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Pediatric Physical Therapy:
doi: 10.1097/PEP.0b013e31829732c4
Clinical Bottom Line

Commentary on “Perceived Effectiveness and Barriers to Physical Therapy Services for Families and Children With Friedreich Ataxia”

Craddock, Debi PT, DPT, MS, PCS; Fetters, Linda PT, PhD, FAPTA

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The authors declare no conflicts of interest.

“How could I apply this information?”

The qualitative nature of this study supports exploration of the complex nature of service provision with parents of children with Friedreich Ataxia. Parent-professional collaboration should determine individual needs and realistic, effective intervention strategies. The authors identified themes that may be used as a foundation for discussion with patients and parents to identify barriers to effectiveness, discuss roles and expectations, and negotiate strategies to maintain patient involvement in meaningful activities. Time invested to understand the child's needs, caregiver stressors, and family capabilities may improve parent perception of services. The physical therapist's role includes becoming an expert educator, resource, and advocate. Professional associations may partner with parent organizations to address the insurance issues and educational needs identified in this study.

“What should I be mindful about when applying this information?”

The authors employed accepted qualitative study methodology by using a coding schema with adequate interrater agreement and multiple strategies to maximize the validity of the emergent themes. Qualitative study findings, however, are not generalizable. The low compliance with home exercise programs stated here has been documented in other research studies. Compliance is essential to rigorously evaluate treatment strategies. Physical therapists must assess each individual's perception of their needs, collaborate with patients and parents to identify intervention strategies that are meaningful and realistic, evaluate effectiveness in a timely manner, and assist with appropriate modifications of interventions. This study would be strengthened by a quantitative analysis of demographic characteristics between the 67% of participants and those who declined participation. Additional research is needed to determine whether themes vary with demographics.

Debi Craddock, PT, DPT, MS, PCS
County of Los Angeles, California Children's Services
Los Angeles, California

Linda Fetters, PT, PhD, FAPTA
University of Southern California
Los Angeles, California

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.

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