The team at the ResearchWorks Podcast are celebrating 200 episodes! With over 4 seasons, invited collaborators with the EACD - European Academy of Childhood-onset Disabilities Conference and the AusACPDM - the Australasian Academy of Cerebral Palsy and Developmental Medicine and Transformative Practice Award Winners for 2024, it has been a stellar journey. 🚀
Join us for a brilliant wrap up for Season 4 - we have some special standalone episodes coming and in 2025, we'll be back on tour again, this time supporting the incredible 2025 EACD/IAACD conference in Heidelberg Germany - so we'll see you there! 🇩🇪✈️
2025 will also see a very very special announcement, taking ResearchWorks beyond the podcast platform and further supporting clinicians and researchers to be empowered and upskilled across the globe! We're very excited for the future! We'll talk with you all soon!
A MASTERFUL LESSON IN COMMUNICATION SKILLS
Reflections on this episode (Dr Pool)
In our last conversation with Ben, we talked a lot about Motivational Interviewing, and how you could consult people in a motivational way. What we didn’t cover though was how you might structure sessions, programs, therapies, workplaces and teams in a way that promotes motivation.
In this episode, we talked a whole lot about the Self Determination Theory which includes not just the type of motivation but also the type of motivational regulation. How can we move from have to, want to, to love to? Ultimately, this is a process of going from being amotivated to being extrinsically motivated and finally, intrinsically motivated. For this to occur, we need to think about three psychological needs that will support a person through this process - this includes autonomy, competence and relatedness. These are all required to foster the most volitional and high quality forms of motivation and engagement in activities.
This relates so much to how we interact with children and families that access health services. If we can really think about these psychological needs, it helps to slow down and take the time to build a trusting relationship that will ultimately support not just the process of setting goals but ultimately, how to achieve them.
Self Determination Theory is well published and there is a website where you can find so much useful information too!
MOTOR OPTIMALITY SCORE-REVISED (MOS-R) AND HAMMERSMITH INFANT NEUROLOGICAL EXAMINATION (HINE) PREDICT HIGH LIKELIHOOD OF AUTISM AT 12 MONTHS CORRECTED AGE IN A DEVELOPMENTALLY VULNERABLE INFANT COHORT
Reflections on this episode (Dr Pool)
Early differences in infant quality of movements and postures may be key biomarkers for later diagnosis. In this particular study, the authors aimed to explore the accuracy of early infant neurodevelopment using cerebral palsy specific tools to predict high likelihood of autism in developmental vulnerable infants at 12 months corrected age.
The origin of this study is interesting and sets a great example for consumer led research questions. Biomarkers are quite the theme of much research at present - probably because of the wealth of digital data that is now available, providing so much opportunity to understand unique relationships between variables and outcomes.
Carly described ever so succinctly the Motor Optimality Score Revised or the MOS-R and the Hammersmith Infant Neurological Examination (HINE). It was so useful to understand its use in practice, its accuracy, the training required and what the outcomes really mean.
These assessments also now open up the possibility of not only ensuring that children at high risk of cerebral palsy are identified and directed to critical early intervention, it also means that children at high risk of other neurodisabilities such as autism are also identified early and directed to early intervention. It feels like we are getting so much closer to being proactive in our interventions rather than just reactive and the impact this will have on both children and their family’s outcomes is exciting.
THE POWER OF PARA SPORT: THE EFFECT OF PERFORMANCE-FOCUSED SWIMMING TRAINING ON MOTOR FUNCTION IN ADOLESCENTS WITH CEREBRAL PALSY AND HIGH SUPPORT NEEDS (GMFCS IV) - A SINGLE-CASE EXPERIMENTAL DESIGN WITH 30-MONTH FOLLOW-UP
Reflections on this episode (Dr Pool)
This paper examines the impact of performance-focused swimming training on adolescents with cerebral palsy and high support needs. Using a single-case experimental design, the research followed participants over 46 months to assess whether the training could improve motor function and prevent the typical motor decline seen in this population.
The study’s findings showed that tailored, performance-focused training can help maintain and even improve motor function in adolescents with severe cerebral palsy, challenging the assumption that motor decline is inevitable for these individuals. This study also introduced the novel concept of "Para Sport as Medicine," emphasising the importance of structured sport in maintaining motor function and promoting overall well-being.
It is hard to express just how incredible this paper and the larger piece of work is. The authors have really gone ahead to investigate an understudied population with a known gap in the literature with such great detail. The result is just valuable knowledge. The study design is unique and robust and fits the population perfectly. Harnessing the power of sport for those that are interested and motivated by it is also just wonderful with the data speaking for itself.
