Commentary on “Power Mobility Training Methods for Children: A Systematic Review”

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“How should I apply this information?”
Power mobility can provide support for young children with mobility impairments to participate in meaningful life experiences from which they may otherwise be excluded. Providing power mobility opportunities in enriched natural environments that incorporate play and encourage self-directed exploration may make power mobility training more relevant and fun for children and families, resulting in more consistent practice. Artificially constructed environments, such as virtual reality or computer-based gaming, may not translate to functional gains. Although power mobility devices are used in medical environments, these findings suggest that power mobility training may be best carried out in natural environments such as homes, schools, and community. Physical therapists in medical settings should collaborate with those who serve children in natural environments to shape opportunities for power mobility training in home, school, and community settings, making these experiences more meaningful for the child and family.
“What should I be mindful about when applying this information?”
More rigorous research is needed to develop evidence-based power mobility training practices. In addition to studies evaluating methods for power mobility training, physical therapists would benefit from research related to timing and dosing of power mobility. What is the optimal age for introducing children and families to power mobility? Is earlier always better, or are there readiness or cognitive cues for which we should wait? Does early exposure to play and movement in power mobility toys lead to earlier success with power wheelchairs? Development of a consistent pediatric power mobility outcome measurement tool that focuses on participation-level outcomes and is reflective of child/family values may help answer these questions and would assist therapists in quantifying the effects of various training methods, dosage, and timing.
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