The Effect of Parent-based Occupational Therapy
Condition: Cerebral Palsy; Parents
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      Background/Aims Parents of children with cerebral palsy face higher levels of stress, anxiety
      and depression, sadness, exhaustion and burnout. Parent-based therapies have been found to
      increase parents' satisfaction with therapy, parent-child interactions and reduced parental
      stress. This study examined the effects of parent-based occupational therapy on stress
      levels, coping skills, and emotional skills and competencies of parents of children with
      cerebral palsy.

      Methods A total of 15 children and their parents who were admitted to the paediatric
      rehabilitation unit for occupational therapy were divided into two groups (control group:
      n=7, study group: n=8) using the coin toss randomisation method. The control group received
      standard occupational thearpy, while the study group received parent-based occupational
      therapy for 45 minutes a session, twice a week, until 10 sessions had been completed.
      Participants were evaluated before and after the intervention.
    

Detailed description: 
      Cerebral palsy is a disability characterized by movement and posture disorders, loss of motor
      control, muscle weakness, cognitive deficits, sensory impairment, language and communication
      problems, and epilepsy, resulting from prenatal, perinatal, and postnatal anomalies. This
      disability is accompanied by intellectual disability, as well as behavioral and emotional
      difficulties. Cerebral palsy is one of the main causes of childhood motor disability in
      developed countries and is reported to affect one out of every 500 births. These effects seen
      in cerebral palsy have negative consequences regarding social participation. Therefore,
      interventions for children with cerebral palsy are important and valuable.

      Rehabilitation of children with cerebral palsy includes interventions that target the child's
      problems, skills, opportunities (facilitator), difficulties (obstacle), needs, and
      relationships with their parents. Occupational therapists plan and apply long-term and
      follow-up interventions to improve children's independence in their environment, such as
      self-care, play, school, and leisure time occupations. In studies with children with cerebral
      palsy, evidence-based interventions, such as constraint-induced movement therapy, hand-arm
      bimanual intensive training, hand-arm bimanual intensive therapy including lower extremity
      seem to focus on increasing the functional use of the hemiplegic side.

      The Ayres sensory integration intervention approach aims to increase functional skills with
      necessary sensory experiences and active participation. In addition, the Bobath approach
      focuses on the child's development at a functional level and being able to participate more
      in activities by improving muscle tone and postural control. These interventions can be used
      according to the child's needs. The goal is to improve occupational performance and increase
      social participation.

      The effectiveness of an intervention for children with cerebral palsy is related to the
      amount and intensity of the treatment, as well as the parent's understanding of their
      children's skills and ability to interact with their children. Stress, anxiety and
      depression, sadness, exhaustion, burnout, and disappointment are some of the emotions that
      negatively affect the interactions of parents with their children, as well as the results of
      the intervention.

      Parent-based intervention approaches include parents in the decision-making and
      implementation of rehabilitation for their child. Law et al stated that parent-based
      therapies increased parents' satisfaction with therapy, parent-child interactions and reduced
      parental stress. Barfoot et al observed that a child with cerebral palsy and his parents
      achieved both emotional and physical wins through a parent-based intervention.

      Novak et al found that parent-based occupational therapy home programs contributed positively
      to the development of children with cerebral palsy and reduced caregivers' burden. The
      studies found that the treatment applied to children with cerebral palsy was not sufficient
      and that parents who spend most of their time at home with their children should be included
      in the interventions.

      It is important to benefit from the parents' expertise and for them to see themselves as a
      part of the intervention. Therefore the aim of the present study was to examine the
      effectiveness of the parent-based occupational therapy intervention program on coping skills
      and stress levels in parents of children with cerebral palsy.
    

Intervention name(s): parent-based occupational therapy; Standard occupational therapy intervention
Intervention type(s): Other; Other
Intervention description(s): Parent-based occupational therapy intervention While the therapist, parent and child were in the therapy area in the first session, the child received the same standard occupational intervention as the control group, and during this process, the parents recorded the therapy with a video recorder. In the second 20 minutes, three activities (such as eating, dressing or mobility activities), which had been decided and planned by the parent and the therapist before the session, were performed by the child and helped by the parent and video-recorded by the occupational therapist.; The sessions in this intervention included the creation of a client-based programme to increase each child's individual skills, functions and social participation. Each session lasted 45 minutes and took place twice a week until 10 sessions had been completed.
Various materials such as toys, blocks, paper and pencils were used to increase the child's participation in daily living, leisure and play activities.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: cerebral palsy; coping skills; parents; occupational therapy; stress level