The effects of "telerehabilitation based structured home program applications" for the improvement of motor function, activity, and participation in pre-schooler children with cerebral palsy

Current study was conducted between preschooler children with Cerebral Palsy (CP) who received usual care (UC), and children who received usual care plus Telerehabilitation Based Structured Home Program (TB-SHP). Comparisons of functional status, activity and participation rates in both groups were made under the International Classification of Functioning, Disability and Health (ICF-CY). TB-SHP protocol was planned as a triple-blinded randomized controlled trial. Forty-three preschooler children with CP whose functional levels range from I-V according to Gross Motor Function Classification System (GMFCS) (mean age 4.66 years [SD 1.08 years]) were randomly assigned to usual care and usual care plus TB-SHP groups. Activity, (Gross Motor Function Measure [GMFM], Quality of Upper Extremity Skills Test [QUEST], Segmental Assessment of Trunk Control [SATCO], ABILHAND-KIDS, ABILOCO KIDS, Goal Attainment Scale [GAS]), participation (Life Habits Questionnaire [LIFE-H], Canadian Activity Performance Measure [KAPÖ], Pediatric Evaluation of Disability Inventory [PEDI]), environmental and personal factors (European Child Environment Questionnaire [ECEQ], Compliance and Perceptions of Parents of Children with Cerebral Palsy to Home Program Questionnaire [CPHP-Q], the Depression Anxiety Stress Scale-21 [DASS-21]) were assessed before, immediately after intervention, and at 12-weeks post-intervention. Usual care plus TB-SHP was found to be more effective than usual care in terms of activity (GAS, COPM, GMFM, QUEST, SATCO), participation (COPM, PEDI) and, environmental (ECEQ, CPHP-Q, DASS-21) factors both immediately after intervention, and at 12-weeks post-intervention (ES: dUC+TB-SHP >dUC). As a result, it is thought that the telerehabilitation used in addition to the home program can be used to improve activity, participation, environmental and personal factors in preschooler children with CP.