Sitting Together and Reaching to Play Physical Therapy Affects Dyadic Emotional Availability in Children With Neuromotor Delay and Their Families.

IF 3.5 4区医学 Q1 ORTHOPEDICS

Physical Therapy Pub Date : 2025-02-06 DOI:10.1093/ptj/pzae167

Rebecca M Molinini, Corri Stuyvenburg, Natalie A Koziol, Regina T Harbourne, Lin-Ya Hsu, Michele A Lobo, Sandra L Willett, James A Bovaird, Virginia W Chu, Sarah K Price, Mary S Shall, Stacey C Dusing

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引用次数: 0

Abstract

Objective: Emotional availability (EA) describes caregiver-child emotional attunement and is critical to fostering adaptive development. Although early physical therapist interventions adopt a family centered approach, the impact of interventions on families is often not quantified. This study compares EA in dyads receiving usual care-early intervention (UC-EI) versus sitting together and reaching to play (START-Play) in addition to UC-EI.

Methods: Data were drawn from 106 children with neuromotor delay who were 7 to 16 months old at baseline (mean = 10.5 months) and from their caregiver (91% were mothers). The EA Scale, Fourth Edition, was scored from 5-min videotaped interactions collected at baseline and at 3, 6, and 12 months after baseline. Piecewise multilevel modeling controlling for baseline age and motor delay estimated short- and long-term effects between treatment groups. Additionally, within-group change over time was analyzed to understand if groups differed in direction of EA trajectories. Analyses were run aggregated across all participants and stratified by baseline severity of motor delay or caregiver reported education.

Results: When comparing EA between groups, there were significant positive short- and long-term effects of START-Play on adult EA (gs > 0.38), sensitivity (gs > 0.26), structuring (gs > 0.43), and nonintrusiveness (gs > 0.36). For dyads with mild or significant motor delay or whose parent reported less than a bachelor's degree at baseline, positive effects of START-Play were observed.

Conclusion: Results support important clinical implications for the positive effect of START-Play on EA. Similar child-level treatment effects highlight that the key difference between START-Play and UC-EI may lie in the way intervention affects caregivers. START-Play may be more beneficial to dyads with higher versus lower risks to EA.

Impact: Early physical therapist interventions can have a significant impact on parents, children, and the parent-child relationship. Measuring the effect of these interventions on the relationship is critical to optimizing the delivery of family centered care.

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一起坐着玩（START-Play）物理疗法影响神经运动迟缓儿童及其家庭的二元情绪可用性。

目的：情感可得性（EA）描述了照顾者与儿童的情感协调，对促进适应性发展至关重要。虽然早期的物理治疗师干预采取以家庭为中心的方法，干预对家庭的影响往往是不量化的。这项研究比较了接受常规护理-早期干预（UC-EI）和坐在一起玩耍（START-Play）的二人组的EA。方法：数据来自106名基线时7 - 16个月（平均10.5个月）的神经运动迟缓儿童及其照顾者（91%为母亲）。情绪可用性量表，第四版，根据基线和基线后3、6和12个月收集的5分钟互动录像进行评分。分段多水平模型控制基线年龄和运动延迟估计治疗组之间的短期和长期影响。此外，还分析了组内随时间的变化，以了解各组是否在EA轨迹方向上存在差异。对所有参与者进行汇总分析，并根据运动迟缓的基线严重程度或护理人员报告的教育程度进行分层。结果：组间EA比较，START-Play在成人EA （gs > 0.38）、敏感性（gs > 0.26）、结构（gs > 0.43）和非侵入性（gs > 0.36）方面均有显著的正性短期和长期影响。对于有轻微或显著运动迟缓或其父母在基线时报告少于学士学位的二人组，观察到START-Play的积极作用。结论：研究结果支持了START-Play对EA的积极作用的重要临床意义。类似的儿童水平治疗效果强调了START-Play和UC-EI之间的关键差异可能在于干预对照顾者的影响方式。开始游戏可能对患ea风险较高的夫妇更有利。影响：早期物理治疗师的干预对父母、孩子和亲子关系都有重大影响。衡量这些干预措施对关系的影响对于优化以家庭为中心的护理的提供至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physical Therapy Multiple-

CiteScore

7.10

自引率

0.00%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.