Structured home-based exercise program to improve ADL and participation among children with cerebral palsy

Abstract

Motor function, activities of daily living (ADL) and participation are of primary concerns of parents or caregivers with cerebral palsy (CP) children. This structured home-based exercise program (SHEP) was developed to offer a practical exercise program, which includes all components of exercise for both upper and lower limbs to improve the above functions. Eleven children participated in this study [7 males and 4 females, mean age 10y 3mo, standard deviation (SD) 3y] with Gross Motor Function Classification System (GMFCS) I–III. The multiple baseline study design was used to measure SHEP effects on ADL with Pediatric Evaluation in Disability Inventory - Computer Adaptive Test (PEDI-CAT), children's participation with Children's Assessment of Participation and Enjoyment (CAPE) questionnaire and motor function (GMFM-66). An exercise logbook was given and OMNI-RPE scale was taught to caregiver and children to monitor exercise intensity. Outcome assessments were done at pre-intervention, intervention and post-intervention phases. The intervention with SHEP phase was done for eight weeks. Two assessments were done at one month and three months post-intervention. Comparison between means of each phases were analyzed using Repeated Measure (RM) Anova and Paired t -test when appropriate. SHEP improves ADL, PEDI-CAT ( P = 0.028, d = 0.5) and participation at Where-domain, CAPE questionnaire ( P = 0.047, d = 0.8) as well as motor function, GMFM-66 ( P = 0.04, d = 0.14) during the intervention period. SHEP is a practical and quick exercise intervention, which can be done at home to achieve short-term goal in improving motor function, activities of daily living and participation.