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Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study
Elisa Maria Garrido-Ardila1, Berta Caro-Puertolas2, Maria Jiménez-Palomares1
1ADOLOR Research Group, Department of Medical-Surgical Therapy, Medicine and Health Sciences Faculty, Extremadura University, 06006 Badajoz, Spain.
Insights
Children with cerebral palsy (CP) often have orthopedic disorders in international projects. While holistic approaches are used, professionals find current orthotic aids insufficient for treatment and prevention.
Area of Science:
- Rehabilitation Medicine
- Pediatric Orthopedics
- International Health
Background:
- Children with cerebral palsy (CP) in developing countries frequently experience orthopedic complications.
- Early intervention and prevention of these disorders are critical for effective management and improved quality of life.
- International cooperation projects address these challenges in resource-limited settings.
Purpose of the Study:
- To document the current rehabilitation strategies for orthopedic disorders in children with cerebral palsy within international cooperation initiatives.
- To identify the treatment approaches and technical aids utilized by healthcare professionals in these projects.
Main Methods:
- An observational, descriptive, cross-sectional study was conducted.
- An online questionnaire was distributed to physiotherapy and rehabilitation professionals involved in international cooperation projects.
- Inclusion criteria focused on professionals working with children aged 0-18 years with cerebral palsy in development aid, humanitarian, or emergency settings.
Main Results:
- Ninety-eight professionals participated, primarily in development cooperation projects in Asia.
- Orthopedic disorders were prevalent, with clubfoot (88.7%), hip subluxation (50%), and scoliosis (77.78%) being common.
- Positioning (88.89%) and the Bobath concept (83.33%) were primary treatment methods, with extensive use of orthoses like AFOs (94.44%) and adapted seating (100%).
Conclusions:
- Rehabilitation for children with CP in international projects adopts a holistic approach, encompassing orthopedic interventions, local device production, and community education.
- Despite comprehensive efforts, surveyed professionals perceive existing orthotic aids as inadequate for effectively treating and preventing orthopedic disorders in children with cerebral palsy.
- Further development and accessibility of appropriate orthotic solutions are needed to enhance care outcomes.
Background:
In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life.
Objective:
To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy.
Methods:
This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old.
Results:
Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%).
Conclusions:
In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.
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