Episode 256 (Assistant Professor Kari Kretch)
Early mobility and crawling: beliefs and practices of Pediatric Physical Therapists in the United States.
Abstract
Purpose: To characterize beliefs of pediatric physical therapists (PTs) in the United States regarding the role of crawling in infant development and clinical practice.
Methods: Pediatric PTs reported their beliefs about early mobility and crawling, clinical approaches related to early mobility and crawling, and agreement with the removal of crawling from the Centers for Disease Control and Prevention (CDC)'s updated developmental milestone checklists in an online survey. Analyses examined associations between information sources and beliefs, between beliefs and clinical approaches, and between beliefs and CDC update opinions.
Results: Most participants believed that crawling was important (92%) and linked to a variety of positive developmental outcomes (71%-99%) and disagreed with its removal from the CDC checklists (79%). Beliefs were linked with clinical approaches focused on promoting crawling and discouraging other forms of mobility.
Conclusions: Further research is needed to determine whether pediatric PTs' beliefs and clinical practices are supported by evidence.
Episode 255 (Professor Noelle Moreau)
Effects of Power Training combined with interval treadmill training on walking capacity versus performance in real world settings in youth with cerebral palsy.
AACPDM 2025 sneak peak!
A sneak peek at an incredible paper to be presented at AACPDM 2025 in New Orleans! This paper is a contender for the AACPDM’s highest abstract honour - the Gayle G Arnold Award!
Episode 254 (Paleg et al)
Where’s the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek Exercises
A seminal paper with a stellar line-up of academic and clinical heavyweights:
Dr Ginny Paleg, Dr Dayna Pool, Associate Professor Álvaro Hidalgo-Robles, Clinical Assistant Professor Roslyn Livingstone, Dr David Frumberg MD and Professor Diane Damiano .
Dynamic Movement Intervention (DMI) and Cuevas Medek Exercises (CME) are promoted as innovative neurorehabilitation methods for children with neurological disabilities, yet both rely on outdated reflex-hierarchical models rather than contemporary motor learning principles.
A review of the literature reveals that CME, despite 5 decades of use, is supported only by a few case reports and 2 small, biased comparative studies. DMI, introduced in 2021, has no published empirical evidence beyond a single conference abstract. Thus, both interventions remain at Sackett Level 5—no evidence.
The ethical implications are substantial. Families often pay thousands for intensive, noncovered therapies that may displace meaningful participation in education and social life. Therapists have a professional responsibility to avoid legitimizing unproven practices and to prioritize interventions supported by robust evidence. Pediatric rehabilitation should shift toward child-led, functional, and task-specific approaches grounded in modern motor learning science, with professional bodies and insurers withholding endorsement of nonevidence-based methods.
Read the paper for FREE!
Episode 253 (Dr Karina Zapata)
Six-minute walk test reference values in ambulatory children with myelomeningocele
Karina A Zapata, Rosa H Cooksey, Daralyn K Fulton, Hayley B Shelton, Chan-Hee Jo, Richard C Adams PMID: 40556501 DOI: 10.1111/dmcn.16397
Abstract Aim: To determine the baseline pediatric reference values of the 6-minute walk test (6MWT) distance (6MWD) across spina bifida functional lesion levels, the associations between the 6MWD and the distances of the 1-minute and 2-minute walk tests, and assess the impact of social determinants on the 6MWD. Method: This prospective cohort study collected the 6MWD of 145 ambulatory children (72 male, 73 female; mean age = 11 years 2 months [range: 6 years 0 months-17 years 11 months]) with mid-lumbar-level (n = 59), low-lumbar-level (n = 28), and sacral-level (n = 58) myelomeningocele at a pediatric hospital. Proxies of social determinants included insurance type and Area Deprivation Index (ADI). Pairwise comparisons evaluated the 6MWD according to lesion level and myelomeningocele functional classification (MMFC) group.
Results: The mean 6MWD was shorter for myelomeningocele at the mid-lumbar versus low-lumbar versus sacral lesion levels (p less than 0.001), and MMFC2 versus MMFC3 versus MMFC4 (p less than 0.001). The mean 1-minute and 2-minute walking distances were strongly associated with the 6MWD. Children with public insurance and a high ADI walked significantly fewer meters than children with private insurance (p = 0.023) and a low ADI (p = 0.048). Interpretation: Children with higher anatomical functional lesion levels walked shorter distances than those with lower levels and according to MMFC group. The 1-minute and 2-minute walk tests are adequate substitutes for the 6MWT. Lower socioeconomic status affecting decreased walking capacity merits interventions to maximize opportunities for activity. https://pubmed.ncbi.nlm.nih.gov/40556501/
Episode 252 (Dr Colleen Peyton)
Trajectories of Fidgety Movements in Infants with and without medical complexity
AACPDM 2025 sneak peak!
A sneak peek at an incredible paper to be presented at AACPDM 2025 in New Orleans! This paper is a contender for the AACPDM’s highest abstract honour - the Gayle G Arnold Award!
Episode 251 (Dr Christopher Modlesky)
Effect of high-frequency, low magnitude vibration on physical activity and physical function in children with cerebral palsy: a randomised controlled trial .
AACPDM 2025 sneak peak!
A sneak peek at an incredible paper to be presented at AACPDM 2025 in New Orleans! This paper is a contender for the AACPDM’s highest abstract honour - the Gayle G Arnold Award!
Episode 250 (Arianna Trionfo MD)
The effect of immediate weightbearing after planovalgus foot reconstruction in ambulatory children with cerebral palsy
AACPDM 2025 sneak peak!
A sneak peek at an incredible paper to be presented at AACPDM 2025 in New Orleans!
Early Mobility and Crawling
This week we speak with the wonderful Dr Kari Kretch! We'll be discussing her paper:
Early Mobility and Crawling: Beliefs and Practices of Pediatric Physical Therapists in the United States