Assessment of Saudi Physicians and Physical Therapists' Adherence to the Updated Clinical Practice Guideline for Benign Paroxysmal Positional Vertigo: A Cross-Sectional Study

Abstract Introduction Variations in clinical practice regarding the management of benign paroxysmal positional vertigo (BPPV) among clinicians have been noted in previous studies. Such variations might be related to the different adherence to clinical practice guidelines. Objective To evaluate clinicians' adherence to BPPV guidelines and investigate the variations in the adherence between different specialties and qualifications. Methods This is a cross-sectional study with a vignettes-based survey conducted between June and August, 2020. We included clinicians engaged in managing BPPV that had at least one year of clinical experience. We excluded students, and clinicians who were not involved in the management of individuals with BPPV. Participants were asked to make their management choices based on four hypothetical patient vignettes. The sample ranged from 77 participants for the first vignette to 45 participants for the last vignette. Results We included 77 clinicians in the study, with the majority being Otolaryngologists (31.2%). The respondents' mean adherence to the guideline was of 63.3%. Result showed that Otolaryngologists' adherence was higher than that of clinicians from different specialties (p = 0.006, d = 0.72). Furthermore, clinicians with a postgraduate degree were more likely to adhere than those with a bachelor's degree only (p = 0.014, d = 0.58) and participants who were aware of the guideline were more likely to adhere to it (p < 0.001, d = 1.05). Lastly, regression analysis exhibited that adherence was affected by postgraduate degree and guideline awareness. Conclusion Otolaryngologists were more likely to adhere to the guideline than other specialties. Among all specialties, higher adherence was associated with guideline awareness and postgraduate degrees.

7. Rainbow Network for Rehabilitation Specialists (Nijiiro Rehab Net) / 医学教育

Rainbow Network for Rehabilitation Specialists (Niijiro Rehab Net) is a voluntary organization of rehabilitation professionals interested in SOGI (Sexual Orientation & Gender Identity).　Members from various professions and fields have come together under the common understanding that SOGI is important in rehabilitation. Since its establishment in 2020, journal clubs, online training sessions, and education at schools have been conducted.　"Rehabilitation" means "total restoration of human rights". It is necessary to continue extending our activities, focusing on how professionals could contribute to people with various SOGI conditions so they may "live as they are".

Nível de atividade física de fisioterapeutas de um hospital público / Level of physical activity of physical therapists at a public hospital

Objetivo: avaliar o nível de atividade física dos fisioterapeutas e identificar o perfil socioeconômico desses profissionais de um hospital público de grande porte em Goiânia. Métodos: Trata-se de um estudo observacional, transversal e quantitativo realizado de abril a agosto de 2020. Foram incluídos fisioterapeutas de ambos os sexos, contratados há no mínimo seis meses, e que assinaram o termo de consentimento livre e esclarecido. Excluídos da pesquisa aqueles em férias ou licença médica no período da coleta de dados. Para avaliar o nível de atividade física utilizou-se o Questionário Internacional de Atividade Física (IPAQ), e um questionário para conhecer o perfil socioeconômico desses profissionais. As variáveis contínuas foram apresentadas como média e desvio padrão, enquanto as categóricas, em frequência absoluta e relativa. Resultados: Grande parte dos indivíduos é do sexo feminino (73,5%) com maior prevalência de inativos (76%), sendo que (49,9%) cumprem carga horária maior que 30 horas semanais. Do total da amostra (61,8%) tem pelo menos especialização na sua formação profissional. Conclusão: Os fisioterapeutas do serviço público apresentam o nível de atividade física reduzido, com maior proporção classificados como inativos, segundo a OMS.

Purpose: evaluate the level of physical activity of physical therapists and identify the socioeconomic profile of these professionals in a large public hospital in Goiânia. Methods: This is an observational, cross-sectional and quantitative study carried out from April to August 2020. Physical therapists of both sexes, hired for at least six months, and who signed a free and informed consent form, were included. The research excluded those on vacation or sick leave during the data collection period. In order to assess the level of physical activity, the International Physical Activity Questionnaire (IPAQ) was used, as well as a questionnaire to learn about the socioeconomic profile of these professionals. Continuous variables were presented as mean and standard deviation, while categorical variables were in absolute and relative frequency. Results: Most of the individuals are female (73.5%) with a higher prevalence of inactive people (76%), and (49.9%) working more than 30 hours per week. From the total sample, 61.8% were at least specialists in their areas. Conclusion: Public service physical therapists have a reduced level of physical activity, with a greater proportion being classified as inactive, according to WHO.

