Rationale: Physical therapist (PT) educational programs must prepare students to practice across the continuum of care, but students often lack confidence in the acute care setting. The purpose of this report is to describe a pilot study aimed at exploring a simulation-based learning experience (SBLE) as a complement to an acute care clinical experience (CE) and its effect on student performance and confidence. Methods: In this quasi-experimental cohort pilot study, the performance and confidence of three students (intervention group-IG) participating in a supplemental SBLE, while completing their final CE in an acute care setting, were compared to six students (control group-CG) who did not participate in the SBLE. The Acute Care Confidence Survey and the Clinical Performance Instrument (CPI) 2.0 were utilized to assess four learning competencies: Safety, Communication, Patient Management, and Clinical Reasoning. Results: At midterm and final CPI ratings, the IG showed a trend towards higher scores than the CG in 60% of the relevant categories. Participants in the IG showed similar confidence scores to participants in the CG at the end of the CE. Discussion and conclusion: This project provided an opportunity for students to self-reflect as part of the SBLE on their patient management, in the acute care setting, with guidance by faculty. This project adds to the evidence on how simulation-based learning can complement physical therapy clinical education.

The COVID-19 pandemic has negatively impacted the childcare industry over the past two years. This study examined how pandemic-related challenges impacted preschool-aged children by disability and obesity status. Participants were 216 children (80% Hispanic, 14% non-Hispanic Black) aged 2 to 5 years in 10 South Florida childcare centers. In November/December 2021, parents completed a COVID-19 Risk and Resiliency Questionnaire, and body mass index percentile (BMI) was collected. Multivariable logistic regression models examined the association of COVID-19 pandemic-related social challenges (transportation, employment) and child BMI and disability status. As compared to normal-weight children, those families with a child who was obese were more likely to report pandemic-related transportation (OR: 2.51, 95% CI: 1.03–6.28) challenges and food insecurity (OR: 2.56, 95% CI: 1.05–6.43). Parents of children with disabilities were less likely to report that food did not last (OR: 0.19, 95% CI: 0.07–0.48) and that they could not afford balanced meals (OR: 0.33, 95% CI: 0.13–0.85). Spanish-speaking caregivers were more likely to have a child who was obese (OR: 3.04, 95% CI: 1.19–8.52). The results suggest that COVID-19 impacts obese preschool children from Hispanic backgrounds, while disability was a protective factor.

Children with disabilities have higher prevalence estimates of obesity than typically developing children. The Healthy Caregivers–Healthy Children Phase 3 (HC3) project implemented an obesity prevention program adapted for children with special health care needs (CSHCN) that includes dietary intake and physical activity (PA) components. The primary outcome was a change in dietary intake, PA, and the body mass index (BMI) percentile. Ten childcare centers (CCCs) serving low-resource families with ≥30 2- to 5-year-olds attending were randomized to either the intervention (n = 5) or control (n = 5). The HC3 CCCs received (1) snack, beverage, PA, and screen time policies via weekly technical assistance; (2) adapted lesson plans for CSHCN; and (3) parent curricula. The control CCCs received a behavioral health attention curriculum. HC3 was delivered over three school years, with data collected at five different timepoints. It was delivered weekly for six months in year one. To ensure capacity building, the HC3 tasks were scaled back, with quarterly intervention delivery in year 2 and annually in year 3. Adaptations were made to the curriculum to ensure appropriate access for CSHCN. Given that the program was being delivered during the COVID-19 pandemic, special modifications were made to follow CDC safety standards. The primary outcome measures included the Environment and Policy Assessment and Observation (EPAO) tool, standardized dietary intake and PA assessments, and the child BMI percentile. CCCs are an ideal setting for targeting CSHCN for obesity prevention efforts as they provide an opportunity to address modifiable risk factors.

Purpose: The purpose of this pilot case series was to describe participation in high-intensity gait training (HIGT) and changes in (1) gait speed/endurance, (2) aerobic capacity, and (3) walking ability in children diagnosed with cerebral palsy (CP). Methods: Three children with CP participated in HIGT for 5 weeks in lieu of their routine physical therapy. Outcome measures were collected at baseline and post-intervention. Results: Post-intervention, all had at or above the minimal clinically important difference for 10-m walk test speed and 6-minute walk test distance. Two participants performed above the minimal clinically important difference in 7.5-m shuttle run test level and Gross Motor Function Measure—88 Dimension E score. Conclusion: This case series demonstrates short-term improvements in the walking outcome measures with participation in HIGT. Further research is needed with a larger and more diverse randomized controlled trial to determine parameters and long-term effects of HIGT in this population.

Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (−6.74, p = 0.007) versus those in control centers (−1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change −3.16, p = 0.03) and fixed play environment (mean change −2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [−7.52, 10.76], p = 0.73), suggesting the intervention’s efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions.