Parental Perceptions of Physical Therapy Use Among Children With Cerebral Palsy: A Meta-Synthesis

Cerebral palsy (CP), the most common cause of childhood motor disability, is often associated with comorbidities such as epilepsy and spasticity. CP is a heterogeneous group of disorders attributed to the nonprogressive injury of the developing brain during fetal life or infancy affecting posture and movement. Physical therapy, the most important current intervention for CP, targets the relief of muscle stiffness, reduction of perceived pain, and improvement of patient mobility.

This study was designed to synthesize the qualitative evidence on the perceptions of parents regarding the utilization of physical therapy in the treatment of children with cerebral palsy.

Four electronic databases, including CINAHL, Embase, OVID Medline, and ERIC, were searched for relevant qualitative studies in March 2023. The included studies were critically appraised using the Critical Appraisal Skills Program tool for qualitative research by 2 independent reviewers, and a content thematic approach was used to synthesize the qualitative findings.

The 8 studies published between 1990 and 2022 included in this review covered data from 150 participants. The 47 findings extracted from these studies were grouped into 11 subthemes and finally into the following 4 synthesized themes: (1) physical therapy is an essential treatment with many positive outcomes, (2) the success of physical therapy depends on realistic partnerships, (3) honest and organized communication flow is critical, and (4) key challenges in physical therapy include service delivery, personal and family adjustments.

Overall, the parents in the included studies perceived physical therapy as an ideal treatment associated with many positive outcomes for their children with disabilities and as a source of hope for their children's future. Notably, the parents required clear information on the goals of therapy from the outset and to be involved in all care planning to promote therapy compliance.