Grant-Beuttler M1, Jonathan N2, Hollandsworth RC1, Sladkey A1, Sawitz S1, Huibsch T1, Nguyen M1
1Chapman University; Crean College of Health and Behavioral Science, Physical Therapy, Irvine, United States, 2Chapman University; Crean College of Health and Behavioral Science, Marriage and Family Therapy, Orange, CA, United States
Background: Quality of life and health outcomes are poorer in children with Cerebral Palsy (CP) and their caregivers versus typical dyads. Functional decline is present in children with CP as they age secondary to decreased contact with rehabilitation services, decreased physical activity, and decreased participation in leisure activity. Ambulation skills also decline as children with CP age. Parents experience increased caregiving demands with increased levels of stress, fatigue and higher rates of depression.
Purpose: This project aimed to:
1) improve function and promote physical activity in children with CP through therapeutic dance,
2) provide a Parent Support Group for families with children diagnosed with CP, and
3) provide inter-professional clinical education for graduate healthcare students.
Methods: Subjects: Seven caregiver/child dyads participated in 3 session of this program. Participants included children diagnosed with CP, ages 7-15 years (mean=9.7 years), 4 male/ 3 female and Gross Motor Functional Classification Scale II (1), III (2), IV (1), and V (3). Two dyads attended all 3 sessions, 3 dyads attended 2 sessions, and 2 dyads attended 1 session. Concurrent with the children´s class, all children had at least one parent participating in a support group. Graduate health students (27 Physical Therapy (PT) and 4 Marriage and Family Therapy (MFT)) received mentored training to led the child and parent programs.
Outcomes: Child outcome measures included the Selective Control Assessment of the Lower Extremity (SCALE), Gross Motor Functional Measure (GMFM), and the Canadian Occupational Performance Measure (COPM). Parent outcomes included the Parental Stress Scale (PSS) and the Outcome Questionnaire (OQ45). Graduate PT students and parents completed a semi-structured interview following each session.
Procedure: An 11-week adaptive dance class for the children was lead by dance teachers and licensed PT´s with a concurrent Support Group for the parents led by a licensed MFT. Pre and post testing sessions occurred prior to and following sessions.
Results: Parents and PT´s developed 52 child participant goals for the dance sessions using the COPM. Ratings of performance increased a mean of 3.8 points with 39/52 (75%) increasing more than 2 points. Goal satisfaction increased a mean of 4.45 points with 42/52 (81%) increasing more than 2 points. Significant improvements were observed on the left extremity SCALE score (Wilcoxon Sign Rank, p=0.049). No significant differences in PSS or OQ45. Qualitative assessment of the interviews revealed 5 themes for parents (Community, Connection versus Isolation, Benefits (Children and Parents), Separation, Emotional Toll) and 5 themes for the Graduate PT students (Pre-conceptions, Student Transformation, Interdisciplinary Environment, Connection between Disciplines, and Overarching Experiences).
Conclusion(s): This Inter-Professional program demonstrated progress towards the child´s goals, facilitation of parent support, and successful education opportunities for graduate health professionals. COPM goals for the children allowed focused intervention in a motivating environment. Continued participation by the families suggests perceived benefits. Positive educational experiences were supported by the student interviews.
Implications: This program provided beneficial therapeutic activity for children with CP, opportunities for parent support, as well as, positive educational experiences that can be adapted and applied to a variety of diagnoses in the educational setting.
Keywords: Cerebral Palsy Intervention, Health and Well Being, Inter-Professional Clinical Education
Funding acknowledgements: Faculty-Led Interdisciplinary Research Grant through the Crean School of Health and Behavior Sciences, Chapman University.
Purpose: This project aimed to:
1) improve function and promote physical activity in children with CP through therapeutic dance,
2) provide a Parent Support Group for families with children diagnosed with CP, and
3) provide inter-professional clinical education for graduate healthcare students.
Methods: Subjects: Seven caregiver/child dyads participated in 3 session of this program. Participants included children diagnosed with CP, ages 7-15 years (mean=9.7 years), 4 male/ 3 female and Gross Motor Functional Classification Scale II (1), III (2), IV (1), and V (3). Two dyads attended all 3 sessions, 3 dyads attended 2 sessions, and 2 dyads attended 1 session. Concurrent with the children´s class, all children had at least one parent participating in a support group. Graduate health students (27 Physical Therapy (PT) and 4 Marriage and Family Therapy (MFT)) received mentored training to led the child and parent programs.
Outcomes: Child outcome measures included the Selective Control Assessment of the Lower Extremity (SCALE), Gross Motor Functional Measure (GMFM), and the Canadian Occupational Performance Measure (COPM). Parent outcomes included the Parental Stress Scale (PSS) and the Outcome Questionnaire (OQ45). Graduate PT students and parents completed a semi-structured interview following each session.
Procedure: An 11-week adaptive dance class for the children was lead by dance teachers and licensed PT´s with a concurrent Support Group for the parents led by a licensed MFT. Pre and post testing sessions occurred prior to and following sessions.
Results: Parents and PT´s developed 52 child participant goals for the dance sessions using the COPM. Ratings of performance increased a mean of 3.8 points with 39/52 (75%) increasing more than 2 points. Goal satisfaction increased a mean of 4.45 points with 42/52 (81%) increasing more than 2 points. Significant improvements were observed on the left extremity SCALE score (Wilcoxon Sign Rank, p=0.049). No significant differences in PSS or OQ45. Qualitative assessment of the interviews revealed 5 themes for parents (Community, Connection versus Isolation, Benefits (Children and Parents), Separation, Emotional Toll) and 5 themes for the Graduate PT students (Pre-conceptions, Student Transformation, Interdisciplinary Environment, Connection between Disciplines, and Overarching Experiences).
Conclusion(s): This Inter-Professional program demonstrated progress towards the child´s goals, facilitation of parent support, and successful education opportunities for graduate health professionals. COPM goals for the children allowed focused intervention in a motivating environment. Continued participation by the families suggests perceived benefits. Positive educational experiences were supported by the student interviews.
Implications: This program provided beneficial therapeutic activity for children with CP, opportunities for parent support, as well as, positive educational experiences that can be adapted and applied to a variety of diagnoses in the educational setting.
Keywords: Cerebral Palsy Intervention, Health and Well Being, Inter-Professional Clinical Education
Funding acknowledgements: Faculty-Led Interdisciplinary Research Grant through the Crean School of Health and Behavior Sciences, Chapman University.
Topic: Paediatrics: cerebral palsy; Health promotion & wellbeing/healthy ageing; Education: clinical
Ethics approval required: Yes
Institution: Chapman University
Ethics committee: Chapman University Internal Review Board
Ethics number: CUIRB#1617H039
All authors, affiliations and abstracts have been published as submitted.
