The ResearchWorks Podcast

• Episode 211 (Associate Professor Paula Chagas)

  Gross Motor Family Report: Refinement and evaluation of psychometric propertiesElton D. D. Magalhães, Peter Rosenbaum, Marilyn Wright, F. Virginia Wright, Lesley Pritchard, Kennea M. A. Ayupe, Ana Carolina de Campos, Rosane S. Morais, Hercules R. Leite, Paula S. C. ChagasAbstractAimTo refine the Gross Motor Family Report (GM-FR) using parents' input and to evaluate its psychometric properties.MethodIn this measurement study, 12 parents of children and adolescents with cerebral palsy (CP), aged 2 to 18 years, classified in all levels of the Gross Motor Function Classification System (GMFCS), were interviewed about their experience completing the GM-FR (content validity). Parents' feedback was used to refine the measure which was then completed by 146 families to evaluate internal consistency, and discriminative and concurrent validity. Forty-six parents completed the GM-FR again, 7 to 30 days later, to evaluate test–retest reliability.ResultsGM-FR scoring, pictures, descriptions, and the total number of items were revised based on parents' feedback. The GM-FR version 2.0 demonstrated high internal consistency (Cronbach's α = 0.99), no floor/ceiling effects, and excellent test–retest reliability (intraclass correlation coefficient = 0.99). GM-FR scores discriminated between GMFCS levels (p less than 0.05) and were strongly negatively correlated with GMFCS level (r = −0.92; p less than 0.001). GM-FR scores correlated positively and strongly with the Gross Motor Function Measure-66 (r = 0.94; p less than 0.001) and the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test mobility domain (r = 0.93; p less than 0.001).InterpretationActive participation of families in the GM-FR's development facilitated creation of a family-friendly instrument. This study provides strong evidence of reliability and validity to support GM-FR use in clinical practice and research for assessing gross motor performance of children and adolescents with CP.https://onlinelibrary.wiley.com/doi/10.1111/dmcn.16042

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• Episode 210 (Professor Gareth Baynam)

  Professor Gareth Baynam is a globally recognised clinical geneticist, researcher, and advocate for rare diseases. He is the Director of the Rare Care Centre at Perth Children's Hospital and the Head of the Western Australian Register of Developmental Anomalies. With a career dedicated to improving the diagnosis, management, and care of individuals with rare and genetic conditions, he has been at the forefront of integrating cutting-edge technologies such as genomics, artificial intelligence, and precision medicine into healthcare. Professor Baynam is also a leader in Indigenous health initiatives, championing equitable access to rare disease diagnostics and treatment. Through his work with organizations such as the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease and the European Rare Diseases Research Alliance (ERDERA),  he continues to drive global collaborations and innovations that aim to transform rare disease care.

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• Epsiode 209 (Associate Clinical Professor Anita Gross and Associate Professor Nikki Milne)

  Spinal manipulation and mobilisation in paediatrics - an international evidence-based position statement for physiotherapistsAnita R Gross, Kenneth A Olson, Jan Pool, Annalie Basson, Derek Clewley, Jenifer L Dice, Nikki MilnePMID: 38855972PMCID: PMC11216248DOI: 10.1080/10669817.2024.2332026AbstractIntroduction: An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) - to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions.Method: A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).Results: Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined.Conclusion: Specific directives to guide physiotherapists' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.

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• Episode 208 (Professor Alicia Spittle)

  Early Detection and Early Intervention - where are we now (and what does the future hold)?The last time we had Alicia on the pod, we spoke about the Cochrane Review she led titled “Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants” which was published in 2024. In this week’s episode, we thought we’d ask Alicia about the state of early intervention right now and what the provision of therapy looks like within our current context of early detection and early intervention for children with cerebral palsy.There have been some rather significant developments in the early detection and early intervention space over the past 20 years. From the rapid technological advances to the value of co-design and involvement of people with lived experience, we now have some impressive evidence to guide our clinical pathways. However, what is very clear now is the vital importance of implementation. The industry has generated substantial knowledge that now needs to be implemented into practice with one particularly important aspect that we must include - family involvement and well-being. Alicia speaks ever so passionately about our role as therapists and I cannot help but to feel even more compelled to ensure that the family is at the centre of everything we do. It is exciting to know that we have the evidence now, so it’s time to put it into practice and it can start in your very next session.https://findanexpert.unimelb.edu.au/profile/27041-alicia-spittle

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• Episode 207 (Dr Michelle Jackman)

  Implementing Clinical Practice Guidelines for Improving Function in Cerebral Palsy: Development of a Fidelity ToolIn this study, the research team developed a 21-item fidelity tool to help clinicians implement evidence-based guidelines for improving function in children with cerebral palsy. Designed for goal setting, intervention, and reflection, the tool was found to be practical and useful but faced challenges like time constraints and family expectations. The study highlights the need for education, self-reflection, and organisational support to bridge the gap between research and practice.AbstractPurpose: To develop a fidelity tool to support the implementation of clinical practice guidelines to improve physical function for children and young people with cerebral palsy.Methods: Fidelity tool development followed a 5-step process: the pilot study, using a mixed-methods action research approach, and including focus groups, questionnaires, and field notes.Results: A 21-item fidelity tool representing the core components of the clinical practice guidelines was developed, including subsections of goal setting, intervention, and elements seen throughout therapeutic intervention. Clinicians and supervisors reported this tool as acceptable and feasible, especially when used as a self-reflection tool.Conclusions: A fidelity tool has been developed that clinicians, supervisors and organizations can use to reflect on current practice and plan for changes to align practice with guidelines to improve function in children with cerebral palsy.https://pubmed.ncbi.nlm.nih.gov/39378353/

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