Factors Affecting Participation of Children with Cerebral Palsy in Meaningful Activities: Systematic Review
Marzieh Pashmdarfard1, Lorie Gage Richards2, Malek Amini1
1Department of Occupational Therapy, School of Rehabilitation Sciences, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
This review found that motor skills, cerebral palsy (CP) type, and environment significantly impact participation for children with CP. Occupational therapists should prioritize motor skill evaluation for effective intervention planning.
Area of Science:
- Pediatrics
- Occupational Therapy
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is the most common childhood motor disability.
- Participation is crucial for the well-being and development of children with CP.
- Understanding factors influencing participation is key for effective occupational therapy interventions.
Purpose of the Study:
- To systematically review factors affecting participation in children with cerebral palsy (CP).
- To identify key areas of participation and influencing factors based on PRISMA guidelines.
- To inform occupational therapy practice regarding intervention planning for children with CP.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Inclusion of peer-reviewed publications from 2000-2018 with AOTA Evidence levels I-IV.
- Screening of titles, abstracts, and full texts to select eligible articles (31 included).
Main Results:
- Gross motor and manual function, CP type, and physical environment (home and community) were the most influential factors.
- Participation was examined across various domains including ADLs, IADLs, play, leisure, social participation, education, work, and rest/sleep.
- Motor skills emerged as the most significant factor across all participation areas.
Conclusions:
- Occupational therapists should comprehensively evaluate factors influencing participation in children with CP.
- Prioritizing the assessment of motor skills (gross and fine) is recommended due to their high impact.
- Occupational therapists can advocate for policy changes to address environmental barriers affecting community participation.
Abstract:
This is a systematic review using PRISMA guidelines to review the factors affecting participation of children with cerebral palsy (CP), the most common childhood motor disability. Inclusion criteria consisted of publications in a peer-reviewed journal between 2000 and 2018, and at I, II, III, and IV levels of AOTA Evidence. After the title, abstract, and a full text screening, 31 articles met eligibility to be included. The studies examined ADLs (12), IADLs (9), play and leisure (19), and social participation (14), but only 3 in rest/sleep, 1 in work, and 8 in education. Gross motor and manual function, CP type, home, and community physical environment, were the most common factors affecting individuals' participation with CP. Results imply occupational therapists must evaluate clients on all factors shown to facilitate or inhibit participation to ensure an adequate intervention plan. However, evaluating every individual case in the occupational therapy process is time-consuming and difficult. Based on this study's findings, we suggest occupational therapists prioritize evaluating motor skills (gross and fine), the most influential of the factors in all areas of participation. Occupational therapists also could advocate for policy around community environmental barrier removal.
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