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Individualized telehealth home programme for children with cerebral palsy during the COVID-19 pandemic
Rachel H S Oliveira1, Marisa C Mancini1, Priscilla R P Figueiredo1,2
1Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Insights
An individualized telehealth home program significantly improved functional goal performance for children with cerebral palsy (CP) during the COVID-19 pandemic. These gains were maintained for at least three months post-intervention.
Area of Science:
- Rehabilitation Medicine
- Pediatric Neurology
- Telehealth Interventions
Background:
- Cerebral palsy (CP) presents significant challenges to functional goal achievement in children and adolescents.
- The COVID-19 pandemic disrupted traditional therapy services, necessitating alternative intervention methods.
- Telehealth emerged as a viable modality to deliver rehabilitative services remotely.
Purpose of the Study:
- To evaluate the effectiveness of an individualized telehealth home program on functional goal performance in children and adolescents with CP.
- To assess the long-term maintenance of functional gains achieved through telehealth intervention.
- To explore factors influencing the success of remote rehabilitation for pediatric CP.
Main Methods:
- A prospective, single-group intervention study involving 144 children and adolescents with CP across all Gross Motor Function Classification System (GMFCS) levels.
- Participants engaged in a 4-month individualized home program delivered via telehealth, focusing on family-chosen functional goals.
- The Canadian Occupational Performance Measure (COPM) was administered at baseline, post-intervention, and 3-month follow-up to assess performance and satisfaction.
Main Results:
- Significant improvements in both performance and satisfaction with functional goals were observed post-intervention (p < 0.001).
- These improvements were sustained at the 3-month follow-up, indicating lasting benefits.
- No significant relationship was found between child's abilities, age, caregiver education, family-centeredness, or goal type and the observed changes.
Conclusions:
- Individualized telehealth home programs are effective in enhancing functional goal attainment for children and adolescents with CP.
- This approach offers a valuable solution for maintaining therapeutic progress, particularly for those with severe CP (GMFCS levels IV and V), during public health crises.
- Telehealth provides a flexible and accessible means to support functional independence and family participation in rehabilitation.
Aim:
To analyse the effects of an individualized telehealth home programme on the performance of functional goals of children and adolescents with cerebral palsy (CP) during the COVID-19 pandemic.
Method:
A prospective single-group intervention study with children/adolescents with CP (n = 144; median age = 92 months [Q1 = 44.0, Q3 = 148.8]; 74 males, 70 females), representing all Gross Motor Function Classification System (GMFCS) levels participated in a 4-month home programme in Brazil. An interdisciplinary team encouraged families to choose a functional goal to be trained. The Canadian Occupational Performance Measure (COPM) was used at pre-intervention (T1), post-intervention (T2), and 3-month follow-up (T3). The differences in COPM scores at T1, T2, and T3 were evaluated using Friedman's test. The effect size was calculated using Cohen's d. Univariate analysis was included.
Results:
Significant improvements were observed after the intervention, with maintenance of scores after 3 months (p < 0.001, dperformance = 1.33; dsatisfaction = 1.31). None of the tested variables (child's abilities, age, caregiver's educational level, perception of family-centredness, and type of goal) were significantly related to the change scores.
Interpretation:
The individualized remote telehealth home programme can be a potential intervention, especially for children with CP classified in GMFCS levels IV and V. Also, this intervention provided a possible solution to help some children and their families in performing prioritized functional goals during the pandemic period.
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