Date Presented 03/28/20
Intensive power mobility training is feasible for children with cerebral palsy ages birth to three years and can yield greater acquisition of power mobility operatory skills due to more frequent sessions, yet scheduling for these sessions can prove difficult with parents. This research study will advance professional practice because the results will add to the current literature to aid in creating a standardized intensive power mobility training protocol, as there is not currently one for this age group.
Primary Author and Speaker: Kaitlyn Snider
Additional Authors and Speakers: Peyton Zimmerman, Kelly Schneider, Claire Morress
Contributing Authors: Ann Bishop
PURPOSE: For non-ambulatory children with cerebral palsy (CP) introducing power mobility training early on is crucial for development of language and cognition, yet power mobility is not an option many therapists turn to due to a lack of standardized training protocols. In this study, researchers examined whether an intensive power mobility training protocol is more effective in helping the child learn how to drive a power wheelchair than a standard protocol. It also examined the feasibility of an intensive protocol for a child under the age of three and his parents.
DESIGN: This study utilized an N-of-1 AB design. The study participant was found via convenience sampling. Inclusion criteria included a confirmed diagnosis of cerebral palsy, no previous experience with power mobility, and current attendance to therapy at the research location.
METHOD: Training was implemented with one child, once weekly for three weeks, then increased to three times a week for the study’s remainder. Each session was videotaped for analysis. The child’s ability to drive the chair was analyzed through video coding using two pairs of independent, blinded reviewers following the completion of training sessions. Analysis consisted of timing how many seconds each variable - independent, assisted, and caregiver - occurred in that training session. A semi-structured parent interview was also conducted post-training, which was audio-recorded for further analysis following transcription.
RESULTS: The only variable that was significantly impacted by intensive training was assisted mobility. Assisted mobility was characterized as the percentage of time the child drove the chair after his hand was placed on the joystick. A parent interview reflected the positive effect on her child’s mobility as well as the emotional impact of seeing her child in a wheelchair and the strain training added to her schedule.
CONCLUSION: Intensive power mobility training is feasible and can yield greater acquisition of power mobility operatory skills due to more frequent sessions, however more research is necessary in the area of intensive versus a more standardized training protocol.
IMPACT: This proposal is important to practice because the results will add to current literature to aid the creation of a standardized intensive training protocol as there is not one for this age and will enable practitioners to expand their clinical reasoning regarding the effects of intensive training.
References
Ragonesi, C.B. & Galloway, J.C. (2012). Short-term, early intensive power mobility training: case report of an infant at risk for cerebral palsy. Pediatric Physical Therapy, 24(2), 141-148. doi: 10.1097/PEP.0b013e31824c764b
Kenyon, L.K., Hostnik, L., McElroy, R., Peterson, C., & Farris, J.P. (2018b). Power mobility training methods for children: A systematic review. Pediatric Physical Therapy, 30(1), 2-8. doi: 10.1097/pep.0000000000000458
