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Functional outcomes and barriers of assistive devices for children with cerebral palsy: a cross-sectional study in
Valentin Nambazimana1, Sylvie Ishimwe1, Emmanuel Biracyaza2,3
1Department of Occupational Therapy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Insights
Assistive devices improve daily living for children with cerebral palsy (CP). However, cost, distance, and education create barriers to access, highlighting the need for affordable, community-based support.
Area of Science:
- Rehabilitation Science
- Assistive Technology
- Pediatric Disability
Background:
- Cerebral palsy (CP) is a significant global cause of childhood physical disability.
- Sub-Saharan Africa faces challenges in assistive device access due to limited rehabilitation services.
- This study focuses on CP assistive device utilization in Rwanda.
Purpose of the Study:
- To examine the utilization of assistive devices among children with CP in Rwanda.
- To identify the perceived benefits of these devices.
- To understand the challenges hindering their use.
Main Methods:
- Cross-sectional study conducted at two rehabilitation centers in Rwanda.
- Involved 50 caregivers of children with CP using assistive devices.
- Utilized sociodemographic questionnaires and the WHO Rapid Assistive Technology Assessment.
Main Results:
- Assistive devices were linked to improved playing skills (standing frames), self-feeding (adapted spoons), and dressing (orthoses).
- Enhanced self-care correlated with higher caregiver education, and better attention spans with daily device use.
- Key barriers included high device cost, long travel distances, stigma, and lower parental education.
Conclusions:
- Assistive devices offer significant benefits for children with CP, enhancing play, self-care, dressing, and attention.
- Equitable access is hampered by economic, geographic, and educational factors.
- Recommendations include promoting affordability, context-specific approaches, and community-based rehabilitation.
Background:
Cerebral palsy (CP) is a leading cause of physical disability worldwide, affecting approximately 2 -3 per 1,000 live births. In sub-Saharan Africa, access to assistive devices supporting participation in occupation remains constrained by inadequate rehabilitation services and limited evidence. This study examined the utilisation, perceived benefits and challenges associated with assistive devices use among children with CP attending rehabilitation centres in Rwanda.
Methods:
We conducted a cross-sectional study at Gatagara Orthopaedic and Rehabilitation Hospital and Gahini Rehabilitation Centre among 50 caregivers of children with CP using assistive devices. Data were collected using a sociodemographic questionnaire and the World Health Organisation's Rapid Assistive Technology Assessment. Descriptive and analytical analyses were performed.
Results:
Improved playing skills were associated with standing frame use (AOR = 2.8, p = 0.02). Self- feeding was associated with the use off adapted spoon use (AOR = 4.5, p = 0.03); while improved dressing was associated with orthosis use (AOR = 3.1, p = 0.047). Enhanced self-care was associated with higher caregiver education (AOR = 2.9, p = 0.04). Better attention span was associated with daily rather than weekly assistive device use (AOR = 3.2, p = 0.025). However, high device cost particularly among the poorest households, long travel distances, stigma, and lower parental education were associated barriers to the utilization of devices.
Conclusion:
Assistive devices improved play, self-care, dressing, and attention with caregiver support. However, persistent economic, geographic, and educational challenges limit equitable access, underscoring the need for affordability, context-approach, and community-based rehabilitation support.
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