The Development of an Orthotic Management Protocol for Preambulatory Children with Spastic Diplegic Cerebral Palsy

Weber, Donald J.

doi:10.1097/00008526-199400630-00003

Cited by 5 publications

(3 citation statements)

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“…As suggested by Weber, a neutral rating was intentionally excluded to require experts to rate each item as positive or negative. 26 Experts were encouraged to provide additional comments for each category of items.…”

Section: Methodsmentioning

confidence: 99%

Determining educational assessment criteria for patellar-tendon-bearing impressions for transtibial prosthetic sockets: A Delphi study

Falbo

Morgan

Brinkmann

2022

Prosthetics &Amp; Orthotics International

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Background:Validated criteria to guide assessment of student performance in clinical tasks in prosthetics and orthotics education have not been established. Lack of established criteria and assessment methods presents challenges in evaluating student performance on clinical tasks, such as taking impressions for patellar-tendon-bearing (PTB) sockets.Objectives:To establish assessment criteria for the PTB impression process for use in educational settings.Study design:Delphi consensus process.Methods:Initial Delphi survey items were based on interviews with prosthetic instructors and focus groups with prosthetic students. Expert prosthetic educators were then identified by purposive sampling to complete multiple-round Internet-based Delphi surveys. The Delphi surveys asked experts to indicate their level of agreement on various assessment methods and criteria in PTB education. Consensus for survey items was reviewed after each survey round and used to determine the content of and need for subsequent rounds.Results:Fourteen experts completed two Delphi survey rounds. Items were categorized into educational materials/strategies, impression stages/materials, measurement tools, measurements taken, assessment during impression, assessment after impression, feedback, student self-assessment, and grading. In two survey rounds, 40 items guiding assessment methods and criteria for PTB impressions achieved 80% consensus.Conclusions:A high level of consensus was achieved in two survey rounds. Lower levels of consensus were reached on specific objective criteria, such as use of measurement thresholds when evaluating student impressions. Standardized assessment of student performance on PTB impression-taking instead relies primarily on qualitative assessments based on instructor expertise.

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Section: Methodsmentioning

confidence: 99%

Determining educational assessment criteria for patellar-tendon-bearing impressions for transtibial prosthetic sockets: A Delphi study

Falbo

Morgan

Brinkmann

2022

Prosthetics &Amp; Orthotics International

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“…Delphi consensus techniques have already been used to generate many prosthetic and orthotic CPGs on a variety of topics including prescription of lower-limb prostheses, 14,15 prescription of microprocessor-controlled prosthetic knees, 9 orthotic management of children with spastic diplegic cerebral palsy, 16 orthotic management of plagiocephaly, 17 and factors influencing transtibial prosthesis fit. 18 The use of Delphi consensus techniques in prosthetic and orthotic rehabilitation was recently summarized in a systematic literature review culminating in a number of recommendations of best practices within this development process.…”

Section: Introductionmentioning

confidence: 99%

Transfemoral interface considerations: A clinical consensus practice guideline

O’Brien

Stevens

Miro

et al. 2022

Prosthetics &Amp; Orthotics International

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Background:Although there have been a number of studies exploring the impact and efficacy of transfemoral prosthetic components such as knee and foot mechanisms, the empirical evidence surrounding transfemoral prosthetic interface considerations is limited. This constitutes a substantial void for practicing clinicians seeking to apply best practices for patients who use transfemoral prostheses. Recent years have seen increased production and availability of clinical practice guidelines germane to prosthetic rehabilitation. In those areas where empirical evidence is lacking, consensus clinical opinions may constitute the highest level of evidence.Objective:A consensus exercise was performed to generate clinical practice recommendations in the areas of transfemoral interface considerations including socket variations and critical design features, suspension and interface considerations, alignment, heat retention and dermatologic considerations, female considerations, surgical considerations, and both regulatory and ethical considerations related to osseointegration.Methods:This began with the generation of postulate items through systematic and narrative literature reviews. A Delphi consensus exercise was performed among clinical experts in government hospital and private clinical practice settings, culminating in a series of clinical practice recommendations associated with the prosthesis–limb interface for individuals with transfemoral amputation.Results:The completed recommendations include guidance statements relative to socket variations and critical design features, female considerations, suspension and interface considerations, surgical variations and prescription considerations, rehabilitation team considerations and both regulatory and ethical considerations related to osseointegration.Conclusions:The Delphi process facilitated the development of practice guidelines for transfemoral prosthetic interface considerations based on aggregated subject matter expertise.

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“…Delphi consensus techniques have already been used to generate many prosthetic and orthotic clinical practice guidelines on a variety of topics including prescription of lower limb prostheses, 18 , 19 prescription of microprocessor-controlled prosthetic knees, 12 orthotic management of children with spastic diplegic cerebral palsy, 20 orthotic management of plagiocephaly, 21 and factors influencing transtibial prosthesis fit. 22 The use of Delphi consensus techniques in prosthetic and orthotic rehabilitation was recently summarized in a systematic literature review culminating in a number of recommendations of best practices within this development process.…”

Section: Introductionmentioning

confidence: 99%

Prosthetic management of unilateral transradial amputation and limb deficiency: Consensus clinical standards of care

O’Brien

Stevens

Mandacina³

et al. 2021

Journal of Rehabilitation and Assistive Technologies Engineerin

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Introduction Upper limb research is currently lacking detailed clinical guidance on the provision of unilateral transradial prostheses. Clinical practice guidelines are meant to serve as assistance for the decision-making process, and Delphi surveys have been used with increasing frequency within orthotics and prosthetics to create these guidelines for clinical practice. Methods A three round Delphi survey was used to gain consensus on clinical statements regarding unilateral transradial prostheses. Results We achieved consensus (> 80% agreement) on a total of 40 statements by surveying 22 experts on upper limb prosthetics over three rounds of surveys. Response rate ranged from 81.8–86.4% with a total of 55 total statements under consideration throughout the duration of the survey. The 40 passing statements were arranged into nine guidelines for provision of prosthetic care in this population. Conclusions The Delphi technique allowed for the creation of a set of clinical practice guidelines for the unilateral transradial patient in the absence of conclusive empirical evidence.

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The Development of an Orthotic Management Protocol for Preambulatory Children with Spastic Diplegic Cerebral Palsy

Cited by 5 publications

References 0 publications

Determining educational assessment criteria for patellar-tendon-bearing impressions for transtibial prosthetic sockets: A Delphi study

Determining educational assessment criteria for patellar-tendon-bearing impressions for transtibial prosthetic sockets: A Delphi study

Transfemoral interface considerations: A clinical consensus practice guideline

Prosthetic management of unilateral transradial amputation and limb deficiency: Consensus clinical standards of care

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