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Parent compliance with therapeutic interventions for children with cerebral palsy
1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Insights
Parental self-ratings of understanding and skill best predicted improvements in hand function for children with cerebral palsy undergoing therapy. This measure offers a reliable way to track home program adherence and therapy outcomes.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Occupational Therapy
Background:
- Children with cerebral palsy often require intensive therapy, including home programs, to improve hand function.
- Parental involvement and compliance are crucial for the success of therapeutic interventions.
- Various methods exist to measure parental compliance, but their effectiveness in predicting outcomes is not always clear.
Purpose of the Study:
- To examine the relationship between different measures of parental compliance and changes in hand function in children with cerebral palsy.
- To identify which parental compliance measures are most predictive of therapeutic outcomes.
Main Methods:
- A clinical trial involving 72 children with cerebral palsy (aged 18 months to 8 years) receiving neurodevelopmental therapy (NDT) and upper-limb casting.
- Interventions included prescribed home programs.
- Parental compliance was assessed through self-ratings (understanding, skill), therapist ratings, attendance records, cast wear time, and home program log completion.
Main Results:
- Parental self-ratings of understanding and skill were the only significant predictors of improved hand function.
- Parent self-ratings showed moderate correlation with other compliance measures.
- Parent self-ratings were predictive of functional hand improvements post-intervention.
Conclusions:
- Parental self-assessment is a valuable and predictive measure of compliance in pediatric cerebral palsy therapy.
- Focusing on parent self-reported understanding and skill may enhance therapy effectiveness and predict hand function gains.
- This finding can inform clinical practice and the design of more effective home-based rehabilitation strategies.
Abstract:
This paper reports the correspondence between different measures of parental compliance and the relationship of these compliance measures to change in hand function after therapy intervention. 72 children with cerebral palsy, aged 18 months to eight years, participated in a clinical trial of neurodevelopmental therapy (NDT) and upper-limb casting; home programmes were part of each intervention. Measures of parental compliance comprised: self-rating of understanding and skill using a questionnaire, therapist's rating of parental compliance, attendances, mean time of cast wear and number of days completed home-programme log-book. Parent ratings were the only significant predictor of change in hand function. Parent self-rating was the most useful measure, since it correlated moderately with two other compliance measures and was predictive of change in hand function.