Dataset Information

Effects of Telerehabilitation-Based Structured Home Program on Activity, Participation and Goal Achievement in Preschool Children with Cerebral Palsy: A Triple-Blinded Randomized Controlled Trial.

ABSTRACT: A home program is implemented as an evidence-based mode of delivering services for physiotherapy and rehabilitation. Telerehabilitation is a method applied in physiotherapy modalities for children. This study aims to determine the effectiveness of usual care plus a Telerehabilitation-Based Structured Home Program on preschool children with cerebral palsy (CP) compared to usual care. Forty-three children aged 3-6 years (mean age 4.66 ± 1.08 years) with CP were randomly assigned to the Telerehabilitation-Based Structured Home Program and usual care groups. Their motor function was assessed with the Gross Motor Function Measure (GMFM); performance and satisfaction were evaluated with the Canadian Occupational Performance Measure (COPM); goal achievement was assessed with the Goal Attainment Scale (GAS); and activity and participation were evaluated with Pediatric Evaluation of Disability Inventory (PEDI). Participants were evaluated at baseline, immediately post-intervention (12 weeks) and at follow-up (24 weeks). There was a statistically significant difference between pre- and post-test GMFM, COPM, GAS and PEDI scores in the intervention and control groups (p < 0.001). The Telerehabilitation-Based Structured Home Program showed statistically significant changes in activity, participation and goal achievement after 12 weeks of intervention (p < 0.001). However, significant results were not obtained in the usual care group. The Telerehabilitation-Based Structured Home Program may be an effective method for preschool children with CP. (Registration number: NCT04807790; no = KA-20124/26.01.2021).

SUBMITTER: Sel SA

PROVIDER: S-EPMC10047243 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Effects of Telerehabilitation-Based Structured Home Program on Activity, Participation and Goal Achievement in Preschool Children with Cerebral Palsy: A Triple-Blinded Randomized Controlled Trial.

Sel Sinem Asena SA Günel Mintaze Kerem MK Erdem Sabri S Tunçdemir Merve M

Children (Basel, Switzerland) 20230222 3

A home program is implemented as an evidence-based mode of delivering services for physiotherapy and rehabilitation. Telerehabilitation is a method applied in physiotherapy modalities for children. This study aims to determine the effectiveness of usual care plus a Telerehabilitation-Based Structured Home Program on preschool children with cerebral palsy (CP) compared to usual care. Forty-three children aged 3-6 years (mean age 4.66 ± 1.08 years) with CP were randomly assigned to the Telerehabil ...[more]

PMID: 36979982

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Project description:Background/Objectives: Children with cerebral palsy (CP) are reported to have lower rates of participation in community and home tasks than typically developing children. Little is known about the participation levels of children with CP and the environmental factors influencing their participation in the community within the Saudi context. This study aimed to determine the degree of participation in community and home tasks in children with CP in Saudi Arabia, as well as the level of support received, and the obstacles faced by children in this context. Methods: Parents of 5-16-year-old children with CP (n = 50) completed the Participation and Environment Measure for Children and Youth (PEM-CY), and their scores were compared with those of typically developing children of the same ages (n = 50). This study was conducted in a hospital setting. Analyses were performed using multivariate logistic regression analyses, controlling for potential confounders. Results: Participation in community activities as well as home activities was reported to be significantly lower in children with CP compared to their typically developing peers in multiple domains (p < 0.05). Additionally, physical, cognitive, and social demands were identified as factors that made community participation more difficult for children with CP (p = 0.002, p = 0.017, and p = 0.029 for physical, cognitive, and social demands, respectively). The availability of personal transportation, programs, services, and financial support were identified by parents as the factors that lowered community participation levels in children with CP (p > 0.005). Conclusions: Physical, cognitive, and social demands are the main obstacles to participation for children with CP. A lack of home supplies and financial support lowered the participation of children with CP. Recognizing environmental barriers as well as providing individualized practical solutions in collaboration with the families of children with CP can assist in developing meaningful participation in community and home activities for children with CP.

