Factors Influencing Attendance to Physical Therapy Services Among Children with Cerebral Palsy in Saudi Arabia

To examine child, caregiver, and physical therapy (PT) service-related factors associated with regular versus irregular attendance to PT services among children with cerebral palsy (CP).

A cross-sectional study was conducted with 108 caregivers of children with CP aged 2-12 years in Saudi Arabia. Caregivers completed an online survey about child and caregiver characteristics, PT characteristics, perceived difficulties related to PT services, and caregiver-reported burden. Attendance was categorized as regular or irregular based on caregiver report and differences were examined. Regular attendance reflected consistent participation in scheduled sessions, whereas irregular attendance reflected missed, delayed, or inconsistent attendance.

Regular attendance was reported by 42.6% of participants. Regular attendance was associated with younger age of children (p = 0.003, d= 0.59) and lack of children's educational enrollment (p = 0.014, φ = 0.24). No significant differences were found between groups for child sex, Gross Motor Function Classification System level, CP type, caregiver characteristics, or PT service characteristics. Irregular attendees reported greater difficulties related to appointment booking policies (r = 0.30), access to therapists (r = 0.26), agreement on treatment plans (r = 0.22), child behavior management (r = 0.25), and caregiver-child interaction during home exercises (r = 0.29), as well as higher financial (r = 0.21) and psychological burden (r = 0.19).

Attendance to PT services for children with CP was associated more with caregiver-perceived difficulties and burden than with demographic or service characteristics. Addressing service processes and caregiver experiences may support more consistent PT attendance.