Occupational Therapy Home Programs for Cerebral Palsy: Double-Blind, Randomized, Controlled Trial

TLDR

The study aimed to evaluate the effectiveness of an occupational therapy home program versus no program on function, parent satisfaction, participation, goal attainment, and upper‑limb skill quality in school‑aged children with cerebral palsy. Thirty‑six children with cerebral palsy were randomized to receive an 8‑ or 4‑week home program or no program, with primary outcomes measured by the Canadian Occupational Performance Measure at 8 weeks and secondary measures at 4 and 8 weeks. Eight weeks of the home program yielded significant improvements in function and parent satisfaction compared with no program, while the 4‑week group continued to 8 weeks and showed similar benefits; no differences were found between the 8‑ and 4‑week groups, and the program proved clinically effective when delivered 17.5 times per month for about 16.5 minutes per session.

Abstract

OBJECTIVE: The goal was to assess the effectiveness of an occupational therapy home program (OTHP), compared with no OTHP, with respect to function and parent satisfaction with child function, participation, goal attainment, and quality of upper limb skill in school-aged children with cerebral palsy. METHODS: Thirty-six children with cerebral palsy (mean age: 7.7 years; male: 69%; Gross Motor Function Classification System: level I, 47%; level II, 14%; level III, 16%; level IV, 7%; level V, 16%; spasticity, 85%; dyskinesia, 14%; ataxia, 3%) were randomly and equally assigned to OTHPs for 8 or 4 weeks or to no OTHP. The primary end point was Canadian Occupational Performance Measure scores 8 weeks after baseline. Secondary measures were recorded at 4 and 8 weeks. RESULTS: Eight weeks of OTHP produced statistically significant differences in function and parent satisfaction with function, compared with no OTHP. Parents in the 4-week OTHP group did not discontinue use at 4 weeks, as instructed, and continued for 8 weeks; results demonstrated statistically significant differences, compared with no OTHP. There was no difference in primary or secondary end point measures between intervention groups. CONCLUSION: Pediatricians can advise families that OTHPs developed with a collaborative, evidence-based approach and implemented by parents at home were clinically effective if implemented 17.5 times per month for an average of 16.5 minutes per session.