Effectiveness of intensive training for children with cerebral palsy – a comparison between child and youth rehabilitation and conductive education

Ödman, Pia; Öberg, Birgitta

doi:10.1080/16501970510032622

Cited by 36 publications

(30 citation statements)

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“…If needed, further probing was performed to elucidate parents' thoughts or perception of the group setting, the environment, intensity and parent-participation as these were considered to be characterizing aspects IGT. Since previous studies had shown similar outcome on functioning and parents' perception of the service-quality between two IGT in these settings [14,22,23], no difference was made whether training was performed within a child and youth habilitation approach or with the conductive education (CE) approach. The sequence of asking questions varied and parents'…”

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confidence: 99%

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Parents' conceptions of intensive group training. The case of cerebral palsy

Ödman

Richt

Öberg

2009

Disability and Rehabilitation

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Purpose:The aim was to explore what wants and needs intensive group training (IGT) fulfil for parents to children with CP and what problems that may arise due to participation. Methods:A phenomenograpical approach was used. Semi-structured interviews were conducted to elicit information about what participation means to parents. Results: Five overarching categories expressing positive functions of IGT were identified: IGT as knowledge promotion, as a complementary training resource, as a bracket to ordinary life, as a means to promote relations with therapists, and as a leisure-activity. One category: IGT as risk for ill-being expresses perceived problems. Each category is in turn divided into a number of subconceptions -13 conceptions of this kind were identified. Conclusions: The conceptions express positive and negative functions of IGT as perceived by parents. These functions in turn can be considered as reflections of basic wants and needs. The results demonstrate that IGT have a potential to contribute to feelings of enhanced care competence among parents, of being supported and of increased strength and vitality. All parents didn't have needs of participation in IGT for themselves. There is also a risk that IGT is experienced as an additional burden and may have negative effects on family-functioning.Key words: Cerebral Palsy, Therapeutics, Qualitative research, Conductive Education, Intensive group trainingIn family-centered child and youth habilitation it is believed that the functioning of the child is enhanced in a supportive family and in an ordinary life context [1,2]. Different functional therapy approaches, based on theories of motor control and learning, have evolved within this framework. These approaches do not rule out training in segregated settings adapted for training acitivities, but commonly advocate that habilitation should take place in the ordinary enviroment of the child [3][4][5]. Goals should be set in collaboration with the child and family and accomplishment of tasks should be reached by identifying resources and changing constraints in the child, task, or the environment [5][6][7].Within the Swedish child and youth habilitation intensive group training (IGT) is offered to children with Cerebral Palsy (CP) and their parents. IGT is pursued in segregated contexts and is considered to be a complement to interventions done in the ordinary life environment. Such training is also offered by private caregivers working with conductive education (CE).Typically, IGT help children exercise functional skills or prerequisites for functional skills over a 3-4 week period, with reiteration of movements and activities day after day. The groups are organized according to the child's level of function and age. Participation of parents, close relatives, and/or assistants is desirable or required and is seen as a means to improve their skills in supporting the child in ordinary life. An important target with interventions is to enhance parents' well-being [8] and feelings of competence in supporting...

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confidence: 99%

“…Rephrasing and probing were used to get a deeper understanding [24] (p.162). The interviewer was not involved in delivering any of the IGT but had experience working with disabled children and evaluating intensive training for children with CP [14,22,23]. …”

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confidence: 99%

Parents' conceptions of intensive group training. The case of cerebral palsy

Ödman

Richt

Öberg

2009

Disability and Rehabilitation

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“…However, there was no difference between the two training programmes in parents' perceptions of functional improvements after the ITP, which is in line with previously reported findings on functional outcomes. 19,20 Parent participation was less important if parents had previous experiences of training programmes. This implies that not all parents perceived that active parent participation was important for the child or themselves, in line with previous findings.…”

Section: Discussionmentioning

confidence: 99%

“…19,20 Parents' perceptions of the service quality were investigated for the same cohort in a structured telephone interview after the ITP.…”

Section: Designmentioning

confidence: 99%

“…18 When a 4-week intensive training programme of physical, social, and communicative skills using the Lemo-approach, an aspect of child and youth rehabilitation within public health care, was compared with conductive education at a private centre, Frosunda Move&Walk, no major difference was found in functional outcome. 19,20 One intensive training period (ITP), regardless of the training approach, facilitated improvements in gross motor function, 20 and in both training programmes parents' expectations about functional outcome mainly involved movement-related body functions or mobility skills. 19 The aim of this study was to evaluate parents' perceptions of the service quality of the two training programmes, Lemo and Move&Walk, and to explore the association between defined factors included in a previously published framework for patients' evaluation process 15 and parents' perceptions of the service quality.…”

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confidence: 99%

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Parents' perceptions of the quality of two intensive training programmes for children with cerebral palsy

Ödman

Krevers

Öberg

2007

Develop Med Child Neuro

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This study explored parents' perceptions of the service quality of two intensive training programmes and the association between perceived service quality and predefined influential factors. Parents of 31 males and 19 females with spastic, dyskinetic, and ataxic cerebral palsy (mean age 8y 7mo [SD 3y 7mo]; range 3-16y), and Gross Motor Function Classification System Level I n=1; Level II n=9; Level III n=8; Level IV n=20; and Level V n=12 were included. Functional outcome had been evaluated previously with the clinical measures Gross Motor Function Measure-88, the Pediatric Evaluation of Disability InventoryFunctional Skills, and the Self-reported Individualized Goal Measure, before and after a 4-week intensive training period (ITP). The two training programmes used were Lemo and Move&Walk. After the ITP, a telephone interview was performed with the same cohort, using the Patient perspective On Care and Rehabilitation process. Data on previous experiences, expectations, and severity of disability were collected before the ITP, and data on achieved expectations afterwards. Previous experiences of the training programme, high expectations of improvements, achieved expectations, gross motor capacity improvements, and intensive training at the child and youth rehabilitation centre were associated with increased probability of fulfilment of needs. Severity of disability was associated with decreased probability of fulfilment of needs and functional improvements. Most parents perceived high service quality, and achieved expectations were influenced by high service quality rather than by perceived functional improvements. This suggests that needs other than functional improvements must be explained and acknowledged.The influence of cerebral palsy (CP) on the functioning of the child is highly variable and gives rise to multiple health care needs. [1][2][3] It is generally thought that the child's needs should be seen in the context of the family and should be defined from the perspectives of both the family and the child in collaboration with health care providers. 4,5 The concept of familycentred services, as opposed to a provider-centred approach, is widely accepted and considered the best way to meet different needs. 4,6 When using a family-centred approach, quality evaluations are needed that measure aspects of the process as well as health and functional outcome. 4,7-9 Service quality could be seen as a measure of parents' perceptions of the rehabilitation process; i.e., the performance of health care providers in meeting value-based needs considered to represent important health care needs. 8 To take into account both professional and family perspectives on functional outcomes, traditional clinical measures should be complemented by measures of self-reported individualized goals. 4 Quality evaluations can help parents to make informed choices about which service to use and can help professionals to adapt intervention programmes to the needs of the child and family, thereby constituting a consumer influence on the...

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2018

Treatment of Cerebral Palsy and Motor Delay

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Effectiveness of intensive training for children with cerebral palsy – a comparison between child and youth rehabilitation and conductive education

Cited by 36 publications

References 41 publications

Parents' conceptions of intensive group training. The case of cerebral palsy

Parents' conceptions of intensive group training. The case of cerebral palsy

Parents' perceptions of the quality of two intensive training programmes for children with cerebral palsy

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