“Strong and steady”: a community-based strength and balance exercise group for children with cerebral palsy

Introduction Poverty is a key contributor to delayed diagnosis and limited access to early intervention and rehabilitation for children with cerebral palsy (CP) in rural Bangladesh. 97% of families of children with CP live below the poverty line in Bangladesh. Therefore, in low-and middle-income countries (LMICs), efforts to improve outcomes for children with CP (including health-related quality of life, motor function, communication, and nutritional attainments) should also include measures to improve family economic and social capital. We propose a randomised controlled trial (RCT) to evaluate the effectiveness of an integrated microfinance/livelihood and community-based rehabilitation (IMCBR) program for ultra-poor families of children with CP in rural Bangladesh. Material and methods This will be a cluster RCT comparing three arms: (a) integrated microfinance/livelihood and community-based rehabilitation (IMCBR); (b) community-based rehabilitation (CBR) alone; and (c) care-as-usual (i.e. no intervention). Seven clusters will be recruited within each arm. Each cluster will consist of 10 child-caregiver dyads totalling 21 clusters with 210 dyads. Parents recruited in the IMCBR arm will take part in a microfinance/livelihood program and Parent Training Module (PTM), their children with CP will take part in a Goal Directed Training (GDT) program. The programs will be facilitated by specially trained Community Rehabilitation Officers. The CBR arm includes the same PTM and GDT interventions excluding the microfinance/livelihood program. The care-as-usual arm will be provided with information about early intervention and rehabilitation. The assessors will be blinded to group allocation. The duration of the intervention will be 12 months; outcomes will be measured at baseline, 6 months, 12 months, and 18 months. Conclusion This will be the first RCT of an integrated microfinance/livelihood and CBR program for children with CP in LMIC settings. Evidence from the study could transform approaches to improving wellbeing of children with CP and their ultra-poor families.

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Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

Brain Sciences ◽

10.3390/brainsci11091189 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1189

Author(s):

Tasneem Karim ◽

Mohammad Muhit ◽

Israt Jahan ◽

Claire Galea ◽

Catherine Morgan ◽

...

Keyword(s):

Experimental Study ◽

Cerebral Palsy ◽

Early Intervention ◽

Intervention Program ◽

Community Based ◽

Children With Cerebral Palsy ◽

Functional Measure ◽

Quasi Experimental ◽

Group A ◽

Group B

We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

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Evaluating the impact of a community-based parent training programme for children with cerebral palsy in Ghana

PLoS ONE ◽

10.1371/journal.pone.0202096 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0202096 ◽

Cited By ~ 27

Author(s):

Maria Zuurmond ◽

David O’Banion ◽

Melissa Gladstone ◽

Sandra Carsamar ◽

Marko Kerac ◽

...

Keyword(s):

Cerebral Palsy ◽

Parent Training ◽

Training Programme ◽

Community Based ◽

Children With Cerebral Palsy ◽

The Impact

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Using Mobile Devices to Support Training of Community-Based Rehabilitation Workers in India Who Provide Services to Children With Cerebral Palsy

American Journal of Occupational Therapy ◽

10.5014/ajot.2018.72s1-po4048 ◽

2018 ◽

Vol 72 (4_Supplement_1) ◽

pp. 7211520314p1

Author(s):

Sutanuka Bhattacharjya ◽

James Lenker

Keyword(s):

Cerebral Palsy ◽

Mobile Devices ◽

Community Based ◽

Community Based Rehabilitation ◽

Children With Cerebral Palsy

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Effects of equine-assisted activities on attention and quality of life in children with cerebral palsy in a randomized trial: examining the comorbidity with attention-deficit/hyperactivity disorder

BMC Pediatrics ◽

10.1186/s12887-021-02597-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bomi Ahn ◽

Yoo-Sook Joung ◽

Jeong-Yi Kwon ◽

Dong Ik Lee ◽

Soohwan Oh ◽

...

