Jill Massey, Leanne Claire Dreyer, Erika Molteni, Ben Siegle, Tomoki Arichi, Anne Gordon
{"title":"循证治疗干预改善上肢功能的伙伴关系:回顾性分析。","authors":"Jill Massey, Leanne Claire Dreyer, Erika Molteni, Ben Siegle, Tomoki Arichi, Anne Gordon","doi":"10.1136/bmjpo-2025-003572","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe clinical characteristics and outcomes of children and young people with hemiplegia completing a novel dedicated therapy intervention, 'Evelina REACH'. This evidence-based upper-limb outpatient intervention is delivered in partnership with the child, caregivers, and occupational therapists at a tertiary hospital and community allied health professionals.</p><p><strong>Design: </strong>Retrospective audit of patients completing a 6-week protocolised therapy intervention with repeated standardised measures of spontaneous arm and hand use and of caregiver goal rating.</p><p><strong>Setting: </strong>A tertiary level children's hospital in London, UK.</p><p><strong>Patients: </strong>156 children (median age 26 months, range 4 months-16.5 years) completing a therapy intervention programme between 2012 and 2023.</p><p><strong>Interventions: </strong>An intensive, protocolised and individualised goal-directed therapy intervention programme, co-delivered by the patient, caregivers and hospital-based and community therapists.</p><p><strong>Main outcome measures: </strong>Assisting Hand Assessment (AHA), Goal Attainment Scaling (GAS)/Goal Attainment Scaling Light and Canadian Occupational Performance Measure (COPM).</p><p><strong>Results: </strong>Clinically significant gains were achieved with a mean AHA logit score change of 7 (n=69) which was maintained at 6 weeks post intervention (n=35). At least 1 GAS goal was met or exceeded by 99.2% participants, with measurable score change across three caregiver-mediated COPM goals, performance=90.17%, and satisfaction=83.58%. Of caregivers surveyed, 97.85% would repeat the programme, and 100% would recommend it to others.</p><p><strong>Conclusions: </strong>Evelina REACH is a clinically effective, goal-directed intensive activity-based therapy intervention that fosters lasting functional improvements in upper-limb use. Further research should explore optimal and scalable co-delivery models to enhance children's access to evidence-based therapy in statutory healthcare.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273171/pdf/","citationCount":"0","resultStr":"{\"title\":\"Partnership delivery of evidence-based therapy intervention to improve upper-limb function: a retrospective analysis.\",\"authors\":\"Jill Massey, Leanne Claire Dreyer, Erika Molteni, Ben Siegle, Tomoki Arichi, Anne Gordon\",\"doi\":\"10.1136/bmjpo-2025-003572\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To describe clinical characteristics and outcomes of children and young people with hemiplegia completing a novel dedicated therapy intervention, 'Evelina REACH'. This evidence-based upper-limb outpatient intervention is delivered in partnership with the child, caregivers, and occupational therapists at a tertiary hospital and community allied health professionals.</p><p><strong>Design: </strong>Retrospective audit of patients completing a 6-week protocolised therapy intervention with repeated standardised measures of spontaneous arm and hand use and of caregiver goal rating.</p><p><strong>Setting: </strong>A tertiary level children's hospital in London, UK.</p><p><strong>Patients: </strong>156 children (median age 26 months, range 4 months-16.5 years) completing a therapy intervention programme between 2012 and 2023.</p><p><strong>Interventions: </strong>An intensive, protocolised and individualised goal-directed therapy intervention programme, co-delivered by the patient, caregivers and hospital-based and community therapists.</p><p><strong>Main outcome measures: </strong>Assisting Hand Assessment (AHA), Goal Attainment Scaling (GAS)/Goal Attainment Scaling Light and Canadian Occupational Performance Measure (COPM).</p><p><strong>Results: </strong>Clinically significant gains were achieved with a mean AHA logit score change of 7 (n=69) which was maintained at 6 weeks post intervention (n=35). At least 1 GAS goal was met or exceeded by 99.2% participants, with measurable score change across three caregiver-mediated COPM goals, performance=90.17%, and satisfaction=83.58%. Of caregivers surveyed, 97.85% would repeat the programme, and 100% would recommend it to others.</p><p><strong>Conclusions: </strong>Evelina REACH is a clinically effective, goal-directed intensive activity-based therapy intervention that fosters lasting functional improvements in upper-limb use. Further research should explore optimal and scalable co-delivery models to enhance children's access to evidence-based therapy in statutory healthcare.</p>\",\"PeriodicalId\":9069,\"journal\":{\"name\":\"BMJ Paediatrics Open\",\"volume\":\"9 1\",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273171/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Paediatrics Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjpo-2025-003572\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Paediatrics Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjpo-2025-003572","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Partnership delivery of evidence-based therapy intervention to improve upper-limb function: a retrospective analysis.
Objective: To describe clinical characteristics and outcomes of children and young people with hemiplegia completing a novel dedicated therapy intervention, 'Evelina REACH'. This evidence-based upper-limb outpatient intervention is delivered in partnership with the child, caregivers, and occupational therapists at a tertiary hospital and community allied health professionals.
Design: Retrospective audit of patients completing a 6-week protocolised therapy intervention with repeated standardised measures of spontaneous arm and hand use and of caregiver goal rating.
Setting: A tertiary level children's hospital in London, UK.
Patients: 156 children (median age 26 months, range 4 months-16.5 years) completing a therapy intervention programme between 2012 and 2023.
Interventions: An intensive, protocolised and individualised goal-directed therapy intervention programme, co-delivered by the patient, caregivers and hospital-based and community therapists.
Main outcome measures: Assisting Hand Assessment (AHA), Goal Attainment Scaling (GAS)/Goal Attainment Scaling Light and Canadian Occupational Performance Measure (COPM).
Results: Clinically significant gains were achieved with a mean AHA logit score change of 7 (n=69) which was maintained at 6 weeks post intervention (n=35). At least 1 GAS goal was met or exceeded by 99.2% participants, with measurable score change across three caregiver-mediated COPM goals, performance=90.17%, and satisfaction=83.58%. Of caregivers surveyed, 97.85% would repeat the programme, and 100% would recommend it to others.
Conclusions: Evelina REACH is a clinically effective, goal-directed intensive activity-based therapy intervention that fosters lasting functional improvements in upper-limb use. Further research should explore optimal and scalable co-delivery models to enhance children's access to evidence-based therapy in statutory healthcare.