Notes

Decreasing intraoperative moment using laryngeal cover up respiratory tract and extender within child fluid warmers adenotonsillectomy.
For more insights from the authors, access Supplemental Digital Content 1, at http//links.lww.com/PPT/A85.
For more insights from the authors, access Supplemental Digital Content 1, at http//links.lww.com/PPT/A85.
To examine the effect of body weight-supported treadmill training (BWSTT) on gait and gross motor skill development in children (2-5 years old) with developmental delay who are ambulatory.

Twenty-four subjects (12 control and 12 BWSTT) were enrolled in this randomized control trial. All subjects continued to receive physical therapy. Subjects were tested at baseline, 4 weeks, 6 weeks, and at 6 weeks after completion of BWSTT. Outcomes were assessed using the 10-m walk test and Gross Motor Function Measure-D and E.

Significant improvements were seen in gait velocity and gross motor skill attainment. With positive interactions in both the 10-m walk test and Gross Motor Function Measure-E, the BWSTT group as compared with the control group demonstrated functional gains in gait velocity and gross motor skills, P = .033 and .017, respectively.

A 6-week high-intensity BWSTT program can improve gait velocity and influence functional gains.
A 6-week high-intensity BWSTT program can improve gait velocity and influence functional gains.
To learn where pediatric physical therapists in the United States are in the process of knowledge translation of the Gross Motor Function Classification System (GMFCS).

Links to an online survey were distributed electronically.

All 283 respondents reported hearing about the GMFCS, 95% agreed it was useful, 81% reported they were confident in their ability to use it, 77% reported they use it, and 42% reported they use it consistently. Therapists primarily used the GMFCS to predict gross motor function, set realistic goals, and anticipate need for assistive technology. The American Physical Therapy Association Section on Pediatrics members were more likely than nonmembers to agree the GMFCS is useful, they are able to use it, that they use it, and that they use it consistently.

The majority of therapists responding use the GMFCS, but not consistently.

For more insights from the authors, see Supplemental Digital Content 1, available at http//links.lww.com/PPT/A91.
For more insights from the authors, see Supplemental Digital Content 1, available at http//links.lww.com/PPT/A91.
Clinical reasoning is an essential skill in pediatric physical therapist (PT) practice. As such, explicit instruction in clinical reasoning should be emphasized in PT education.

This article provides academic faculty and clinical instructors with an overview of strategies to develop and expand the clinical reasoning capacity of PT students within the scope of pediatric PT practice. Achieving a balance between deductive reasoning strategies that provide a framework for thinking and inductive reasoning strategies that emphasize patient factors and the context of the clinical situation is an important variable in educational pedagogy.

Consideration should be given to implementing various teaching and learning approaches across the curriculum that reflect the developmental level of the student(s). Deductive strategies may be helpful early in the curriculum, whereas inductive strategies are often advantageous after patient interactions; however, exposure to both is necessary to fully develop the learner's clinical reasoning abilities.

For more insights from the authors, see Supplemental Digital Content 1, available at http//links.lww.com/PPT/A87.
For more insights from the authors, see Supplemental Digital Content 1, available at http//links.lww.com/PPT/A87.
The Section on Pediatrics of the American Physical Therapy Association has developed a number of resources to support and improve the consistency of professional pediatric physical therapy education, including a set of core competencies that all graduates must attain. The purpose of this article is to advocate for the inclusion of experiential learning activities with children, including children with participation restrictions, as a necessary component to achieve the core competencies.

Experiential learning is a form of practice-based education that provides exposures and opportunities for students to explore the work, roles, and identities they will encounter as future professionals. Experiential learning is learning by doing, and occurs within a relevant setting. Six representative curricular exemplars are presented to provide readers with a variety of suggestions for development and integration of experiential learning.

Recommendations for future research are provided and 4 key recommendations are provided.
Recommendations for future research are provided and 4 key recommendations are provided.
The aim of this study was to evaluate the effect of dynamic elastomeric fabric orthoses (DEFOs) on postural control in children with cerebral palsy (CP).

Ten children with spastic diplegic CP and 10 children with typical development participated. Knee extension was measured using electrogoniometry. The standard deviation of excursion and phase plane portraits of velocity in the anteroposterior and mediolateral directions were calculated from force platform signals as center of pressure parameters with or without a DEFO.

Maximum standing knee extension for children with CP improved after 6 weeks of wearing DEFOs (P < .05). Center of pressure parameters did not improve when comparing pre- to 6 weeks post-DEFO use (P < .05).

The DEFO can reduce the crouch position without any negative effect on postural stability in children with CP. However, postural control does not improve in a 6-week timeframe.
The DEFO can reduce the crouch position without any negative effect on postural stability in children with CP. However, postural control does not improve in a 6-week timeframe.
The Pediatric Balance Scale (PBS) is a 14-item measure of functional balance for children. This study examined PBS dimensionality, rating scale function, and hierarchical properties using Rasch analysis.