Project description:IntroductionFrailty is common among patients entering cardiac rehabilitation (CR). Frailty is associated with poor health outcomes; however, it is unclear if frailty influences achieving goals in CR.MethodsWe report a secondary analysis of participants who were referred to an exercise and education-based CR program from 2005 to 2015. Frailty was measured by a 25-item accumulation of deficits frailty index (FI) ranging from 0 to 1; higher scores indicate higher frailty. Participants were categorized by admission frailty levels (FI scores: < 0.20, 0.20-0.29, 0.30-0.39, > 0.40). CR goals were determined with shared decision-making between CR staff and the patients. We conducted logistic regression analyses to examine the odds of goal attainment by CR completion, adjusting for age, sex, education, marital status, and referring diagnosis. Analyses were performed using baseline frailty as a categorical and continuous outcome, and frailty change as a continuous outcome in separate models.ResultsOf 759 eligible participants (age: 59.5 ± 9.8, 24% female), 607 (80%) participants achieved a CR goal at graduation. CR goals were categorized into similar themes: control or lose weight (n = 381, 50%), improve physical activity behaviour and fitness (n = 228, 30%), and improve cardiovascular profile (n = 150, 20%). Compared to the most severe frailty group (FI >0.40), lower levels of frailty at baseline were associated with achieving a goal at CR completion [FI < 0.20: OR = 4.733 (95% CI: 2.197, 10.194), p < .001; FI 0.20-0.29: OR = 2.116 (1.269-3.528), p = .004]. Every 1% increase in the FI was associated with a 3.5% reduction in the odds of achieving a CR goal [OR = 0.965 (0.95, 0.979), p < .001]. Participants who reduced their frailty by a minimally clinically important difference of at least 0.03 (n = 209, 27.5%) were twice as likely to achieve their CR goal [OR = 2.111 (1.262, 3.532), p = .004] than participants who increased their frailty by at least 0.03 (n = 82, 10.8%). Every 1% improvement in the FI from baseline to follow up was associated with a 2.7% increase in the likelihood of CR goal achievement [OR = 1.027 (1.005, 1.048), p = .014].ConclusionLower admission frailty was associated with a greater likelihood of achieving CR goals. Frailty improvements were associated with CR goal achievement, highlighting the influence of frailty on goal attainment.

Project description:ImportanceThere is no evidence-based system to guide occupational therapists in implementing theory-based, client-engaged goal setting and goal management. A new system is needed to support high-quality goal setting and goal management.ObjectiveTo determine the acceptability, appropriateness, feasibility, credibility, and expectancy of a new structured theory-based, client-engaged goal setting and goal management system, called MyGoals, for occupational therapists. We explored MyGoals' implementation determinants, potential positive outcomes, and comparative advantages.DesignThis was a mixed-methods feasibility study.SettingCommunity.ParticipantsOccupational therapists (N = 7).Outcomes and measuresAcceptability, appropriateness, and feasibility were assessed using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). Credibility and expectancy were assessed with the Credibility and Expectancy Questionnaire (CEQ). Semistructured 1:1 interviews were conducted to explore occupational therapy perspectives on MyGoals and its implementation-related factors.ResultsMyGoals had high AIM (M = 18.1, SD = 1.9), IAM (M = 17.9, SD = 2.2), FIM (M = 17.3, SD = 2.1) scores and high CEQ Credibility (M = 22.1, SD = 5.0) and Expectancy (M = 20.6, SD = 4.3) scores. Interview data revealed suggestions to improve MyGoals, implementation determinants across the individuals involved, inner setting, and intervention characteristic domains, client- and clinician-related potential positive outcomes, and comparative advantages.Conclusions and relevanceMyGoals is an acceptable, appropriate, feasible, credible, and promising system to guide occupational therapists in implementing theory-based, client-engaged goal setting and goal management for adults with chronic conditions in community-based rehabilitation. What This Article Adds: MyGoals is an easy-to-use, appealing, and helpful system to support occupational therapists in delivering theory-based goal setting and goal management components and to enable adults with chronic conditions to actively engage in their rehabilitation. This study supports the usefulness of MyGoals in community-based rehabilitation to improve goal setting and goal management quality and personally meaningful rehabilitation goal achievement in this population.

Dataset Information

Effects of Telerehabilitation-Based Structured Home Program on Activity, Participation and Goal Achievement in Preschool Children with Cerebral Palsy: A Triple-Blinded Randomized Controlled Trial.

Publications

Effects of Telerehabilitation-Based Structured Home Program on Activity, Participation and Goal Achievement in Preschool Children with Cerebral Palsy: A Triple-Blinded Randomized Controlled Trial.

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