Development of a Quantitative Tool to Assess the Content of Physical Therapy for Infants

In Brief Purpose: The study aim was to describe and quantify physical therapy interventions for infants at high risk for developmental disorders. Methods: An observation protocol was developed based on knowledge about infant physical therapy and analysis of directly observable physiotherapeutic (PT) actions. The protocol's psychometric quality was assessed. Videos of 42 infant physical therapy sessions at 4 or 6 months of corrected age were analyzed. Results: The observation protocol classified PT actions into 8 mutually exclusive categories. Virtually all PT actions during treatment could be classified. Inter- and intrarater agreements were satisfactory (intraclass correlations, 0.68–1.00). Approximately 40% of treatment time was spent challenging the infant to produce motor behavior by themselves, whereas approximately 30% of time facilitation techniques were applied. Tradition-based sessions could be differentiated from function-oriented ones. Conclusions: It is possible to document PT actions during physical therapy treatment of infants at high risk for cerebral palsy in a systematic, standardized, and reliable way. The authors successfully developed and used a classification tool to record physical therapists' actions in a systematic, standardized, and reliable way while they were treating infants at high risk for CP.