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

Publication date: Available online 11 December 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Sarah E. Reedman, Roslyn N. Boyd, Stewart G. Trost, Catherine Elliott, Leanne Sakzewski

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 cerebral palsy (CP).

Design

Randomized waitlist-controlled trial.

Setting

Home and community.

Participants

Thirty-seven children Gross Motor Function Classification System (GMFCS) I-III were recruited (18 males, mean age 10y 0mo [SD 1y 5mo]) from a population-based register.

Interventions

Participants were randomized to ParticiPAte CP (an 8-week 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 (COPM). Accelerometers were worn for objective measurement of HPA (min·day^-1 moderate to vigorous physical activity, MVPA, and sedentary time). Barriers to participation, community participation, and quality of life outcomes were also collected. Data were analysed by intention-to-treat using generalized estimating equations.

Results

ParticiPAte CP led to significant improvements in goal performance (MD=3.58, 95% CI=2.19 to 4.97, p<0.001), satisfaction (MD=1.87, 95% CI=0.37 to 3.36, p=0.014), and barriers to participation (MD=26.39, 95% CI=6.13 to 46.67, p=0.011) compared with usual care at eight weeks. There were no between group differences on min·day^-1 MVPA at eight weeks (MD=1.17, 95% CI=-13.27 to 15.61, p=0.874). 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 to 27.89, p<0.0061). Following ParticiPAte CP, low active participants had increased average MVPA by 5.98 (SD=12.16) min·day^-1.

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.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2Gl5VxU
via IFTTT