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Barriers and Facilitators of Home Programmes in Children With Cerebral Palsy: A Systematic Review and a Metasynthesis

Mª Inmaculada Medina-Valera1,2, Aarón Fernández-Del Olmo3,4, Elena Pinero-Pinto1

  • 1Faculty of Nursery, Physiotherapy and Podology. Department of Physiotherapy, University of Seville, Seville, Spain.

Child: Care, Health and Development
|February 12, 2025
PubMed

Insights

Implementing home programs (HP) for children with cerebral palsy (CP) faces barriers like time constraints and limited support. Facilitators include training, daily routine integration, and strong family-professional communication for successful HP.

Area of Science:

  • Pediatrics
  • Rehabilitation Medicine
  • Family-Centered Care

Background:

  • Home programs (HP) are a highly supported treatment for children with cerebral palsy (CP).
  • Implementation of HP can present significant challenges for families and healthcare providers.
  • A systematic review is needed to identify factors influencing HP effectiveness.

Purpose of the Study:

  • To systematically review the literature on barriers and facilitators to implementing home programs (HP) for children with cerebral palsy (CP).
  • To synthesize findings regarding challenges and supportive elements in HP delivery for pediatric CP.

Main Methods:

  • A systematic literature search was conducted across major databases (Web of Science, Scopus, ERIC, PubMed, CINAHL).
  • Inclusion criteria focused on home-based therapies for children with CP (0-8 years) and their families.
  • Qualitative content analysis using inductive coding was employed, with risk of bias assessed using Cochrane tools.

Main Results:

  • Twenty-one articles were selected from 1,336, involving 523 families and professionals.
  • Six key themes emerged: participation, personal cost/social support, family impact, training, professional role, and efficacy.
  • Quantitative analysis was descriptive, indicating a superficial exploration of HP research.

Conclusions:

  • Key barriers include lack of time, inadequate social support, and emotional distress.
  • Facilitators involve comprehensive training, integrating therapy into daily routines, and effective family-professional communication.
  • Further research is needed to analyze family variables and confounding factors in HP implementation.
Abstract

Keywords:
barrierscerebral palsyfacilitatorshome programmeshome‐based intervention

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