Development and content validation of a questionnaire on the perception of PPE usage in response to COVID-19 for Filipino physical therapists: A study protocol

BACKGROUND@#The COVID-19 pandemic has led to innumerable challenges in the practice of physical therapy (PT) in both local and global settings. Healthcare settings often use Personal Protective Equipment (PPE) to prevent contamination. Despite its benefits, compliance is challenged by issues such as discomfort, availability, accessibility, and individual perception. @*OBJECTIVES@#Considering the contrasting roles and nature of healthcare practitioners' work and the differences in the demands of PPE usage, this study aims to develop a profession-specific questionnaire on the perceptions of physical therapists on PPE usage in response to the COVID-19 pandemic with good face and content validity.@*METHODS@#The study comprises Phase 1 for questionnaire development and Phase 2 for questionnaire validation. Five experts recruited using purposive sampling participated in three rounds of the validation process. Each expert evaluated the face and content validity through Google Forms. Consequently, an expert panel evaluation to reach a consensus on the final items. Google sheets were utilized for analysis.@*EXPECTED RESULTS@# The final questionnaire will have 35 items covering the Health Belief Theory domains. All items will receive FVI (overall agreement scores), I-CVI, S-CVI/Ave, and S-CVI/UA scores that meet the cut-off. The final questionnaire will be useful in evaluating physical therapists' perceptions of using PPE due to COVID-19 and may also be helpful to organizations, policymakers, and other entities in their decision-making for PPE protocols, guidelines, and implementation. Future researchers can use this study to conduct a pilot study that assesses other psychometric properties of the tool.

Commonly used outcome measurement tools in pediatric physical therapy telerehabilitation in the Philippines: A quantitative cross-sectional descriptive study protocol

BACKGROUND@#With the COVID-19 pandemic, the need for social distancing presents an apparent barrier to in-clinic consultation. Therefore, the adoption of telerehabilitation has rapidly increased to improve access and minimize cross-infection risk to patients. Nevertheless, Filipino pediatric physical therapists must ensure that they conduct evidence-based procedures for specific tests and measures to determine patient outcomes. The utilization of outcome measurement tools (OMTs) enhances the quality of assessment in clinical decision-making and provides a credible and reliable justification for treatment on an individual patient level. However, a lack of information on utilizing OMTs in telerehabilitation by pediatric physical therapists internationally and locally is evident@*OBJECTIVE@#To determine the most common pediatric OMTs used in telerehabilitation by Filipino pediatric physical therapists catering to 0 to 21-year-olds in the Philippines.@*METHODS@#The study will use an adapted questionnaire to gather data on common OMTs used during pediatric telerehabilitation. Phase I will include the validation of the 15-item adapted questionnaire by determining the content validity index. In Phase II, participants will be recruited through email and social media. Descriptive statistics will be used to report participants' responses@*EXPECTED RESULTS@#In Phase I, the expected result is a valid and reliable questionnaire to investigate the common OMTs used in pediatric telerehabilitation for Phase II. The results will be synthesized to inform other researchers and clinicians and encourage nonusers to utilize OMTs despite the challenge of the pandemic. The study can give insights to stakeholders on what OMTs optimize pediatric telerehabilitation.

Competency Model of Physical Therapists in China: An Exploratory Research / 中国康复理论与实践

Objective:To construct the competency model of physical therapists in China. Methods:A set of physical therapists' competency elements was established based on literature review and expert interviews. A questionnaire was designed based on the set, and 641 rehabilitation practitioners were investigated (521 valid questionnaires returned) with the questionnaire. Exploration factor analysis was used to construct the competency model of physical therapists, and confirmatory factor analysis was used to confirmed. Results:The set of physical therapists' competency elements included 74 elements in four dimensions. There were 44 competency elements in the competency model of physical therapists, including five dimensions that were Professionalism and Moral Conduct, Knowledge and Skills of Evaluation and Intervention, Abilities of Educational-Research and Advocate, Abilities of Cooperation and Management, and Basic Knowledge of Discipline, covering 74.41% of the total variance. The Cronbach's α coefficient of the whole questionnaire and each dimension was more than 0.8. Model fitness indexes of confirmatory factor analysis were as follow: χ2/df = 2.340, Root Mean Square Error of Approximation = 0.060, Goodness of Fit Index = 0.746, Normed Fit Index = 0.811, Incremental Fit Index = 0.850, Comparative Fit Index = 0.850. Conclusion:The competency model can provide a basis for physical therapists to become independent occupation, as well as for the education, selection, evaluation of physical therapists in China.

