None listed
Conditions
Brief summary
Many children with cerebral palsy participate in fewer physical activities than peers without a physical disability. Some studies have tried to increase participation in physical activities for children with CP through programs that develop their physical skills and remediate physical impairments like low muscle strength. Participation depends on many things however, not just the presence of physical limitations; participation is related to environmental barriers like lack of accessible venues, and personal factors like self-efficacy. This project will test whether a new integration of physiotherapy and a positive counselling technique called motivational interviewing can increase the participation of children with cerebral palsy in physical activities, compared to a control group who receive usual care. We think the intervention will work because it primarily focuses on environmental and personal factors, and because it may help parents to be supportive of their child's autonomy (making choices).
Interventions
Dosage and Location:
Participating child-parent dyads allocated to the intervention group will be present for a 1-hour intervention session with a physiotherapist once weekly over an 8-week intervention period. The majority of intervention sessions will take place in the participant's home environment with the physiotherapist travelling to the participant. There is an 8-week follow-up period where no treatment will be provided at the conclusion of the intervention period.
Intervention:
The inter
Dosage and Location: Participating child-parent dyads allocated to the intervention group will be present for a 1-hour intervention session with a physiotherapist once weekly over an 8-week intervention period. The majority of intervention sessions will take place in the participant's home environment with the physiotherapist travelling to the participant. There is an 8-week follow-up period where no treatment will be provided at the conclusion of the intervention period. Intervention: The intervention is a novel integration of goal-directed, family-centred physiotherapy with a behaviour change counselling technique called motivational interviewing. The intervention is individualised to each child-parent dyad based on their reported barriers and facilitators to participation, and therefore not every possible intervention element will apply to all dyads. The common elements are: collaborative goal-setting, motivational interviewing, action-planning, and provision of information and advice. Other elements likely to be delivered include: motor-learning approach physiotherapy, home exercise programs, equipment suggestion, problem-solving, and communication with stakeholders. Adherence: Participants will be sent text message reminders about their scheduled appointments. Parents will be directed to individually relevant internet and media resources to view in their own time. Child-parent dyads must participate in the development of a maintenance plan, which outlines how progress in physical activity participation will be continued or maintained, at the end of the 8-week period. Other: Participants may continue their usual care therapies (physiotherapy, occupational therapy, speech-language therapy, psychology etc.) during the intervention and follow-up period, although episodes of care must be recorded in a usual care diary.
Sponsors
Sarah Reedman
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
8 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants are children with a diagnosis of Cerebral Palsy (GMFCS I-III, confirmed by the Child’s Paediatrician, Rehabilitation Physician, or Neurologist), aged between 8 and 12 years inclusive. The primary residence of the child during the study period is within 200kms of South Brisbane, Queensland. Each included child’s primary caregiver (one person who has a long-term parenting role including a biological parent, step parent, adoptive parent or foster parent AND has at least 30% of caregiving responsibilities) is also a participant.
Exclusion criteria
Children are excluded if they: (1) Have limited ability to communicate insight into a preferred future (needs, wants and desires) in spoken English AND/OR through an interpreter or augmentative and alternative communication (i.e. Communication Function Classification System levels IV-V and/or children with moderate to severe intellectual disability) (2) Have uncontrolled epilepsy (as this may impact on safety to engage in certain physical activities) (3) Have a severe visual impairment or blindness (defined as 6/60 vision or lower, when appropriately corrected, in the better eye, or in the written opinion of an ophthalmologist the cortical visual impairment, visual field loss and/or other deficits result in a combined approximate acuity of 6/60 or lower) (4) Have severe asthma exacerbated by exercise that is not controlled with medications under an asthma management plan (5) Have orthopaedic and/or neurological surgery 6 months prior to and/or planned during the entire study period including follow-up assessments. Intramuscular botulinum toxin (BoNT-A) injections in the lower limbs and some minor surgeries may not automatically exclude entry Caregivers are excluded if they: (1) Have a diagnosed moderate to severe intellectual disability or significant communication impairment
Outcome results
None listed