Home Programme to Improve Hand Function for Children with Bilateral Cerebral Palsy: Beneficial but Challenging

Aim: To explore parents' and occupational therapists' experiences with a home program using goal-directed training to improve hand function in daily activities for children with bilateral cerebral palsy.Methods: The study had a qualitative exploratory design that included two focus group interviews. One group consisted of five parents, the other of three occupational therapists. Data were analyzed by qualitative content analysis. The intervention consisted of daily goal-directed training, with a dose of 25-33 hours for eight weeks. Weekly visits from the occupational therapists were provided.Results: Three themes were identified; 1) Home training promotes parent awareness and the child's mastery, 2) Home training is challenging and exhausting over time, and 3) Parent support is necessary, and the child's involvement is important. The parents reported improvements in the children's use of hands in daily activities.Conclusion: The findings indicate that the home program was beneficial but challenging, and that motivation is a key factor for implementing home-based intervention. Ongoing support to the parents, as well as strengthening the children's involvement may enhance motivation. Future research should focus on developing strategies to increase motivation, and on exploring a "hybrid" model for home training divided between home and kindergarten or school.