Review for the Curriculum and License Exam of Physical Therapists in the United States

PURPOSE: This study was conducted to review the curriculum and license examination of physical therapists in the United States. METHODS: The doctor of physical therapy (DPT) curriculum was evaluated by a review Course Work Tool version 6 (CWT6) data and current physical therapy licensure examination (National Physical Therapy Exam, NPTE) category in the United States. RESULTS: The results indicated that they were required to meet the doctor of physical therapist degree based on ‘Guide to Physical Therapist Practice’ of American Physical Therapy Association (APTA). This includes general education in the areas of communications and humanities, physical science, biological science, social and behavioral science, and mathematics. A minimum of one course must be completed successfully in each area of general education. Moreover, there should be at least 68 didactic credits of professional education and 22 clinical education credits, which is a minimum of two full-time clinical internships with no less than 1050 hours in total, which were supervised by a physical therapist. Regarding the physical therapy licensure examination, National Physical Therapy Exam (NPTE, 2016) consisted of a physical therapy examination (26.5%), evaluation, differential diagnosis, baseline of prognosis (32.5%), intervention (28.5%), protection, responsibility, and research (6.5%) based on the ‘Guide to Physical Therapist Practice’. CONCLUSION: Based on the study results provided above, it is considered a standard to meet domestic reality as the Guide to Physical Therapist Practice of APTA for South Korean physical therapists.

Dotación de kinesiólogos en unidades de pacientes críticos de adultos en hospitales públicos chilenos / Staffing of physiotherapists in critical adult patient units in chilean public hospitals

INTRODUCCION: Actualmente en Chile no existe un registro respecto a la razón kinesiólogo: cama (rK:C) en las unidades de paciente crítico de adultos (UPCa) de los hospitales públicos del país. El objetivo de esta investigación fue describir la dotación de kinesiólogos en las UPCa de hospitales públicos chilenos MÉTODOS: Estudio descriptivo transversal realizado entre junio y agosto de 2015. Se incluyeron los hospitales del sistema público con UPCa. Se aplicó una encuesta electrónica a los coordinadores de Kinesiología de cada hospital. Las variables primarias fueron: Número de camas y kinesiólogos, disponibilidad de 4° turno, calidad contractual y estudios de postgrado. El análisis estadístico se realizó en el programa SPSS v.19. RESULTADOS: La población total correspondió a 45 hospitales, de los cuales 34 (75,5%) respondieron la encuesta. El número total de camas y kinesiólogos fue 953 y 233 respectivamente. El promedio de camas de UPCa por kinesiólogo en horario diurno de lunes a viernes (L-Vd) fue de 12,5 (ESM= ±1.3). Dicha cifra aumenta a 20,2 (ESM= ± 2.1) durante fines de semana y festivos (F-Fd). El 32,4% de los hospitales no poseía sistema de cuarto turno. De acuerdo a calidad contractual, el 32,6% del total de kinesiólogos a nivel poseían contrato indefinido, el 42,6% a plazo fijo y el 24,8% a honorarios. En relación a estudios de postgrado, el 60,9% había cursado diplomados del área y el 33,5% no poseía estudios posteriores. CONCLUSIÓN: La rK:C en las UPCa del sistema público de salud es de 1:12,5 de L-Vd y de 1:20,2 durante F-Fd, cifra que supera a las recomendaciones internacionales.

