Children with Cerebral Palsy (CP) have complex conditions affecting their health which makes it challenging for assistive technology professionals to achieve desired intervention outcomes. Health professions examining quality of life (QOL) changes must use measurement tools capable of capturing intervention-related changes for the specified population. Investigators aimed to complete a scoping review of QOL-related postural care (PC) publications, identify QOL-based assessments and critically analyze their suitability in measuring intervention outcomes for children with non-ambulatory CP. Investigators searched articles published between 1998-2022 relevant to children with CP that addressed QOL-related: meanings/domains, outcome measures and clinical intervention outcomes. Investigators followed standardized published guidelines throughout each step of the scoping review process from search through data analysis. Subsequently, investigators used a published guideline for analyzing the PC outcome measures identified during the review process, examining their suitability for the target population. Results of this review will help care teams understand QOL and choose outcome assessments capable of measuring QOL-related intervention changes. Thus, making it possible for them to better serve children with severe CP.

Among persons with neuromuscular mobility limitations, therapeutic positioning has been implemented to improve body function, avoid secondary complications such as contractures and body shape distortions, and optimize body energy through restorative sleep. This case study describes the application of a 24-hour posture care management intervention for a preadolescent girl with Aicardi syndrome. The intervention was administered by adding therapeutic bed positioning to use of a custom molded wheelchair seating system. Over the 6-year intervention period overlapping with the subject\'s adolescent years (age 11-17), marked improvement was observed in thoracic shape and symmetry. Moreover, the subject\'s mother reported regular full-nights of uninterrupted sleep, relaxed muscle tone upon waking, a stronger cough with less audible congestion, more efficient swallowing and zero hospitalizations. The 24-hour posture care management intervention offers an alternative option for families and caregivers of persons with neuromuscular mobility impairments who wish to use a low-risk, noninvasive, locally available approach to improve body symmetry, increase hours of restorative sleep, and ease caregiving routines. Further research in 24-hour posture care management, including positioning for sleep and rest, should be explored in individuals with complex movement limiting disabilities who are at risk of developing neuromuscular scoliosis.

Background: This scoping review aims to identify evidence-based practices for educating rehabilitation professionals who provide assistive technology interventions, specifically night-time postural care, to children with cerebral palsy. Methods: A review of both peer-reviewed and grey literature published between 2000 and 2021 was undertaken in June 2021. The articles were analyzed using a process outlined by Arksey and O\'Malley in 2005: scanning abstracts, completing initial and critical reviews, collating and summarizing data into themes. Results: The search resulted in 15 articles, predominantly from the United Kingdom and the United States: 10 primary research, two reviews, two conceptual/theoretical, and one gray-literature source. Four themes emerged (1) Successful service delivery required competence, (2) Benefits of incorporating practice, collaboration, and feedback, (3) Effective online education through multifactorial approaches, (4) Considering different learning requirements among team members. Conclusions: There\'s beginning evidence that rehabilitation professionals\' competence with night-time postural care might be achieved via active, interactive, multi-factorial online training.

UNASSIGNED: Compare effectiveness of two differently formatted training programs in educating night-time postural care implementers.
UNASSIGNED: Mixed-methods parallel-group double-blind design with random assignment.
UNASSIGNED: United States academic institution.
UNASSIGNED: Thirty-eight adult caregivers/providers of children with cerebral palsy.
UNASSIGNED: Both 2-hour online programs included content on night-time postural care evidence, risk-factor monitoring, sleep-system types, positioning methods, and assessments. Group A used interactive videos, Group B summary information with web-links.
UNASSIGNED: We measured self-perceived competence via questionnaires (baseline, post-training, post-simulation) containing 4-point rating-scales of knowledge, ability, and confidence and measured positioning ability via a simulation observation instrument comprising 16 positioning-task ratings with space for describing performance. We recorded participant actions/statements using fieldnotes.
UNASSIGNED: Thirty-eight completed training (19 per group). Group A (vs B) showed significantly greater self-perceived competence changes post-training (0.46 points (SE 0.17), P = 0.008). Thirty-seven positioned a standardized \"client,\" with groups not differing significantly on total tasks completed correctly (F(1, 92.32) = 1.91, P = 0.17) averaging 11.85 (SE 0.83) and 12.60 (SE 0.84) of 16 tasks correct. Group A\'s post-positioning/simulation self-ratings were significantly associated with actual ability (r = 0.53, P = 0.019). In both groups ⩾47% of caregivers incorrectly completed the tasks of placing head and neck in neutral and snugging up all [positioning] parts.
UNASSIGNED: The sleep care positioning training program (interactive video-based format) is effective in building caregivers\' self-perceived competence for night-time postural care. While the lesson was well-received by caregivers and considered a \"match [to their] learning style,\" the lesson did not lead to greater improvement in actual ability to position the \"client\" compared to control training.

BACKGROUND: Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function.
METHODS: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and Web of Science) covering January 1990 to March 2016, and email requests to researcher networks. Results were collated via descriptive numerical summary of studies and thematic analysis.
RESULTS: Twenty-three studies were identified and summarized narratively in relation to three themes: characteristics and prevalence, interventions and service related issues. The evidence base is small with significant gaps. Lack of evidence for night-time positioning equipment and 24-hr postural care needs to be addressed urgently.
CONCLUSIONS: Future research should be clearly directed towards ascertaining how best postural care interventions can be employed to help improve the health and quality of life of people with intellectual disabilities.

BACKGROUND: Previous research has highlighted lack of knowledge, understanding and confidence among parents and teachers responsible for the postural care of children with physical disability. Interventions designed to improve these qualities require a reliable and validated tool to assess pre- and post-intervention levels. Currently, however, no validated measure of postural care confidence (i.e. self-efficacy) exists. Hence, the aim of this research was to develop a reliable and valid questionnaire to assess parents\' and teachers\' confidence, alongside knowledge and understanding of postural care - the Understanding Knowledge and Confidence in providing POSTural CARe for children with Disabilities (UKC PostCarD) questionnaire.
METHODS: Items were developed by a multidisciplinary team and designed to map onto the content of \'An A-to-Z of Postural Care\'. Parents, teachers and therapists assessed items for face validity. Scale reliability was then assessed using Cronbach\'s alpha and known-group validity was assessed by comparing scores of an \'expert\' group (physiotherapists and occupational therapists) with those of a \'non-expert\' group (with no formal training in postural care).
RESULTS: The total scale and all three subscales (understanding and knowledge, confidence and concerns) demonstrated adequate reliability (α > 0.83) and subscale correlations formed a logical pattern (understanding and knowledge correlated positively with confidence and negatively with concerns). Experts\' (n = 111) scores were higher than non-experts\' (n = 79) for the total scale and all subscales (P < 0.001).
CONCLUSIONS: Findings support the reliability and validity of the UKC PostCarD questionnaire as a measure of understanding, knowledge and confidence in providing postural care for children with disabilities.