The PBS data were analyzed retrospectively for 823 children, aged 2 to 13 years, with uni- and multidimensional Rasch partial credit models.

The PBS best fits a unidimensional model based on the Bayesian information criterion analysis (12,400.73 vs 12,404.48), strong correlations between 3 proposed dimensions (r = 0.946-0.979), and high internal consistency (Cronbach α = 0.94). Analysis of rating scale functioning is limited by small numbers of children achieving low scores on easy items. Item maps indicated a ceiling effect but no substantive gaps between item difficulty estimates.

The PBS items are best targeted to preschool-age children; additional children with known balance dysfunction are required to fully assess functioning of the easiest PBS items. Revisions may improve PBS utility in older children.
The PBS items are best targeted to preschool-age children; additional children with known balance dysfunction are required to fully assess functioning of the easiest PBS items. Linsitinib in vitro Revisions may improve PBS utility in older children.
To examine postural control of anteroposterior (AP) and mediolateral sway of children with probable developmental coordination disorder (pDCD) and children with typical development (TD).

Forty-eight children (24 in each group) aged 11 to 12 years performed an aiming task, maintaining a laser beam within targets placed in 2 locations (front/side). Precision was compromised primarily by the control of mediolateral sway for the front target and by the control of AP sway for the side target. The task was performed with large and small targets.

In the side target condition, only (1) the TD group showed reduced AP sway in response to reduced target size, whereas the pDCD group increased AP sway, and (2) aiming performance for reduced target sizes deteriorated to a greater degree in the pDCD group than in the TD group.

These findings suggest children with pDCD have specific deficits in controlling AP sway.
These findings suggest children with pDCD have specific deficits in controlling AP sway.
The purpose of this study was to evaluate the utility of postural sway variability as a potential assessment to detect altered postural sway in youth with symptoms related to a concussion.

Forty participants (20 who were healthy and 20 who were injured) aged 10 to 16 years were assessed using the Balance Error Scoring System (BESS) and postural sway variability analyses applied to center-of-pressure data captured using a force plate.

Significant differences were observed between the 2 groups for postural sway variability metrics but not for the BESS. Specifically, path length was shorter and Sample and Renyi Entropies were more regular for the participants who were injured compared with the participants who were healthy (P < .05).

The results of this study indicate that postural sway variability may be a more valid measure than the BESS to detect postconcussion alterations in postural control in young athletes.
The results of this study indicate that postural sway variability may be a more valid measure than the BESS to detect postconcussion alterations in postural control in young athletes.
This retrospective study aimed to compare the sentinel lymph node (SLN) mapping results of methylene blue (MB) and indocyanine green (ICG) in women with early-stage endometrial or cervical cancer.

From August 2011 to March 2015, all consecutive patients with stage I endometrial or cervical cancer who underwent SLN mapping with intracervical injection of MB or ICG using a 22-gauge spinal needle were included in the study. Radical or simple hysterectomy with bilateral pelvic and/or aortic lymphadenectomy was performed after SLN mapping.

Overall, 81 women (64 women with endometrial cancer and 17 women with cervical cancer) underwent surgery, including SLN mapping. Sixty-five patients (80%) underwent minimally invasive surgery. The overall detection rate was 84% (34 of 38) and 100% (43 of 43) for MB and ICG, respectively (P = 0.041). Bilateral SLN detection was higher in the ICG group than in the MB group (88% vs 50; P = 0.002). Eleven patients (13.5%) were found to have positive nodes with at least 1 positive SLN. The sensitivity and negative predictive value of SLN were 100%.

Real-time florescence mapping with ICG shows better overall detection rate and bilateral mapping than MB alone. In our pilot study, the differences are statistically significant. The higher number of bilateral mapping of ICG may increase the quality of life and recovery of women by reducing the need for complete lymphadenectomy.
Real-time florescence mapping with ICG shows better overall detection rate and bilateral mapping than MB alone. In our pilot study, the differences are statistically significant. The higher number of bilateral mapping of ICG may increase the quality of life and recovery of women by reducing the need for complete lymphadenectomy.
The aim of this study was to evaluate the incremental prognostic value of pelvic magnetic resonance imaging (MRI) and whole-body F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) findings compared with clinical-histopathologic factors in patients with newly diagnosed cervical cancer.

The institutional review board approved this retrospective study of 114 patients (median age, 40.6 years) with International Federation of Gynecology and Obstetrics (FIGO) stage I-IVB cervical cancer who underwent pretreatment MRI and PET/CT. All scans were reviewed for locoregional tumor extent, pelvic or/and para-aortic lymphadenopathy, and distant metastases. Univariate Cox proportional hazard regression was performed to evaluate associations between clinical-histopathologic factors, imaging findings, and progression-free survival (PFS). Multivariate models were built using independent predictors for PFS. Harrell C was used to measure concordance (C index).

Forty patients progressed within a median time of 10.
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