La rééducation pédiatrique de la paralysie cérébrale utilisant les niveaux d’évolution motrice répond-elle aux attendus actuels de pratique professionnelle en kinésithérapie ? Enquête par entretiens d’autoconfrontation

Abstract

IntroductionCerebral palsy is the largest cause of motor deficiency in children. However their best practice recommendations for rehabilitation spark debate. The relevance of the work of “motor development milestone” is criticized in this regard. This study aims to identify the professional practice expectations and to observe whether invariants can be observed during care built on the work of “motor development milestone” for children with cerebral palsy (CP) in order to know whether they meet these expectations. MethodA literature review was conducted to identify the expectations of professional practice for the rehabilitation of CP children using qualitative analysis sorted by thematization to construct an analysis grid. An observational study of practice by a selfconfrontation interview with 3 independent physiotherapists was carried out. The interviews were analyzed using the grid in order to first identify possible invariants of practice and then, if necessary, to link them to the expectations of professional practice. ResultsForty-one “sub-headings” were identified to describe the professional practice expectations for the rehabilitation of CP children. Analysis of the self-confrontation interviews showed that 24 subheadings were common to all 3 observations. The subheadings most represented in the literature review were most often encountered during the sessions. Discussion/ConclusionThe results suggest that there are practice invariants in rehabilitation using NEM for CP children and that they partially meet practice expectations. The development of good practice guidelines, the EBP and patient expectations require justification of therapeutic choices and their performance. Their formalization must be developed in order to make them assessable according to validated scientific standards.