Efficacy of participation-focused therapy on performance of physical activity participation goals and habitual physical activity in children with cerebral palsy: a randomized controlled trial.

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Efficacy of participation-focused therapy on performance of physical activity participation goals and habitual physical activity in children with cerebral palsy: a randomized controlled trial.

Arch Phys Med Rehabil. 2018 Dec 10;:

Authors: Reedman SE, Boyd RN, Trost SG, Elliott C, Sakzewski L

Abstract
OBJECTIVE: To determine the efficacy of a participation-focused therapy (ParticiPAte CP) on leisure-time physical activity goal performance and satisfaction and habitual physical activity (HPA) in children with cerebral palsy (CP).
DESIGN: Randomized waitlist-controlled trial.
SETTING: Home and community.
PARTICIPANTS: Thirty-seven children Gross Motor Function Classification System (GMFCS) I-III were recruited (18 males, mean age 10y 0mo [SD 1y 5mo]) from a population-based register.
INTERVENTIONS: Participants were randomized to ParticiPAte CP (an 8-week goal-directed, individualized, participation-focused therapy delivered by a physical therapist) or waitlist usual care.
MAIN OUTCOME MEASURES: The primary outcome was Canadian Occupational Performance Measure (COPM). Accelerometers were worn for objective measurement of HPA (min·day-1 moderate to vigorous physical activity, MVPA, and sedentary time). Barriers to participation, community participation, and quality of life outcomes were also collected. Data were analysed by intention-to-treat using generalized estimating equations.
RESULTS: ParticiPAte CP led to significant improvements in goal performance (MD=3.58, 95% CI=2.19 to 4.97, p<0.001), satisfaction (MD=1.87, 95% CI=0.37 to 3.36, p=0.014), and barriers to participation (MD=26.39, 95% CI=6.13 to 46.67, p=0.011) compared with usual care at eight weeks. There were no between group differences on min·day-1 MVPA at eight weeks (MD=1.17, 95% CI=-13.27 to 15.61, p=0.874). There was a significant difference in response to intervention between participants who were versus were not meeting HPA guidelines at baseline (MD=15.85, 95% CI=3.80 to 27.89, p<0.0061). Following ParticiPAte CP, low active participants had increased average MVPA by 5.98 (SD=12.16) min·day-1.
CONCLUSION: ParticiPAte CP was effective at increasing perceived performance of leisure-time physical activity goals in children with CP GMFCS I-III by reducing modifiable barriers to participation. This did not translate into change in HPA on average, however low active children may have a clinically meaningful response.

PMID: 30543803 [PubMed - as supplied by publisher]

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