The effect of family education in children with cerebral palsy on functional level and activity of children and families

In our study, the effect of family education on the functional and activity levels of children with CP and families was investigated. The work consisted of two stages. In the first stage, a descriptive study was conducted by recruiting 258 children with cerebral palsy between the ages of 3-18 and their parents attending rehabilitation centers throughout the province of Gaziantep. In this context, in order to evaluate the functional level and activity in children; Gross Motor Function Classification System (GMFCS) for gross motor status, Manual Ability Classification System (MACS) was used for children with Cerebral Palsy for hand-handling skills, and Communication Function Classification System for determining Communication Skills System - CFCS) was used. At the same time, Pediatric Evaluation of Disability Inventory (PEDI), Gross Motor Function Measurement (GMFM-66) and ABILHAND-Kids Scale were also included. Beck Depression Inventory values were recorded to determine the depression status of the families, and the Family Impact Scale (IPFAM) values were recorded for the affect status. The study was performed on 169 (65.5%) boys and 89 (34.5%) girls, with a mean age of 10.82 ± 4.65 years. 219 (85.21%) mothers and 38 (14.79%) fathers were included in the study. According to functional classification, the most crowded group was hemiplegic CP with 97 (37.6%), 112 (43.4%) level II according to GMFCS score, 96 (37.2%) level II according to CFCS score, 94 (Level I was observed in 36.4%. According to Beck depression results, it was found that minimal depression was observed in families. A total of 34 children with CP who met the inclusion criteria were included in the second phase of the study. There were 17 children in each group as the study and control groups. Children were divided into 3-6, 7-12, 13-18 age groups and randomized by closed-envelope method. Both groups received a routine physiotherapy program of 40 minutes, twice a week, in rehabilitation centers. Family education was given to the study group in addition to the routine program. The family education program was continued for 6 weeks. Two assessments were made for both groups, at the beginning of the training and at the end of 6 weeks. In addition to the evaluation parameters in the first stage for each child, the Visual Function Classification Scale (VFCS) to define their visual abilities, the Eating and Drinking Ability Classification System (EDACS) to define the eating and drinking functions, and Viking Speech Scale (VSS) was applied to describe their speech. Beck Depression Scale and IPFAM were used for families. PEDI Functional skills self-care criterion ((F=1.648; p=0.208), mobility criterion (F=3.994; p=0.054) and social function criterion (F=0.305; p=0.585) compared pretest-posttest for the study group No significant difference was found for the PEDI caregiver's help level, self-care criterion (F=2.830; p=0.102) and social function criterion (F=0.005; p=0.944), while no significant difference was observed for the mobility criterion (F=6.095; p). =0.019) in favor of the study group No significant difference was found between the groups for the ABILHAND-Kids inventory (F=1.771; p=0.193) and the Family Impact Scale (F=0.183; p=0.672). (F=10.703; p=0.003) and Beck Depression Inventory (F=5.017; p=0.032), being in the study group provided a significant advantage. (VAS1: p=0.002, VAS2: p=0.00). It was observed that mobility, manual dexterity and gross motor measures evaluating the state of the child provided an advantage in the scales of reaching the goal and the depression levels of the parents. According to the results obtained, we believe that the implementation of structured family education programs in addition to the routine treatment of children with CP will be effective for families as well as the functional level and activity level of children. Keywords: Cerebral Palsy, Family Education, Functional Status, Activity, ICF