Parents’ Perspectives of Partnering With Therapists to Administer Intensive Rehabilitation for Children With Perinatal Stroke

Research Objectives: Parental participation in their young children’s rehabilitation has been promoted to increase intervention intensity. Yet, parents’ perspectives on increased involvement, including the barriers and facilitators, remain unclear. The objective of this study was to explore parent perspectives of partnering with therapists to administer early, intensive rehabilitation to their children with perinatal stroke.

Design: Parents participated in semi-structured interviews before and after partnering with a physical therapist (PT) to deliver a 12-week intervention for their child. Interviews were audio recorded and transcribed verbatim. Interpretive description methodology was used to generate knowledge that is relevant for clinical practice.

Setting: Rehabilitation occurred in the child’s home and in pediatric physical therapy clinical sites in three cities in Canada.

Participants: Twelve Parents (11 mothers, 1 father) of children between 8 months and 3 years old with spastic unilateral cerebral palsy (CP) as a result of perinatal stroke. A diverse group was sampled including single parents, parents of one or multiple children, parents working in and outside the home, families who had immigrated to Canada and families with a wide range of previous experience with rehabilitation.

Interventions: The intervention was ELEVATE (Engaging the Lower Extremity Via Active Therapy Early), a play-based PT intervention targeting the lower extremity of children with CP. The intervention was 1 hour/day, 4 days/week for 12 weeks and was administered by a PT in partnership with parents (2 sessions delivered by each/week).

Main Outcome Measures: N/A

Results: The three themes were 1) the importance of taking a positive approach to therapy, 2) the focus on maximizing their child's potential, and 3) participating in intensive rehabilitation is "worth it", despite the challenges. Families discussed the importance of making therapy fun, the value of intervening when their child is young, and a number of barriers to participating in intensive rehabilitation including long commutes and requiring child care for siblings.

Conclusions: These results will help facilitate meaningful engagement of parents in their children’s rehabilitation, especially early, intensive rehabilitation and home exercise programs.

Author(s) Disclosures: None