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Addition of an educational programme for primary caregivers to rehabilitation improves self-care and mobility in children with cerebral palsy: a randomized controlled trial [with consumer summary]
Saquetto MB, de Santana Bispo A, da Silva Barreto C, Goncalves KA, Queiroz RS, da Silva CM, Gomes Neto M
Clinical Rehabilitation 2018 Jul;32(7):878-887
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To assess whether the addition of an education programme for primary caregivers to rehabilitation improves daily functioning in children with cerebral palsy. DESIGN: A randomized, single-blind, controlled study. SETTING: This study was conducted in a rehabilitation centre in Salvador, Brazil. PARTICIPANTS: A total of 63 boys and girls with cerebral palsy, at 1 to 12 years of age, with Gross Motor Function Classification Systems I to V, were randomly assigned to two groups: educational programme for primary caregivers and conventional rehabilitation (n = 29) or conventional rehabilitation alone (n = 31). INTERVENTION: Each group received 12 sessions of 30 minutes of conventional rehabilitation and 12 sessions of 45 minutes to intervention group. MEASUREMENTS: Gross Motor Function Classification System, Gross Motor Function Measure and daily functioning with the Pediatric Evaluation of Disability Inventory were assessed by a blinded assessor. The clinical outcomes were obtained at the completion of treatment (12 weeks). RESULTS: Of the 63 patients included, 60 (mean +/- SD age 4.6 +/- 2.74 years) completed the protocol. The combined education and rehabilitation, as compared with conventional rehabilitation alone, yielded significantly greater benefit in the self-care domain of the Functional Skills Scale (mean change 1.74 versus 5; p = 0.001), self-care (mean change 5.52 versus 13.99; p = 0.017) and the mobility domain of the Caregiver Assistance Scale of Pediatric Evaluation of Disability Inventory (mean change 0.87 versus 17.88; p = 0.002). CONCLUSION: Self-care and mobility improved in children with cerebral palsy with the addition to conventional rehabilitation of an educational programme for primary caregivers.

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