Section Information: Abstracts of Platform and Poster Presentations for the 2005 Combined Sections Meeting: Poster Presentations
PURPOSE/HYPOTHESIS: The purpose of this pilot program was to study the effects of a year long mobility program implementing the MOVE curriculum with 39 children in five special education classrooms, ranging in age from 3.5 to 13 years, with severe multiple disabilities.
NUMBER OF SUBJECTS: 39 children aged 3.5 to 13 years with a median age of 9.2 years. Subjects were selected for the program based on IEP team and physical therapist recommendation. Most of the children were receiving monitor or consult physical therapy services prior to the start of the program.
MATERIALS/METHODS: Range of motion using goniometry, developmental motor level using the Revised Gesell Developmental Schedule and functional mobility using the MOVE Curriculum were assessed for each child before implementing the program and at the end of the school year. The MOVE program is a top down model focusing on teaching children to sit, stand and walk during their classroom day. The program does not address lower level developmental milestones such as rolling or crawling. All activities in the classroom were designed individually for each child using the MOVE curriculum by their special education teacher and physical therapist. Physical therapists consulted in each classroom two to four hours per week to train and assist the staff in carrying out the program. None of the children received traditional physical therapy services such as range of motion or developmental therapy during the year long program.
RESULTS: Seventy-nine percent of the children made gains in functional mobility, while 8% showed no changes and 13% lost function. Thirty percent gained range of motion in the lower extremities, 13% lost range of motion and 57% showed no changes in range of motion. Twenty-eight percent improved their developmental level, 3% decreased and 69% maintained the same developmental level. Several of the children who lost function and range of motion throughout the year had medical conditions impacting their participation in the program. One child became an independent ambulator during the program. Older children were able to achieve functional mobility improvements as well as the younger children. Families and therapists reported increased alertness and ease of care for these children.
CONCLUSIONS: The majority of children in the pilot program made functional gains in sitting, standing and walking without traditional physical therapy.
CLINICAL RELEVANCE: The MOVE Curriculum may be considered as an alternative model for the delivery of physical therapy services to children with severe multiple disabilities in the educational setting.