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Pediatric Physical Therapy:
doi: 10.1097/PEP.0b013e31829730bf
Clinical Bottom Line

Commentary on “The Use of Video Clips in Teleconsultation for Preschool Children With Movement Disorders”

Wiley, Michele PT, DPT, PCS; Fetters, Linda PT, PhD, FAPTA

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The authors declare no conflicts of interest.

“How should I apply this information?”

This study provides preliminary evidence for the efficacy of telepractice as a vehicle for examination in pediatric populations with suspected neuromotor developmental diagnoses. The use of videotaped assessment could be useful if physical therapists are not available for live observation of a child such as in a rural setting or in an underserved area. Of note is the increased rigor that was identified in implementing criteria for scoring the assessment from the video recordings. This suggests that videotaped assessments might provide a useful tool for therapists after live assessment to more specifically score performance even if it has been directly observed.

“How should I be mindful in applying this information?”

The Hempel examination technique was used to evaluate the children. This “standardized free-field” environment as described by the authors allows for general observation of movement, but it does not provide a complete motor assessment. The authors acknowledged that the validity and predictive value of this instrument has not been established. In addition, the researchers modified the examination by removing items, further potentially affecting the validity of the tool. While agreement between examiners in scoring the tool was demonstrated, there was no follow-up to indicate if any of the children later received a confirmed diagnosis of a neuromotor disorder. The observations of the children and the videos were done by the same examiners, introducing the possibility of bias, which may have also influenced the validity of the study.

Michele Wiley, PT, DPT, PCS
Loudoun County Public Schools
Ashburn, Virginia

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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