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Variation in Intensive Pediatric Physical Therapy Practice in the United States: Results From a National Survey
Kelly Greve1, Dana Chole, Meaghan Rubsam
1Division of Occupational Therapy and Physical Therapy, Division of Patient Services Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Greve); Department of Physical Therapy, College of Health Sciences, University of Missouri, Columbia, Missouri (Drs Chole and Hall); Shirley Ryan AbilityLab, Chicago, Illinois (Dr Rubsam); Rehabilitation Sciences, University of Illinois Chicago, Illinois (Dr Rubsam); Hedgecock Physical Therapy, PLLC, Denver, Colorado (Dr Hedgecock); Pediatric Therapies, Providence Alaska Children's Hospital, Anchorage, Alaska (Dr Hedgecock); Department of Biostatistics, Health Informatics and Data Sciences, College of Medicine, University of Cincinnati, Cincinnati, Ohio (Mr Li); and Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Zhang).
Purpose:
Intensive pediatric physical therapy (PT) programs are increasingly common yet lack a clear definition. This study aimed to examine current practice patterns of intensive pediatric PT in the United States.
Methods:
A survey was developed and administered using the FITT (frequency, intensity, time, type) model and Knowledge to Action Cycle for pediatric physical therapists providing intensive PT. Survey respondents included pediatric physical therapists providing intensive physical therapy in outpatient, non-acute settings. Data analysis used descriptive statistics and cluster analysis.
Results:
Eighty pediatric physical therapists reported intensive programs involved children aged 4-6 years with cerebral palsy (90%), neuromuscular (78%), and neuromotor (44%) disorders. Greatest dose often-always ranged from 2-5 visits per week, ≤60-120 minute sessions over 3-8 weeks. Top interventions included locomotor training (80%), task-specific training (78%), and progressive resistive exercise (76%). Two clusters were identified based on therapist organization and dose.
Conclusions:
This first study of intensive pediatric PT revealed marked variability, underscoring the need for a standardized definition to improve clinical care.
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