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Outcomes and standardized tools in telehealth physical therapy for children with cerebral palsy: A scoping review
Isabella S Christovão1, Paula S de C Chagas2, Ana Alice V Aniceto3
1Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Insights
This review found that telehealth physical therapy for children with cerebral palsy primarily measures activity outcomes. In-person assessments are still preferred, highlighting a need for more telehealth research.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Health Technology
Background:
- Cerebral palsy (CP) significantly impacts children's development and function.
- Telehealth offers a potential avenue for delivering physical therapy interventions to pediatric CP populations.
- Standardized outcome measures are crucial for evaluating the effectiveness of these interventions.
Purpose of the Study:
- To systematically review outcomes and standardized tools used in telehealth physical therapy for children and young people with CP.
- To analyze these measures within the International Classification of Functioning, Disability and Health (ICF) framework.
- To describe the administration methods of these assessment tools.
Main Methods:
- A comprehensive scoping review following JBI methodology.
- Searches across multiple databases (MEDLINE, Embase, Cochrane, Scopus, Web of Science, PEDro, Lilacs) and grey literature.
- Inclusion of studies on telehealth physical therapy for individuals up to 20 years old, without date or language restrictions.
Main Results:
- Fourteen studies involving 625 participants were included, covering all Gross Motor Function Classification System levels.
- Outcomes predominantly focused on the activity domain (59.3%), followed by body structure/function (29.6%) and participation (22.2%).
- Thirty standardized tools were identified, with the Assisting Hand Assessment and Gross Motor Function Measure being most common; most tools were administered in-person (68.2%).
Conclusions:
- Current telehealth physical therapy outcome measures for pediatric CP prioritize the activity domain, aligning with parental priorities.
- In-person assessment remains the dominant method for standardized evaluations in this field.
- Further research is essential to explore the feasibility and psychometric properties of telehealth-administered standardized tools for pediatric CP.
Aim:
To identify the outcomes and standardized tools used to measure changes following telehealth-delivered physical therapy interventions in children and young people with cerebral palsy, within the framework of the International Classification of Functioning, Disability and Health domains, and to describe how these tools were administered.
Method:
This scoping review followed the steps of the JBI and identified studies on telehealth-delivered physical therapy interventions in children and young people up to 20 years old using standardized assessment tools. Searches were conducted in MEDLINE/PubMed, Embase, Cochrane, Scopus, Web of Science, PEDro, Lilacs, and grey literature, with no date or language restrictions.
Results:
Fourteen studies (625 participants, age range 6 months-20 years, all levels of the Gross Motor Function Classification System) met inclusion criteria. Outcomes were primarily in the activity domain (59.3%), followed by body structure and function (29.6%) and participation (22.2%) domains. Thirty standardized tools were used; the most frequent were the Assisting Hand Assessment (n = 5) and Gross Motor Function Measure (n = 3). Most standardized tools were applied in-person (68.2%), while others used mixed methods (telehealth and in-person: 18.2%) or did not specify the mode of administration (6.8%). Only two studies administered all tools by telehealth.
Interpretation:
The outcomes and standardized tools identified in this review target the activity domain, reflecting parental priorities. In-person assessments remain the preferred modality for conducting standardized evaluations. Further research is necessary to investigate the feasibility and measurement properties of using standardized tools by telehealth.
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