Keyword(s):

Quality Of Life ◽

Cerebral Palsy ◽

Exercise Group ◽

Control Group ◽

Commission Error ◽

Positive Effects ◽

Significant Difference ◽

Children With Cerebral Palsy ◽

Equine Assisted

Abstract Background Attention problems and decreased quality of life are frequently accompanied in Cerebral Palsy (CP), which can negatively affect rehabilitation of physical disability. However, the majority of affected children remain untreated in the aspects of attention or psychosocial factors. Equine-Assisted Activities and Therapies (EAAT) use horse as a therapeutic modality including grooming as well as mounted riding activities in which patients exercise and experience mounted stimulation. It is known to help improve attention in children with ADHD, so that it can be an exercise therapy that is expected to improvement of attention as well as rehabilitating effects in CP patients. EAA may be a promising strategy to address the unmet need for CP patients. This study aims to investigate the efficacy of EAA for children with CP, those with both CP and ADHD and confirm the comorbidity between CP and ADHD. Methods Forty-six children with cerebral palsy participated in this study. For the exercise group, they participated in a 40-min session twice a week for a 16-week period, while the control group engaged in daily life without any special treatments. Each children individually were assessed on attention and psychological wellbeing at baseline and post-treatment. Comorbidity were identified based on the Diagnostic and Statistical Manual of Mental Disorder 5th edition (DSM-5) and confirmed by Korean Kiddie-Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL). Results Perseveration rated using the Conner’s Performance Test (CPT) showed a significant decrease only in the exercise group (p < .024). However, no significant improvement in children’s quality of life was observed after EAA program compared with control group. Among the total participants, fifteen children (31.91%) were diagnosed with ADHD. When conducting an additional analysis with the subsample of CP patients diagnosed with ADHD, the d’, commission error and perseveration showed a significant decrease only in the exercise group. Children with CP and ADHD reported an improvement in quality of life both in exercise and control group, but only in the exercise group social functioning exhibited a significant difference. Conclusion The positive effects of the EAA on attention and quality of life were confirmed. Children with CP in the exercise group were more capable to sustain their attention longer. Those with CP and ADHD showed an increase in attention and perceived to have better social skills after receiving 16 weeks of EAA compared to those in the control group. Considering high comorbidity of CP and ADHD, it seems that the EAA program could be the better alternative treatment for CP with attentional problem. The results of this study will contribute to growing evidence for the efficacy of EAA in children especially with CP and ADHD. Trial registration This trial was registered on ClinicalTrials.gov (NCT03870893). Registered 26 July 2017.

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Parent and Clinician Perspectives on the Participation of Children with Cerebral Palsy in Community-Based Football: A Qualitative Exploration in a Regional Setting

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17031102 ◽

2020 ◽

Vol 17 (3) ◽

pp. 1102

Author(s):

Carmel Sivaratnam ◽

Katherine Howells ◽

Nicole Stefanac ◽

Kelly Reynolds ◽

Nicole Rinehart

Keyword(s):

Cerebral Palsy ◽

Environmental Factors ◽

Community Based ◽

Child Characteristics ◽

Regional Setting ◽

Factors Influencing ◽

Australian Rules Football ◽

Children With Cerebral Palsy ◽

Clinician Perspectives ◽

Qualitative Exploration

The current study aimed to qualitatively explore parent and clinician perspectives on the factors influencing participation in a community-based Australian-Rules Football program for five to 12-year-old children with cerebral palsy (CP) in a regional setting. Six allied-health clinicians and two parents of children with CP participated in focus groups exploring factors influencing participation. Thematic analysis indicated seven key factors influencing participation—of which, six were environmental factors and one was related to child characteristics. Environmental factors included resources, communication, knowledge and previous experience, attitudes and expectations, game factors and community relevance. Child characteristics included age, preferences, confidence, as well and cognitive and physical functioning. Notwithstanding limitations, the current study highlights the central role of ‘people factors’ in the child’s environment, in facilitating participation in community-based physical activity.

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