Pediatric physical therapy is making progress and there are several signs of our advancement in this issue. First, our lead article, by Bailes and colleagues,1 represents a randomized controlled trial investigating the effects of suit therapy. We are beginning to demonstrate our willingness to carefully design and execute studies that provide validity for our clinical decision making. Bailes and her colleagues are to be commended for carrying out what is considered the gold standard of research design. The findings of their study illustrate that suit therapy was as effective as their control condition. That alone should give us pause in considering the effectiveness of this newer therapy. Whereas the work by Bailes et al is not definitive, it is a study to be seriously considered by therapists using suit therapy.
Second, in this issue we can see that we are seriously engaged in preventative therapy. The report by Nervick et al2 documents the detrimental relationship between motor development and overweight and obesity in very young children, and the authors advocate for the role of physical therapists in preventing this major health risk. We need to continue to recognize our role in health promotion and seize every opportunity that presents to solidify our profession as practitioners of choice in combating the effects of inactivity that without question lead to obesity.
I would also point out the article by Martinsson and Himmelmann,3 which addresses prevention and illustrates the potency of our interventions in preventing hip subluxation in children with CP who are not ambulatory. Those of us who have practiced long enough to watch the secondary effects of hip asymmetries manifest in children with more severe CP welcome this study's findings that positioning children in abduction and extension is as effective as tenotomies in preventing migration of the hip. We also realize that such intervention takes time and commitment from families, but the outcomes are clearly worth the outcome: preventing not only hip dislocation, but I might also theorize a positive benefit on the control of progressive neuromuscular scoliosis, so common in this group of children.
Third, all of these articles illustrate the potency of our interventions, when applied at proper dosage. And that provides the challenge for the future, we are making progress but we need to continue to evolve to a point where we are asking and answering even more explicit questions regarding dosage in very well designed and executed studies. Our upcoming Section on Pediatrics Research Summit should provide timely direction for further development of research questions on dosage.
Ann F. Van Sant, PT, PhD, FAPTA
1. Bailes AF, Greve K, Burch CK, Reder R, Lin L, Huth MM. The effect of suit wear during an intensive therapy program in children with cerebral palsy. Pediatr Phys Ther. 2011;23:136–142.
2. Nervick D, Martin K, Rundquist P, Cleland J. The relationship between body mass index and gross motor development in children aged 3 to 5 years. Pediatr Phys Ther. 2011;23:144–148.
3. Martinsson C, Himmelmann K. Effect of weight-bearing in abduction and extension on hip stability in children with cerebral palsy. Pediatr Phys Ther. 2011;23:150–157.