Translating evidence to increase quality and dose of upper limb therapy for children with unilateral cerebral palsy: a pilot study

Sakzewski, Leanne, Ziviani, Jenny and Boyd, Roslyn N. (2016) Translating evidence to increase quality and dose of upper limb therapy for children with unilateral cerebral palsy: a pilot study. Physical and Occupational Therapy in Pediatrics, 1-25. doi:10.3109/01942638.2015.1127866


Author Sakzewski, Leanne
Ziviani, Jenny
Boyd, Roslyn N.
Title Translating evidence to increase quality and dose of upper limb therapy for children with unilateral cerebral palsy: a pilot study
Journal name Physical and Occupational Therapy in Pediatrics   Check publisher's open access policy
ISSN 0194-2638
1541-3144
Publication date 2016-02-09
Sub-type Article (original research)
DOI 10.3109/01942638.2015.1127866
Open Access Status Not Open Access
Start page 1
End page 25
Total pages 25
Place of publication Philadelphia, PA, United States
Publisher Taylor and Francis
Collection year 2017
Formatted abstract
Aims: To pilot efficacy of a tailored multifaceted implementation program to change clinical practice of occupational therapists (OTs) providing upper limb (UL) therapy for children with unilateral cerebral palsy (UCP). Methods: This before and after study piloted a multifaceted implementation program comprising audit/feedback, barrier identification, and education. Medical chart audits were conducted prior to and 12 months after the intervention. Primary process outcomes included proportion of children with UCP with (1) goals set; (2) goals measured; (3) received contemporary motor learning approach; (4) an adequate dose (30–40 hours); and (5) measured UL outcomes. Results: Three teams of OTs (n = 9) participated. Forty-three audits at baseline and 53 at 12 months postimplementation program were conducted. Average time to complete audits was 10 min and four out of the five evidence criteria had complete data extracted from files. Changes in clinical behavior included greater measurement of goals before (+17%) and after (+22%) therapy; use of constraint therapy (+38%), bimanual therapy (+26%), home programs (+14%); measurement of UL outcomes before (+29%) and after (+23%) therapy. Children receiving the target dose increased from 0 to 10%. Conclusions: A tailored multifaceted implementation program was feasible to implement and led to meaningful changes in clinical practice behavior.
Keyword Cerebral palsy
Occupational therapy
Research translation
Upper limb therapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published online 9 February 2016

 
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Created: Thu, 11 Feb 2016, 09:22:05 EST by Ms Leanne Sakzewski on behalf of School of Health & Rehabilitation Sciences