INTRODUCTION: Currently in Chile there is no record on the amount of physical therapists (PTs) and PTs: bed ratio in adult intensive care unit (ICU) of public hospitals. The objective was to describe PTs staff on adult ICU in chilean public hospitals. METHODS: Cross- sectional study conducted between June and August, 2015. Public system hospitals with adult ICU were included. An email survey was sent to physical therapist leader of each hospital. The primary variables were: number of beds and PTs, availability of night shift, contract type and graduate studies. Statistical analysis was performed using SPSS v.19 program. RESULTS: The total population was 45 hospitals. 34 (75.5%) answered the survey. The number of beds was 953 and the number of PTs was 233. The average of ICU beds for PTs was 12.5 (SD=7.7) in daytime on weekdays. This number increases to 20.2 (SD= 14.0) during weekends and holidays. 32.4% of hospitals had no night shift system. According to contract type, 32.6% of PTs had permanent contract, 42.6% had fixed term contract and 24.8% had fee contracts. Regarding the graduate level, 60.9% had completed ICU postgraduate and 33.5% had no graduate studies. CONCLUSION: The PTs: bed ratio in the adult ICU of public health system is 1:12.5 in daytime on weekdays and 1:20.2 in weekends and holidays, exceeding international recommendations.

Ventilación no invasiva en insuficiencia respiratoria aguda pediátrica: rol del terapeuta ventilatorio / Non-invasive mechanical ventilation in pediatric acute respiratory failure: the role of the respiratory therapist

Currently, Chilean pediatric intensive care units use non-invasive mechanical ventilation as ventilation support in acute respiratory conditions. However, there are differences in methodology and the number of patients treated annually. These units have a physiotherapist who has progressively incorporated skills related to non-invasive mechanical ventilation application, as well as to other forms of respiratory support and care in general. At present the role of the therapist is fundamental to the ventilatory support of patients with acute respiratory failure

En la actualidad todas las unidades de cuidados intensivos pediátricos nacionales utilizan Ventilación Mecánica no Invasiva como método de soporte ventilatorio en condiciones agudas, no obstante, estas difieren en metodología de aplicación y número de pacientes conectados anualmente. El kinesiólogo que se desempeña como terapeuta respiratorio en estas unidades, ha incorporado de manera progresiva competencias técnicas que lo relacionan con la aplicación de la ventilación no invasiva, así como con otras formas de soporte ventilatorio y cuidados respiratorios en general. Particularmente en ventilación mecánica no invasiva, existe importante dependencia de los cuidados que este profesional puede ofrecer y que son requeridos durante todo el desarrollo de la terapia

Physical therapists role in Family Health Support Center / Atuação do fisioterapeuta no Núcleo de Apoio à Saúde da Família

Abstract Introduction: The creation of Family Health Support Centers (FHSC) configured advances in health care policy, however, it must recognize challenges of structural and logistical conditions for physiotherapist's role in Primary Care (PC). Objective: The study aimed to describe the physiotherapist's role in the context of the Family Health Support Centers. Methods: It was held a quantitative survey with a cross-sectional census of Physiotherapists working in FHSC in the city of Salvador, Bahia. The instrument was a questionnaire designed by the researchers, and was based, prior readings related to the theme of work. Results: There was the presence of the physiotherapist in all teams FHSC, with a predominance of type I and FHSC recent effective linkages work. Difficulties were presented that permeates from accountability among workers, managers and users of services, the operational issues such as lack of resources, transport and dismantling of the health care system in which led most of the limitations of working in FHSC. Regarding the physiotherapist's work demands in FHSC, presented greater representation for situations with neurological patients and related activities gerontology. Conclusions: Despite the challenges, the enlargement perspective of care services Primary Care to the physiotherapist is promising, in the proposed within the proposed comprehensive care to prevention and primary care users care, and that reflects, a step further decentralization of physiotherapy in the levels of health care.

Resumo Introdução: A criação dos Núcleos de Apoio à Saúde da Família (NASF) configurou avanços na política de atenção à saúde, entretanto, é necessário reconhecer desafios das condições estruturais e logística para atuação do fisioterapeuta na Atenção Básica (AB). Objetivo: Descrever o contexto da atuação do Fisioterapeuta no Núcleo de Apoio à Saúde da Família. Métodos: Foi realizada uma pesquisa quantitativa do tipo transversal com um censo dos Fisioterapeutas que trabalham no NASF, na cidade de Salvador, Bahia. O instrumento utilizado foi um questionário construído pelas pesquisadoras, e teve como base, leituras prévias relacionadas ao tema do trabalho. Resultados: Verificou-se a presença do profissional fisioterapeuta em todas as equipes do NASF, com predomínio do NASF tipo I e vínculos efetivos recentes de trabalho. Foram apresentadas dificuldades que perpassam desde a corresposabilização entre os trabalhadores, gestores e usuários dos serviços, às questões operacionais como falta de recursos, transporte e desarticulação da rede de saúde no qual lideraram a maior parte sobre as limitações do trabalho no NASF. Em relação às demandas de trabalho do Fisioterapeuta no NASF, apresentou maior representatividade para as situações com pacientes neurológicos e atividades relativas a gerontologia. Conclusão: Apesar dos desafios, a perspectiva de ampliação dos serviços de Atenção Básica para o fisioterapeuta é promissora, dentro da proposta de atenção integral para a prevenção e cuidado dos usuários da atenção básica, e que reflete, um passo frente a descentralização da fisioterapia nos níveis de atenção à saúde.

