title: Performance following ability-focused physical therapy intervention in individuals with severely limited physical and cognitive abilities.
abstract: OBJECTIVE
  Do individuals with severely limited physical and cognitive abilities improve their gross motor abilities when given physical therapy intervention, and does improvement transfer to nontreatment settings?
  
  
  METHODS
  The subjects were 24 individuals (10 female, 14 male), aged 3 to 30 years (X = 20.1, SD = 8.1), who were nonambulatory and had limited adaptive behavior.
  
  
  METHODS
  Change in gross motor ability during 18 weeks of twice-weekly therapy was measured using goal attainment scaling (GAS). Three gross motor goals were developed for each subject based on individual or caregiver needs, with one goal randomly selected as a control. Physical impairments were treated, and behavioral management principles, low-level communication approaches, high-repetition practice of goals, and a progressive reduction of both physical assistance and multisensory cues were used. An independent rater scored goal level from randomly ordered videotapes recorded during therapy and in recess and home settings.
  
  
  RESULTS
  Mean GAS T scores were higher for treatment goals (X = 45.6, SD = 10.5) compared with control goals (X = 34.6, SD = 11.8). When the expected goal level (50) was met during therapy, mean GAS T scores in recess settings ( X = 35.9, SD = 11.5) and home settings (X = 42.2, SD = 12.2) were lower. At the conclusion of therapy, there were no differences in goal levels between treatment and control goals in both the recess and home settings.
  
  
  CONCLUSIONS
  The subjects demonstrated improvement of gross motor abilities practiced during therapy. Level of ability during therapy, however, did not consistently transfer to the recess of home settings. [Brown DA, Effgen SK, Palisano RJ. Performance following ability-focused physical therapy intervention in individuals with severely limited physical and cognitive abilities.
authors.affiliation: Department of Physical Therapy, University of New England, Biddeford, ME 04005-9599, USA. dbrown@mailbox.une.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Brown
authors.forename: S K
authors.initials: SK
authors.lastname: Effgen
authors.forename: R J
authors.initials: RJ
authors.lastname: Palisano
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000534:rehabilitation*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D009048:Motor Skills; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities / Q000379:methods*; D013023:South Dakota