Partnership delivery of evidence-based therapy intervention to improve upper-limb function: a retrospective analysis
Bibliographic record
Abstract
OBJECTIVE: To describe clinical characteristics and outcomes of children and young people with hemiplegia completing a novel dedicated therapy intervention, 'Evelina REACH'. This evidence-based upper-limb outpatient intervention is delivered in partnership with the child, caregivers, and occupational therapists at a tertiary hospital and community allied health professionals. DESIGN: Retrospective audit of patients completing a 6-week protocolised therapy intervention with repeated standardised measures of spontaneous arm and hand use and of caregiver goal rating. SETTING: A tertiary level children's hospital in London, UK. PATIENTS: 156 children (median age 26 months, range 4 months-16.5 years) completing a therapy intervention programme between 2012 and 2023. INTERVENTIONS: An intensive, protocolised and individualised goal-directed therapy intervention programme, co-delivered by the patient, caregivers and hospital-based and community therapists. MAIN OUTCOME MEASURES: Assisting Hand Assessment (AHA), Goal Attainment Scaling (GAS)/Goal Attainment Scaling Light and Canadian Occupational Performance Measure (COPM). RESULTS: Clinically significant gains were achieved with a mean AHA logit score change of 7 (n=69) which was maintained at 6 weeks post intervention (n=35). At least 1 GAS goal was met or exceeded by 99.2% participants, with measurable score change across three caregiver-mediated COPM goals, performance=90.17%, and satisfaction=83.58%. Of caregivers surveyed, 97.85% would repeat the programme, and 100% would recommend it to others. CONCLUSIONS: Evelina REACH is a clinically effective, goal-directed intensive activity-based therapy intervention that fosters lasting functional improvements in upper-limb use. Further research should explore optimal and scalable co-delivery models to enhance children's access to evidence-based therapy in statutory healthcare.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".