Certified Hand Therapist Exam and Credential System of the United States:Introduction and Implication / 中国康复理论与实践

This study descriptively illustrated the definition of certified hand therapist, eligibility requirement and accreditation system based on the official guidelines from American Society of Hand Therapists (ASHT), Hand Therapy Certification Commission (HTCC) and Handbook of Certified Hand Therapy Examination. Besides, this exam was compared with National Physical Therapy Examination (NPTE) and Occupational Therapist Registered Examination (OTR Exam). The testing domains and contents may help the domestic teaching faculty to standardize the course syllabi, promote divided development of physical therapy and occupational therapy in a specialized manner, and ex-erted positive impact for promoting establishment of the hand specialists and accreditation system of China itself.

Research Status of Competency for Physical Therapist (review) / 中国康复理论与实践

Competency has been talked and studied a lot on management science. This article briefly reviewed the concept of competen-cy and competency model with its construction methodology. The details of the documents (or analogous documents), that described the competencies for physical therapist published by Ireland, UK, Canada, USA, World Confederation for Physical Therapy, and Australia, were introduced. Then the research development of competencies for physical therapist in China was represented.

Knowledge and attitudes towards evidence-based practice among clinical physical therapists in Metro Manila / The Health Sciences Journal

Introduction @#The study aimed to determine the demographic profile of clinical physical therapists in Metro Manila, their knowledge and attitudes towards evidence-based practice and the relationship of their educational background to knowledge and attitudes towards evidence-based practice.@*Methods @#A quantitative correlational research design was utilized to describe the profile, knowledge and attitudes of clinical physical therapists, selected by purposive sampling, towards evidence-based practice. An adapted Likert-type questionnaire was utilized to gather data necessary to the study.@*Results @#Majority of 33 respondents had their basics of evidence-based practice as part of their academic preparation and had positive attitudes towards evidence-based practice. There was a weak non-significant correlation of educational background with knowledge of evidence-based practice and no correlation with attitudes towards evidence-based practice@*Conclusion @#Educational background may be factor in terms of knowledge of evidence- based practice. However, educational background is not correlated with the personal attitudes towards evidence-based practice.

Survey on Clinical Application of 'Neurodevelopmental Treatment'

OBJECTIVE: To investigate the recognition about clinical application of "neurodevelopmental treatment (NDT)". METHOD: We surveyed on the recognition for Bobath and NDT concepts and its training programs provided by Korean Academy of Rehabilitation Medicine from Jan 2009 to Feb 2009. The survey was made for physiatrists and physical therapists (PTs), separately. One hundred twelve physiatrists and 322 PTs have participated. RESULTS: In physiatrist, interest in NDT was very high (98%), and the need for further knowledge of NDT was also high (95%). Though the NDT was mainly used techniques in neuro-rehabilitation setting, the expectation about effectiveness of it was moderate (56%) and the requirement of changing concepts of the NDT was very high (93%). PTs have carried out NDT most frequently with Bobath's concepts, but they also did not regard NDT as the best procedure. PTs emphasized the importance of their handling technique in NDT practices and also had high interest in the other maneuvers beside Bobath's. CONCLUSION: Physiatrists and PTs regard NDT as one of the most important treating method for patients with brain lesions, but it is not approved as the most effective method yet. Nowadays NDT is changing or adapting, with discarding some of the old Bobath's concepts and adding new modern scientific knowledge. Therefore we suggest that physiatrists to give PTs the revised NDT concepts and evidence based the other therapeutic methods. And the NDT needs to be verified its therapeutic efficacy with evidence based view points through proper studies.

