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Arch Phys Med Rehabil. 2019 Apr;100(4):676-686. doi: 10.1016/j.apmr.2018.11.012. Epub 2018 Dec 11.

Efficacy of Participation-Focused Therapy on Performance of Physical Activity Participation Goals and Habitual Physical Activity in Children With Cerebral Palsy: A Randomized Controlled Trial.

Author information

1
Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland. Electronic address: sarah.reedman@uqconnect.edu.au.
2
Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland.
3
Institute of Health and Biomedical Innovation at Queensland Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland.
4
School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia; Child and Adolescent Health Services, Perth Children's Hospital, Perth, Australia.

Abstract

OBJECTIVE:

To determine the efficacy of a participation-focused therapy (ParticiPAte CP) on leisure-time physical activity goal performance and satisfaction and habitual physical activity (HPA) in children with CP.

DESIGN:

Randomized waitlist-controlled trial.

SETTING:

Home and community.

PARTICIPANTS:

Children classified at Gross Motor Function Classification System (GMFCS) levels I-III were recruited (n=37; 18 males; mean age ± SD, 10.0±1.4y) from a population-based register.

INTERVENTIONS:

Participants were randomized to ParticiPAte CP (an 8-wk goal-directed, individualized, participation-focused therapy delivered by a physical therapist) or waitlist usual care.

MAIN OUTCOME MEASURES:

The primary outcome was Canadian Occupational Performance Measure. Accelerometers were worn for objective measurement of HPA (min/d moderate-to-vigorous physical activity [MVPA], sedentary time). Barriers to participation, community participation, and quality-of-life outcomes were also collected. Data were analyzed by intention-to-treat using generalized estimating equations.

RESULTS:

ParticiPAte CP led to significant improvements in goal performance (mean difference [MD]=3.58; 95% confidence interval [95% CI], 2.19-4.97; P<.001), satisfaction (MD=1.87; 95% CI, 0.37-3.36, P=.014), and barriers to participation (MD=26.39; 95% CI, 6.13-46.67; P=.011) compared with usual care at 8 weeks. There were no between-group differences on minutes per day of MVPA at 8 weeks (MD=1.17; 95% CI, -13.27 to 15.61; P=.874). There was a significant difference in response to intervention between participants who were versus were not meeting HPA guidelines at baseline (MD=15.85; 95% CI, 3.80-27.89; P<.0061). After ParticiPAte CP, low active participants had increased average MVPA by 5.98±12.16 minutes per day.

CONCLUSION:

ParticiPAte CP was effective at increasing perceived performance of leisure-time physical activity goals in children with CP GMFCS I-III by reducing modifiable barriers to participation. This did not translate into change in HPA on average; however, low active children may have a clinically meaningful response.

KEYWORDS:

Cerebral palsy; Leisure; Physical activity; Randomized controlled trial; Rehabilitation

PMID:
30543803
DOI:
10.1016/j.apmr.2018.11.012

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