We had a great conversation about the use of the GMFM item sets as well as task and assessment specificity. This conversation follows our podcast from last week ever so perfectly and once again, I cannot speak highly enough about this work!
EFFECTIVENESS OF POSTURAL INTERVENTIONS IN CEREBRAL PALSY: UMBRELLA SYSTEMATIC REVIEW
Reflections on this episode (Dr Pool)
This paper investigates the effectiveness of postural management interventions for individuals with cerebral palsy. The study evaluates a range of interventions aimed at improving movement, managing tone, supporting posture, and preventing musculoskeletal deformities.
By synthesising data from over 200 randomised controlled trials and other studies, the review provides valuable insights into which interventions show the most promise, while also highlighting the need for further research due to the overall low quality of evidence in many areas. The findings offer practical recommendations for clinicians and caregivers working to improve the quality of life for children with cerebral palsy.
This is such an interesting paper and the conversation was even better! Postural control and management are common topics of conversation and it is easy to feel a bit lost with what interventions are available and what is likely to be more effective. I do love the visual of the traffic light system which provides a great overview of interventions and the current state of the evidence. What is even better is the kind of conversation that visuals like this provide.
We had a great discussion about the interventions that fall below the worth it line. In this podcast, we spoke at length about what is meant by “passive” interventions. Perhaps this has been misinterpreted lately with passive referring to muscle activation when in fact, it is referring to the brain and the self generated, self initiated movements that are the most important. Monica provides some great ideas on how to communicate this evidence within our profession as well as to families. A fantastic episode indeed!
THE MALARIA ATLAS PROJECT, ASTRONOMY, EPIDEMIOLOGY, STATISTICS, MACHINE LEARNING, ARTIFICIAL INTELLIGENCE, LARGE LANGUAGE MODELS AND CHATGPT!
Reflections on this episode (Dr Pool)
I really enjoyed this conversation. It is not often when you get to sit and chat with someone that has such a wealth of experience and knowledge in modern statistical methods. In this conversation, we asked:
We certainly need to be keeping up with the advances in technology and statistical methods. The Malaria Atlas Project is certainly at the forefront of these techniques and there is so much to learn! We hope you enjoy this conversation!
VALIDATING THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH CORE SETS FOR AUTISM IN A SAMPLE OF AUSTRALIAN SCHOOL AGED CHILDREN ON THE SPECTRUM.
Reflections on this episode (Dr Pool)
This article focuses on validating the International Classification of Functioning, Disability, and Health Core Sets (ICF-CSs) for autism in an Australian sample of school-aged children on the autism spectrum. The study aimed to assess the applicability of these core sets in measuring functioning, particularly in areas of body structure and functions, activities, and participation.
Caregivers of children on the spectrum were surveyed, with results showing that while the ICF-CSs effectively captured issues related to body functions, activity and participation, the findings on environmental factors were less conclusive. The study suggests that certain areas not currently included in the ICF-CSs for autism may need further investigation and that the language used in the measures should be revised for clarity.
I have to admit, the ICF-CS is something that I needed a reminder about. Perhaps it is also because I wasn’t sure how to use the core sets within a clinical setting. This discussion was really enlightening because it just shows how the core sets can be used in a clinical setting. Whilst the simplified version of the core sets are still to be published from Maya’s work, we can think about downloading them and using them as a conversation piece when assessing or setting goals. This will certainly help in prioritising needs and understanding a child’s strength which could be used to support the intervention strategy.
AN ANNUAL Q AND A SESSION WITH THE HOSTS (DR DAYNA POOL AND MARISSA SMITH)
Reflections on this episode (Dr Pool)
The pod now has many (thousands!) of new listeners and we decided to bring forward our annual Q and A session with the hosts of the show.
A little more backstory of each host, a look back at why we do what we do, some incredible highlights you might have missed and why the pod is a firm proponent of evidence based practices.
We cover off many topics, including:
Is the podcast a full-time gig?
What the difference between evidence-based and evidence-informed practice is,
Qualitative research and the rich benefits of it's implementation,
The often overlooked concept of maturation,
The view of pain and discomfort in therapy - the good and the bad,
Hands-on vs hand-off approach and the top-down and bottom-up philosophies,
Our scientific stance on manual facilitation techniques and why we have a section on the website that is dedicated to our conversation with the DMI (Dynamic Movement Intervention) founder(s).
