Documenting the content of physical therapy for children with acquired brain injury: development and validation of the motor learning strategy rating instrument

Phys Ther. 2011 May;91(5):689-99. doi: 10.2522/ptj.20100415. Epub 2011 Mar 17.

Abstract

Background: A goal of physical therapy interventions for children and youth with acquired brain injury (ABI) is the learning and relearning of motor skills. Therapists can apply theoretically derived and evidence-based motor learning strategies (MLSs) to structure the presentation of a task and organize the environment in ways that may promote effective, transfer-oriented practice. However, little is known about how MLSs are used in physical therapy interventions for children with ABI.

Objective: The purpose of this study was to develop and validate an observer-rated Motor Learning Strategy Rating Instrument (MLSRI) quantifying the application of MLSs in physical therapy interventions for children with ABI.

Design: A multi-stage, iterative, item generation and reduction approach was used.

Methods: An initial list of MLS items was generated through literature review. Seven experts participated in face validation to confirm item comprehensiveness. In a content validation process, 12 physical therapists with pediatric ABI experience responded to a questionnaire evaluating feasibility and importance of items. Six physical therapy sessions with clients with ABI were videotaped at a children's rehabilitation center. The 12 physical therapists participated in a session where they: (1) rated session videos to test the MLSRI and (2) provided verbal feedback.

Results: Revisions were made sequentially to the MLSRI based on these processes.

Limitations: The MLSRI was scored during videotape observation rather than being given a live rating, which may be onerous in certain settings and may influence therapist or child behavior.

Conclusions: Further reliability investigations will determine whether the 33-item MLSRI is of help in documenting strategy use during intervention, as an evaluation tool in research, and as a knowledge transfer resource in clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Brain Injuries / rehabilitation*
  • Child
  • Decision Making
  • Disability Evaluation*
  • Disabled Children / rehabilitation*
  • Evidence-Based Practice
  • Humans
  • Motor Skills*
  • Physical Therapy Modalities*
  • Recovery of Function*
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Videotape Recording