Clinical Bottom Line
“How can I apply this information?”
One aspect of clinical management is predicting outcomes related to a patient/client's condition (prognosis) as well as the value of the services received. The results of this research apply to the process of prognosis. The authors help to identify ultimate outcomes related to life roles. Of interest to a clinician is the understanding of the association between ultimate outcomes of independent activity and participation in life roles as a response to therapy received during childhood. The authors of this article report on the link between receiving physical therapy (PT) and/or occupational therapy (OT), by persons with physical disabilities when they are in their adolescence and later participation in postsecondary education and paid employment. Those teens who received PT/OT were 3.2 times more likely to attend postsecondary education. Clinically, this provides rationale for adolescents with physical disabilities staying in therapy through their teen years. It also provides some direction for goals and the focus of treatment toward attaining independence in activities of daily living and mobility possibility via wheelchair.
“What should I be mindful about in applying this information?”
This information as currently provided is limited to youths 19 to 23 years of age. To determine ultimate prognosis, these individuals must be followed for a significantly longer period to identify employment outcomes. The authors acknowledge this limitation and identify that further analyses are necessary. In addition, while the factors have been identified in very broad terms, that is, PT and OT services, for further application it would be important to know what those services comprised and whether they addressed mobility and self-care.
In addition, what were the dosages of the services? How important was family involvement in the services? This article begins to explore the difference among white and nonwhite races and the influence of level of parental education in paid employment and postsecondary education, respectively. Whereas this article is groundbreaking in its look at long-term outcomes, it is limited in details for exact application to decision making about specific interventions.
Karen Marie Kott, PT, PhD
Old Dominion University
Sharon Held, PT, DPT, MS
Amherst, New York