It's about why research both matters and why ResearchWorks! 😉
We still plan on bringing you some incredible interviews with amazing researchers over the last 7 episodes of the year, culminating in our historic 200th episode milestone, so be sure to stayed tuned!
IMPLEMENTATION OF LEARNING THROUGH EVERYDAY ACTIVITIES WITH PARENTS OF INFANTS WITH CP (LEAP CP) EARLY DETECTION AND INTERVENTION PROGRAM IN INDIA
Reflections on this episode (Dr Pool)
LEAP-CP stands for Learning through Everyday Activities with Parents, an early detection and intervention program that adapts the international clinical practice guideline for early detection and intervention in CP for low and middle income countries.
In this paper, LEAP-CP was tested in an RCT with Asha Bhavan Centre in India from 2019 to 2019 and has continued implementation since 2021. This study aimed to determine the acceptability, appropriateness, feasibility, penetration, retention and fidelity of LEAP CP at the Asha Bhavan Centre in India.
Some of the amazing results from this work include:
When designing interventions, it is so important that implementation is also considered. This is such a wonderful example!
THE SELECTIVE DORSAL RHIZOTOMY AND BRIDGING THE GAP: CO-DESIGNING A DECISION AID FOR INFORMED DECISION MAKING
Reflections on this episode (Dr Pool)
Selective Dorsal Rhizotomies are often spoken about. It is a surgical procedure that may be offered to children with cerebral palsy to provide more long term spasticity reduction. There is often discussion around who is the most appropriate for this surgery as well as the outcomes that one might expect.
The Australian Selective Dorsal Rhizotomy Registry houses rich datasets as an ongoing multicentre national research registry involving 5 tertiary paediatric hospitals in Australia, providing clinically relevant information for clinicians, researchers and of course, children and their families.
In this episode, we find out more about what the expected outcomes might be. This is such an important discussion because of the incredible commitment that is required from the child and family post surgery.
In what is often years of high dosage therapy sessions to follow, it is important to know that according to the register, 49% of children still need to have orthopaedic surgery, which means more therapy to follow. Knowing what to expect is so important for every family and therefore vital to incorporate into discussions right from the beginning.
RANDOMISED CONTROLLED TRIAL OF HAND ARM BIMANUAL INTENSIVE TRAINING INCLUDING LOWER EXTREMITY TRAINING (HABIT-ILE) FOR CHILDREN WITH BIMANUAL CEREBRAL PALSY
Reflections on this episode (Dr Pool)
This pragmatic, multi-site waitlist randomised controlled trial aimed to compare Hand Arm Bimanual Intensive training including Lower Extremity or HABIT-ILE to usual care in a multi-site randomised controlled trial to improve gross motor function and manual ability in children with bilateral cerebral palsy.
HABIT-ILE is a novel intensive goal directed motor intervention that integrates both upper and lower limb training, provided in 65 hours of therapy over 10 days. Outcomes were assessed at baseline, immediately post and at 26 weeks post intervention with primary outcomes being the GMFM and ABIL-HAND Kids.
With 90 children having been involved, it was found that HABIT-ILE was effective in improving manual ability, goal attainment, self-care and mobility compared to usual care.
As always, conversations with Leanne are insightful - her experience in conducting large multisite studies is second to none. The coordination required, particularly considering many studies we are hearing about now, had to endure during the pandemic. So much to learn from this discussion!
My biggest take home here is that not all ‘intensive therapies” are the same. Whilst the term intensive therapy really is a term to describe an increased dosage, the reality is that not only are the dosages variable across services but the ingredients are too - the actual ‘what you are doing’ is extremely variable. Describing what it is we are actually doing is a vital part of both science and translation.
The advantage here in HABIT-ILE is that it is extremely transparent - the contents of the intervention as well as the outcomes. From here, we can discern what to implement and how.
The problem lies when an intervention is described as simply “intensive” - what does it actually mean? What is the dosage, what is the actual number of active engagements and what are the outcomes? It is only when these questions are answered that we can make an educated and informed decision on where and what to spend our precious resources of time and finances on.
The ResearchWorks Podcast
Recorded at the RW Studio at the Healthy Strides Foundation, East Victoria Park, WA 6101, Australia
Copyright © 2024 The ResearchWorks Podcast - All Rights Reserved.
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The team at the ResearchWorks Podcast are celebrating 200 episodes! With over 4 seasons, invited collaborators with the EACD and AusACPDM conferences and Transformative Practice Award Winners for 2024, it has been a stellar journey. 🚀
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