A Critical Review of the Article "Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Performance for Children Ages 0–5 years: A Systematic Review"

A critically appraised review of the article: "Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Performance for Children Ages 0–5 years: A Systematic Review" 


Tanner, K., Schmidt, E., Martin, K., & Bassi, M. (2020). Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Performance for Children ages 0–5 years: A Systematic Review. American Journal of Occupational Therapy, 74, 7402180060. https://doi.org/10.5014/ajot.2020.039644


Introduction: Occupational therapy practitioners (OTs) who work with children ages 0-5 years of age do so across many settings, and as such, incorporate various interventions to help improve their participation in daily routines. A systematic review focused on interventions designed to promote motor development and prevent delay in children was conducted, and the intention was to update OT’s practice guidelines. This review includes literature published in English between January 2010 and March 2017.  Information gleaned  from this review can inform OTs use of evidence-based interventions that are within their scope of practice. 


Methods/Outcome Measures: A literature search was conducted using MEDLINE, PsycINFO, CINAHL, OTseeker, ERIC, and Cochrane databases. Search terms were broad to capture a variety of interventions. Inclusion criteria included articles: 1) published in English between January 2010 and March 2017, 2) studied interventions addressing motor skills, 3) fell within OT’s scope of practice, as defined by the American Occupational Therapy Association (AOTA), and 4) contained a Level 1, II, or III design as defined by the AOTA. Data were extracted from included articles using AOTA’s guidelines for systematic reviews. The authors extracted data on the level of evidence, quality, and statistical significance using standardized forms from the AOTA. The quality of each article was appraised using the Cochrane Collaboration’s Tool and Assessment of Multiple Systemic Interventions. 


Results: A total of 56 studies were included in this systematic review. Results were divided into three areas of intervention: early intervention (EI) 0-3 years; preschool children 3-5 years; and children 0-5 years with or at-risk for Cerebral Palsy (CP).  Each area represented multiple intervention strategies, including but not limited to home-based parent coaching, massage, video games, sensory-based therapy, and constraint-induced movement therapy. For children with CP, hippotherapy plus conventional physical therapy (PT) was examined and demonstrated significant increases in motor function (p


Limitations: Several limitations of this systematic review exist that warrant attention. Only articles published in English were included. No qualitative, descriptive, expert opinion, or case series designs were included. Many included articles did not describe blinding. And lastly, the majority of articles incorporated a variety of outcome measures, with few presenting long-term findings. These factors limit the generalizability of reported findings. Additionally, the focus of this systematic review was on the statistical significance of the interventions, not their clinical significance. 


Critique: The study’s intention was to update OT’s practice guidelines. However, the volume of information gathered was cumbersome, as there was a wide range of intervention and outcome measures reported across the included studies. Therefore, drawing conclusions for best practice may be difficult. With the increase in recent publications describing the use of equine movement by PT, OT, and speech language pathology, it was surprising that only one study was included in the systematic review that demonstrated the effectiveness of utilizing hippotherapy as a treatment tool.


Clinical Bottom Line: There are a variety of interventions within the scope of OT practice that have a positive impact on children with, or at-risk for developmental delays. This systematic review included one study focused on hippotherapy that demonstrated moderate strength of evidence for use of the treatment tool to improve gross motor function in children 0-5 years of age with or at-risk for CP.

 
Share this post:

Comments on "A Critical Review of the Article "Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Performance for Children Ages 0–5 years: A Systematic Review""

Comments 0-500 of 0

Please login to comment