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Task-Specific Training to Improve Sitting in a Child With Severe Postural Impairments: A Single-Subject Design
Jaya Rachwani1, Victor Santamaria
1Department of Physical Therapy (Dr Rachwani), Hunter College, City University of New York, New York, New York; Rehabilitation Sciences Department (Dr Santamaria), New York Medical College, School of Health Sciences and Practice, Physical Therapy Division, Valhalla, New York.
Purpose:
To evaluate the potential of a task-specific training model to improve sitting through tailored trunk support and incrementally challenging reaching.
Methods:
A single-subject AB design with follow-up was conducted with a 20-month-old child with severe postural impairments due to 16p11.2 deletion syndrome and multiple comorbidities. Phase A included 6 baseline assessments during 2 weeks, followed by 15 intervention sessions (Phase B) during 5 weeks, and 4 post-intervention assessments during follow-up. Outcomes included the Segmental Assessment of Trunk Control (SATCo) and the Gross Motor Function Measure (GMFM) sitting dimension. Visual analysis, the 2 standard deviation band method, and C-statistics evaluated change.
Results:
SATCo and GMFM scores were stable during baseline but had significant trend changes from baseline to intervention and follow-up phases. Independent sitting skills emerged after the intervention.
Conclusions:
Task-specific training tailored to the child's ability by systematically progressing trunk support and reaching practice may promote long-lasting sitting function.
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