循证治疗干预改善上肢功能的伙伴关系:回顾性分析。

IF 2.3 4区 医学 Q2 PEDIATRICS
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}
引用次数: 0

摘要

目的:描述儿童和青少年偏瘫患者完成一种新的专用治疗干预的临床特征和结果,“Evelina REACH”。这种基于证据的上肢门诊干预是与儿童、护理人员和三级医院的职业治疗师以及社区联合卫生专业人员合作提供的。设计:对完成为期6周的方案化治疗干预的患者进行回顾性审计,反复测量自发性手臂和手的使用以及护理人员目标评分。地点:英国伦敦一家三级儿童医院。患者:156名儿童(中位年龄26个月,范围4个月-16.5岁)在2012年至2023年间完成治疗干预计划。干预措施:由患者、护理人员、医院和社区治疗师共同提供的密集、有协议和个性化的目标导向治疗干预方案。主要结果测量:辅助手评估(AHA),目标实现量表(GAS)/目标实现量表光和加拿大职业绩效量表(COPM)。结果:取得了临床显著的进展,平均AHA logit评分变化为7 (n=69),并在干预后6周(n=35)保持不变。至少有一个GAS目标达到或超过了99.2%的参与者,在三个护理者介导的COPM目标中有可测量的得分变化,表现=90.17%,满意度=83.58%。在接受调查的护理人员中,97.85%的人会重复该计划,100%的人会推荐给其他人。结论:Evelina REACH是一种临床有效的,目标导向的强化活动治疗干预,可促进上肢使用功能的持久改善。进一步的研究应探索最佳和可扩展的共同交付模式,以提高儿童获得法定医疗保健中的循证治疗的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Partnership delivery of evidence-based therapy intervention to improve upper-limb function: a retrospective analysis.

Partnership delivery of evidence-based therapy intervention to improve upper-limb function: a retrospective analysis.

Partnership delivery of evidence-based therapy intervention to improve upper-limb function: a retrospective analysis.

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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
BMJ Paediatrics Open
BMJ Paediatrics Open Medicine-Pediatrics, Perinatology and Child Health
CiteScore
4.10
自引率
3.80%
发文量
124
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信