into practice is the limited time and skills clinicians have to find and appraise emerging evidence. Social media may provide a bridge between health researchers and health service providers. The aim of this study was to determine the efficacy of social media as an educational medium to effectively translate emerging research evidence into clinical practice. The study used a mixed-methods approach. Evidence-based practice points were delivered via social media platforms. The primary outcomes of attitude, knowledge, and behavior change were assessed using a preintervention/postintervention evaluation, with qualitative data gathered to contextualize the findings. Data were obtained from 317 clinicians from multiple health disciplines, predominantly from the United Kingdom, Australia, the United States, India, and Malaysia. The participants reported an overall improvement in attitudes toward social media for professional development (P<.001). The knowledge evaluation demonstrated a significant increase in knowledge after the training (P<.001). The majority of respondents (136/194, 70.1%) indicated that the education they had received via social media had changed the way they practice, or intended to practice. Similarly, a large proportion of respondents (135/193, 69.9%) indicated that the education they had received via social media had increased their use of research evidence within their clinical practice. Social media may be an effective educational medium for improving knowledge of health professionals, fostering their use of research evidence, and changing their clinical behaviors by translating new research evidence into clinical practice.