Güeita (2014) pediatric AT and ICF (PhD thesis Spanish)

Purposes: To identify the categories of the ICF-CY needed to describe “what to measure” and “how to measure” in children treated with Aquatic Physical Therapy and so build the bases for a Core Set in Aquatic Therapy for children with disabilities.

Material and Methods) A world-wide expert 3-round survey using a Delphi technique (n=69, from 21countries); ii) a multicentre qualitative study, using the methodology of “focus group”(n=23, 5 groups) and individual semi-structured interviews (n=20) with parents of children with disabilities; and iii) a systematic review of the aquatic outcome measurements and a content comparison of the 4 scales identified. The content comparison was carried out with a qualitative phenomenological approach. Latent content analysis (Duggan, 2008) and ICF linking rules (Cieza et al, 2005) were applied.

Results:(i) Delphi: Answers were linked and divided in 4 expert groups (neurology, psychomotor delay, neuro musculoskeletal and pervasive developmental disorder) at the second, third and fourth ICF-CY levels. Overall in the 4 groups, 83 body functions, 43 body structures, 87 activities and participation categories, 7 environmental factors that are intervention targets, 7environmental factors that influence aquatic therapy and 33 personal factors were identified.(ii) “Focus group” and individual semi-structured interviews: In both type of interviews, 73 body functions, 22 body structures, 79 activities and participation categories, 14 environmental factors that are intervention targets, and 20personal factors were identified.(iii) Review: Seven body functions, 25 activities and participation categories, 4 environmental factors and 6 personal factors were identified.

Conclusion: A formal consensus is needed to integrate the outcomes from these qualitative studies and expert opinion based on the ICF-CY framework. The result will be a Brief and a Comprehensive version of ICF-CY Aquatic Therapy Core Set.

Clinical relevance: This study shows that children receiving Aquatic Physical Therapy have very diverse problems in functioning. The ICF-CY has proven useful to provide comprehensive framework for the description of health in chronic diseases and now inchildren in a specific fluid mechanical environment. This study was supported by the Colegio Profesional de Fisioterapeutas de Madrid(CPFM). Spain.

Key words: pediatrics, aquatic therapy, outcome assessment, ICF-CY.