Mobility skills programme for children with cerebral palsy

This research is concerned with the ability of ambulant children with cerebral palsy to take part, and sustain their participation, in community-based physical activities. The included children with cerebral palsy will be able to walk with and without walking aids and will participate in a programme designed to improve their running and high-level mobility skills such as jumping, hopping and skipping. The programme will be run as a community group based programme at a local park and school. Each child's goals and programme will be individualised. The group will be run by an experienced paediatric physiotherapist (28 years of physiotherapy) and a trainer who is skilled in training children. The programme will focus on participation attendance and involvement in a high-level mobility programme (HLMP) for three months, and the extent to which participation in community-based physical activities of their choice for a further nine months is sustained, will be assessed. Community activities will include those done at home, school or wider community, but not therapy-based activities. The children will keep a diary of their physical activities. There will be physical performance and participation outcome measures tested at baseline, before and after the high level mobility programme intervention and after 6 months of follow up for physical performance and 9 months for participation. The research will be run as a SSRD - single subject research design with multiple baselines. Each child will attend 2 sessions per week of the programme during the intervention phase for 3 months. Each session will last 1 hour and be targeted at each child's ability and self selected goals. The programme will use rebounders, agility ladders, small hurdles, cones and balls. It is anticipated that such a programme may support the children’s medium to long term health and well being. The aim is to recruit eight children with cerebral palsy. The children will be placed into two groups based on cerebral palsy mobility classification - gross motor functional classification system (GMFCS). This will form the treatment fidelity. One group of 4 children will be classified GMFCS I - able to mobilise independently over all surfaces but lack high level motor skills of their typically developing peers and the second group GMFCS II - walks without assistive devise but has limitations in walking outdoors, in the community and requires a rail for stairs. Each child will then follow their own course through the SSRD based on their individualised goals.