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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

Pediatric Physical Therapy: October 2013 - Volume 25 - Issue 3 - p 330
doi: 10.1097/PEP.0b013e31829730bf

Loudoun County Public Schools Ashburn, Virginia

University of Southern California Los Angeles, California

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

Copyright © 2013 Academy of Pediatric Physical Therapy of the American Physical Therapy Association