ABSTRACT
OBJECTIVE: The aim of this study is to identify the main processes and outcomes related to family-centred care (FCC) in neuromotor and functional rehabilitation of preschool children with cerebral palsy (CP). BACKGROUND: FCC is considered a reference for best practices in child rehabilitation. CP is the most common cause of physical disability in childhood with repercussions on functionality. There is a gap in knowledge of the practical principles of FCC, and it is necessary to develop a reference model for the practice of child rehabilitation professionals. METHODS: In this scoping review, the main databases selected were as follows: LILACS; Pubmed; Embase; The Cochrane Library; CINAHL (EBSCO); Scopus; Web of Science; PEDro (Physiotherapy Evidence Database); Open Gray and other banks of thesis. The terms combined in the search strategy were as follows: 'Family-centered', 'Family-centred' and 'CP'. Inclusion criteria are as follows: studies on preschool-aged children with CP, undergoing family-centred functional therapeutic interventions (FCFTI) with outcomes on bodily structures and functions and/or activities and/or participation. RESULTS: The main participatory care methods identified were home intervention, environmental enrichment, collaborative realistic goal setting, planning of home-based activities and routine, child assessment feedback, family education/training, family coaching, encouraging discussion, observation of therapist and supervised practice. The main relational care qualities identified were as follows: respect, active listening, treat parents as equals, clear language, respect parents' ability to collaborate, demonstrate genuine care for the family, appreciate parents' knowledge and skills, demonstrate competence, experience and commitment. The main outcomes identified in children were improvement in motor and cognitive function and the child's functional ability. The main parentaloutcomes identified were empowerment, feeling of competence, self-confidence, motivation and engagement. CONCLUSION: The main differences in FCFTI programs refer to the parental education/guidance component and the amount of intervention carried out by parents. It is possible that the elements chosen by the therapist in a FCFTI depend on characteristics of the child and caregivers.
Subject(s)
Cerebral Palsy , Humans , Cerebral Palsy/rehabilitation , Child, Preschool , Child , Patient-Centered Care , Family Therapy/methods , Professional-Family RelationsABSTRACT
BACKGROUND: Stroke has been increasingly recognized as an important morbidity and mortality factor in neonates and children. Children have different and more diverse risk factors than adults, commonly related to an underlying disease. Stroke may compromise functional capacity in children. Few studies have focused on functional outcomes related to activities and participation. OBJECTIVES: To investigate post-stroke functionality of children related to self-care, mobility, and social function. METHODS: We assessed the functional outcome of 14 children younger than 7.5 years who suffered a stroke in early childhood through the use of the Pediatric Evaluation of Disability Inventory (PEDI). RESULTS: The average age of the sample at assessment was 3.6 ± 1.4 years (2 - 6 years). The average scores in the PEDI functional domains of self-care, mobility, and social function were, respectively, 37.6 ± 15.4, 36.2 ± 15.4, and 48.7 ± 11.1. Children showed age-appropriate functional outcomes in the PEDI functional domains: 71.4% of them in self-care and mobility and 92.9% in social function. Children with bilateral injuries (p = 0.05) and longer hospital stays (r = -0.79, p = 0.001) showed the worst scores in ââPEDI's social function domains. CONCLUSIONS: Overall, our sample of preschool children showed age-appropriate functional outcomes on self-care, mobility, and social function domains after stroke. However, children with bilateral injuries and longer hospital stays showed the worst scores in social function domains. We recommend focusing on functional rehabilitation to promote activities and participation and to monitor the development of children's social skills after stroke.
Subject(s)
Self Care , Stroke , Activities of Daily Living , Adult , Child , Child, Preschool , Cohort Studies , Disability Evaluation , Humans , Infant, NewbornABSTRACT
ABSTRACT Background: Stroke has been increasingly recognized as an important morbidity and mortality factor in neonates and children. Children have different and more diverse risk factors than adults, commonly related to an underlying disease. Stroke may compromise functional capacity in children. Few studies have focused on functional outcomes related to activities and participation. Objectives: To investigate post-stroke functionality of children related to self-care, mobility, and social function. Methods: We assessed the functional outcome of 14 children younger than 7.5 years who suffered a stroke in early childhood through the use of the Pediatric Evaluation of Disability Inventory (PEDI). Results: The average age of the sample at assessment was 3.6 ± 1.4 years (2 - 6 years). The average scores in the PEDI functional domains of self-care, mobility, and social function were, respectively, 37.6 ± 15.4, 36.2 ± 15.4, and 48.7 ± 11.1. Children showed age-appropriate functional outcomes in the PEDI functional domains: 71.4% of them in self-care and mobility and 92.9% in social function. Children with bilateral injuries (p = 0.05) and longer hospital stays (r = -0.79, p = 0.001) showed the worst scores in PEDI's social function domains. Conclusions: Overall, our sample of preschool children showed age-appropriate functional outcomes on self-care, mobility, and social function domains after stroke. However, children with bilateral injuries and longer hospital stays showed the worst scores in social function domains. We recommend focusing on functional rehabilitation to promote activities and participation and to monitor the development of children's social skills after stroke.
RESUMO Antecedentes: O acidente vascular cerebral (AVC) tem sido reconhecido como um importante fator de morbimortalidade em neonatos e crianças. As crianças têm fatores de risco diferentes e mais variados que os adultos, comumente relacionados a uma doença subjacente. A funcionalidade das crianças pode estar comprometida após um AVC. Poucos estudos focaram em desfechos funcionais relacionados à atividade e participação. Objetivos: Investigar a funcionalidade de crianças com AVC, relacionada à autocuidado, mobilidade e função social. Métodos: Avaliamos a evolução funcional de 14 crianças com idade menor que 7,5 anos com AVC na primeira infância pela aplicação do PEDI. Resultados: A idade média de nossa amostra na avaliação foi de 3,6 ± 1,4 anos (2 - 6 anos). O escore médio nos domínios de autocuidado, mobilidade e função social do PEDI foram, respectivamente, 37,6 ± 15,4, 36,2 ± 15,4 e 48,7 ± 11,1. As crianças apresentaram evolução adequada para a idade nos domínios do PEDI: 71,4% delas em autocuidado e mobilidade e 92,9% em função social. Piores escores no domínio função social se relacionaram com lesões bilaterais (p = 0,05) e maior tempo de internação (r = -0,79; p = 0,001). Conclusões: Nossa amostra de crianças em idade pré-escolar mostrou, em geral, evolução funcional adequada para a faixa etária nos domínios de autocuidado, mobilidade e função social. Porém, lesões bilaterais e internações hospitalares mais longas se relacionaram com piores performances no domínio função social. Sugerimos focar na reabilitação funcional e acompanhar o desenvolvimento das habilidades sociais de crianças pós-AVC.
