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The effectiveness of a physical activity stimulation programme for children with cerebral palsy on social participation, self-perception and quality of life: a randomized controlled trial [with consumer summary]
van Wely L, Balemans ACJ, Becher JG, Dallmeijer AJ
Clinical Rehabilitation 2014 Oct;28(10):972-982
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; 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 determine the effects of a six-month physical activity stimulation programme on social participation, self-perception and quality of life in children with cerebral palsy. DESIGN: Multicentre randomized controlled trial with concealed allocation, blinded assessments and intention-to-treat analysis. SETTING: Paediatric physiotherapy practices, special schools for children with a disability, and the child's own home. SUBJECTS: Forty-nine children with spastic cerebral palsy (28 male), aged 7 to 13 years, able to walk with and without walking aids. INTERVENTIONS: The intervention group followed a six-month physical activity stimulation programme involving counselling through motivational interviewing, home-based physiotherapy and four months of fitness training. The control group continued regular paediatric physiotherapy. MAIN MEASURES: Outcomes included social participation in domestic life, social participation in recreation and leisure (Life-Habits for Children questionnaire and Children's Assessment of Participation and Enjoyment questionnaire), self-perception (Harter's Self-Perception Profile for Children) and parent-reported quality of life (Cerebral Palsy Quality of Life Questionnaire). Assessments were performed at baseline, at six months (except quality of life) and at twelve months. RESULTS: Intervention resulted in a positive effect on social participation in domestic life at twelve months (mean between-group difference 0.9, 95% confidence interval (CI) 0.1 to 1.7 (1 to 10 scale), p = 0.03), but not at six months. No significant effects were found for social participation in recreation and leisure, self-perception at six months and twelve months or for quality of life at twelve months. CONCLUSIONS: The combination of counselling, home-based physiotherapy and fitness training was not effective in improving social participation in recreation and leisure, self-perception or quality of life, but did show a potential for improving social participation in domestic life over the longer term.

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