N. Waiserberg1,2, P. Feder-Bubis1
1Ben Gurion University of the Negev, Department of Health Systems Management, School of Public Health, Faculty of Health Sciences & Guilford Glazer Faculty of Business and Management, Beer Sheva, Israel, 2Tel Aviv University, Faculty of Medicine, School of Health Professions, Physical Therapy Department, Tel Aviv, Israel
Background: Physical Therapy (PT) is a common intervention for children with motor disabilities. They usually receive PT intervention since infancy to adulthood. PT may be provided to these children in different settings, usually within the healthcare or educational systems.
Purpose: This study aimed to describe children’s perceptions of school-based PT (SBPT) intervention.
Methods: We conducted a qualitative study that included four focus-groups with children and adolescents with motor disabilities (n=19), aged 4.5-21 years. They received PT at school, and most of them (17/19) attended special education schools that specialized in children with motor disabilities. The focus-groups discussions were transcribed and a thematic analysis was conducted. Study trustworthiness was ensured using the constant comparison method, peer debriefing, reflexivity and audit.
Results: Participants’ perceptions were categorized in four main themes:
1) PT intervention in general: children and adolescents viewed PT as an integral part of their lives, crystallized in their daily or weekly routine. Most participants described PT as important for generating movement and health, noting that without PT their body might degenerate. Some emphasized their need for intensive PT;
2) The goals of the PT intervention: only a few adolescents described their involvement in PT goals setting, whereas younger participants perceived their physical therapist and parents as responsible for goal setting. Some participants were not sure about their PT goals; strengthening, stretching, balance and walking were described as main goals;
3) The SBPT intervention: most of the participants described facets of body function and structure (muscle strengthening, stretching, balance practice), and activity (walking, cycling) as main components of their PT intervention. Participants perceived tailored assistive devices as part of their PT intervention. PT was described also as facilitating their participation in family activities and in their leisure time. Some noted they prefer not to be touched and not to be hurt during PT intervention. They clearly distinguished SBPT from PT in health settings; the later was linked especially with body function and structure;
4) Relationships: participants wished for a close and enduring relationship with their physical therapist, one beyond the physical-related aspects of the PT intervention. Such a relationship shaped their perception of “a good physical therapist”.
1) PT intervention in general: children and adolescents viewed PT as an integral part of their lives, crystallized in their daily or weekly routine. Most participants described PT as important for generating movement and health, noting that without PT their body might degenerate. Some emphasized their need for intensive PT;
2) The goals of the PT intervention: only a few adolescents described their involvement in PT goals setting, whereas younger participants perceived their physical therapist and parents as responsible for goal setting. Some participants were not sure about their PT goals; strengthening, stretching, balance and walking were described as main goals;
3) The SBPT intervention: most of the participants described facets of body function and structure (muscle strengthening, stretching, balance practice), and activity (walking, cycling) as main components of their PT intervention. Participants perceived tailored assistive devices as part of their PT intervention. PT was described also as facilitating their participation in family activities and in their leisure time. Some noted they prefer not to be touched and not to be hurt during PT intervention. They clearly distinguished SBPT from PT in health settings; the later was linked especially with body function and structure;
4) Relationships: participants wished for a close and enduring relationship with their physical therapist, one beyond the physical-related aspects of the PT intervention. Such a relationship shaped their perception of “a good physical therapist”.
Conclusion(s): Children and adolescents with motor disabilities perceive their school-based physical therapist as a significant other, whose impact reaches much beyond the duration of their face-to-face sessions. These children/adolescents perceive the impact of the PT intervention on all the components and in the different levels of the International Classification of Functioning, Disability and Health (ICF). These young persons demand to be involved both in the planning and in the execution of their PT intervention, demanding its tailoring to their own, specific needs and preferences as specified by them. Education settings enable flexibility of the PT intervention and the development of relationships that children with motor disabilities look for.
Implications: Children and adolescents with motor disabilities can provide detailed, relevant, and meaningful information and opinions worth taking into account while planning and providing PT interventions. This information may also serve for pediatric PT professional development.
Funding, acknowledgements: This research was funded by a grant of the Israel National Institute for Health Policy and Health Services Research (NIHP)
Keywords: Pediatric Physical Therapy, School-Based Physical Therapy, Children perceptions
Topic: Paediatrics
Did this work require ethics approval? Yes
Institution: Ben Gurion University of the Negev
Committee: Human Subjects Research Committee
Ethics number: 1701-1
All authors, affiliations and abstracts have been published as submitted.
