Walking from class to the school library, Josh falls to the back of the line. Shortly thereafter a gap forms between Josh and the rest of his class. He is last to arrive and gets the half-functioning computer that everyone else avoids. As his PT, you are there to observe, problem-solve and treat. The computer lab is a half-minute walk from class. His teacher comments “Is that really as fast as Josh can walk? Has it always been that way?”. Do you have an answer for this question?
Josh’s slow walking speed was a major concern at the begining of the school year. At that time you did the thirty-second walk test (30sWT) and the result was clear; he was below the 5th percentile for boys his age and off the low-end of the chart. Although you are having this conversation right now, you think he has improved because he has propulsion and a more efficient gait. Continue reading “How to Use the 30-Second Walk Test”
Elise is constantly falling during her school day. She often has skinned knees and bruises. Although she is 10, she walks down stairs one step at a time. As Elise’s physical therapist, what observational measure will you use to measure her functional balance skills? How will you document her progress?
Balance is defined as the ability to keep the center of mass over the base of support.
Postural control is the act of maintaining, achieving or restoring a state of balance during an activity.
Link to Pediatric Balance Scale Score Sheet
Pediatric physical therapists informally evaluate balance and postural control in every movement. Multiple body systems contribute to balance, and this makes measurement of functional balance somewhat challenging.
Continue reading “How to Use the Pediatric Balance Scale”
Freya is a 6-year-old girl with ataxic cerebral palsy. She moved to California from Iowa last month and has been prescribed six months of physical therapy. Freya’s parents are concerned; she has been having difficulty going down the front stairs of their new home. As her physical therapist, do I have a standardized test that will measure her initial gross motor function? In six months, how will I determine whether Freya has made statistically significant progress?
My Gross Motor Function Measure User’s Manual is tattered. I could not work without the GMFM! Like all things that are well designed, the creators have taken a complex concept and made it logical and simple. The GMFM is an evaluative measure that assesses change in motor function over time. I can test Freya in January, provide PT 1x/week and then retest in July to determine if she has made significant progress. In addition, I won’t overlook Freya’s inability to reach across midline while I am heavily focused on her stair skills; the test covers all domains from lying and rolling up to running and jumping, with each skill being incrementally harder than the last. Continue reading “How to Use the Gross Motor Function Measure (GMFM-66)”