Prevalencia de sintomatología compatible con rizartrosis en la profesión de fisioterapeuta en colombia, replica / Prevalence of rhizarthrosis compatible symptomatology in physiotherapy profession in Colombia

La rizartrosis es la degeneración de la base del pulgar. Ésta lesiona la articulación metacarpofa-lángica y su síntoma más común es el dolor. El objetivo de éste estudio es describir la frecuencia sintomatológica compatible con rizartrosis y determinar los factores relacionados con su desa-rrollo en la población de fisioterapeutas de diferentes ciudades de Colombia.Para tal fin entre los meses de Noviembre y Diciembre de 2011, se aplicó una encuesta para identificar la sintomatolo-gía de la patología en una muestra de 59 fisioterapeutas en ejercicio asistencial de su profesión. El análisis de datos comprende dos componentes, uno descriptivo y otro correlacional, que se realizaron mediante el programa SPSS.La edad media de los participantes fue de 32 años y el 50% de la población ejerce como fisioterapeuta hace más de 6 años, trabaja más de 3 horas diarias y utiliza el pulgar en el 60% del tiempo laboral. 22 participantes reportan dolor pero solo el 1.7% de estos manifiesta dolor en la articulación trapeciometacarpiana. Adicionalmente, se encontró relación entre el dolor y los procedimientos de masaje, digitopresión y de agarres. Se concluye que la fisioterapia se puede considerar una profesión en riesgo para desarrollar sintomatología compatible con rizartrosis, siendo los esfuerzos de masaje, digitopresión y agarres, los que favo-recen su desarrollo.

Rhizarthrosis is the degeneration of the base of the thumb. It injuries the trapeziometacarpal joint and its most common symptom is pain.The objective of this study to describe the frequency of symptomatology compatible with rhizarthrosis and to determine the factors related to its development among the physiotherapist in different Colombian cities. For this purpose during the months of November and December in 2011 was applied a survey to identify the symptomatology of the pathology in a sample of 59 therapists in care exercise of their profession. The data analysis includes two components, a descriptive one and a correlational one, made using the SPSS software. The average age of the sample was 32 years and 50% of them has practiced the profession for more than 6 years, works more than 3 hours and uses the thumb 60% of their working time. 22 participants report pain but only 1.7% reports it in the trapeziometacarpal joint. Additionally, relationship was found between pain and massage procedures, digital pressure and holds. It was concluded that p-hysiotherapy can be considered as a profession with high risk to develop symptoms compatible with rhizarthrosis, being the massage efforts, digital pressure and holds the factors that promote its development.

Situation and Development of Technology Literacy of Physical Therapist in China / 中国康复理论与实践

@#The field of rehabilitation medicine physical therapist (PT) training and education has been relatively weak links in China, how to build a rehabilitation therapist team, we constantly explore and get a greater progress. However, most of the time is still confined to empty the contents of most theoretical level, and some basic steps and the specific contents are lacked. How to stabilize therapists team? How to position therapists? It deserves to pay more attentions.

Current Physical Therapy Status for the Children with Cerebral Palsy in Korea

OBJECTIVE: Treatment of children with cerebral palsy needs much time and effort, so it is very hard for many patients to get hospital based treatment. To develop the home treatment program with the parents, we tried to elucidate the current difficulties to which therapists were facing during the treatment of cerebral palsies. METHOD: A cross-sectional study was performed to 250 physical therapists in 110 hospitals with a questionaire by mail. Sixty two universities and general hospitals, 37 rehabilitation centers and 31 community rehabilitation centers were involved in treatment for cerebral palsy, 51% of them are located in Seoul and Kyungi-do. RESULTS: 1) The current treatment time was 33.7 minutes, but most therapists replied that 45 minutes would be optimal. 2) Fifty four therapists (86.1%) had reviewed on introduction or basic course of the Bobath or Vojta program; the duration of the course ranged from 5 days to 1 to 2 months. 3) Fifty five cerebral palsy patients (66.7%) continued treatment for 1 to 2 years and 25% received treatment for more than 2 years. 4) Twenty nine patients (35%) received home therapy from trained parents, 75% of the cases noted significant improvement. CONCLUSION: Cerebral palsy treatment programs require more time than the actural duration of time given during therapy sessions. Thus, parent education for home therapy is considered to be an essential part of cerebral palsy management.