Home-based rehabilitation for children with spastic cerebral palsy: Implications for motor function and family burden

This study aimed to evaluate the effects of home-based, parent-delivered rehabilitation on motor function and family burden among children with spastic cerebral palsy (CP) and explore the relationship between changes in children's motor function, family burden, and parental negative emotions.

A randomized controlled design was adopted. Forty families of children with CP were recruited and randomly assigned, using a random number table, to either the conventional (n = 20) or the family (n = 20) rehabilitation group. Both groups received a 6-month intervention: the conventional group received standard in-hospital rehabilitation administered by clinicians, whereas the family group conducted motor function training at home under professional guidance, with other intervention components identical to those of the conventional group. Monthly assessments were performed in both groups to evaluate family economic burden, caregivers' psychological outcomes, and the gross motor function of the children. Repeated-measures ANOVA was used to analyse data collected at baseline, 3 months, and 6 months, whereas regularized regression was applied to identify predictors of parental emotions.

Significant time effects were observed in the family rehabilitation group for the D (F = 27.47, p = 0.00, ηp² = 0.33) and E (F = 28.09, p = 0.00, ηp² = 0.33) domains of the Gross Motor Function Measure, as well as for balance function (F = 489.88, p = 0.00, ηp² = 0.90). Regarding family burden, a significant interaction effect was observed (F = 36.47, p = 0.00, pη² = 0.39), with the family rehabilitation group showing significantly lower burden scores than the conventional group at month 6 (p = 0.00; 95% CI: [9.04, 12.07]). For depressive symptoms, the interaction effect was significant (F = 3.62, p = 0.03, pη² = 0.06), and the family rehabilitation group scored significantly lower at month 6 (p = 0.01, 95% CI [-4.76, -0.94]). For anxiety, both group effects (F = 13.13, p = 0.00, pη² = 0.10) and time effects (F = 104.88, p = 0.00, pη² = 0.65) were significant. Regularized regression identified changes in family burden as the only stable predictor of parental emotions.

Home-based, parent-delivered rehabilitation achieved improvements in gross motor and balance function comparable to those of conventional hospital-based rehabilitation. However, compared with conventional rehabilitation, this model effectively reduced family burden and alleviated negative emotional states, such as depression and anxiety, among parents of children with cerebral palsy.