Goal-Directed Therapy to Improve Gross Motor Function and the Quality of Life of Children with Cerebral Palsy: A Randomized Controlled Trial

Suwannika  Palee; Teerada  Ploypetch; Kingkaew  Pajareya; Suttirat  Timdang

doi:10.33192/Smj.2022.1

Authors

Suwannika Palee Department of Rehabilitation Medicine, Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
Teerada Ploypetch Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University
Kingkaew Pajareya Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Suttirat Timdang Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University

DOI:

https://doi.org/10.33192/Smj.2022.1

Keywords:

Cerebral palsy, goal-directed therapy, gross motor function, quality of life, caregiver burden

Abstract

Background: The multiplicity of interventions for the treatment of cerebral palsy (CP) can cause confusion about which are most suited to certain individuals. Hypothesis is that goal-directed therapy (GDT) can guide integrating therapies to improve clinical outcomes compared with conventional therapy (CT).

Method: A prospective, assessor-blinded, randomized controlled trial was done with 23 children with CP (mean age, 4 years 4 months old; SD 1y4mo), who were divided into groups according to their level of gross motor function: GDT and CT. Both groups received 12 physiotherapy (PT) sessions and advice on daily home programs. The GDT group additionally had a team meeting to set a specific goal, and PT programs were shaped toward that goal. Assessments were done at baseline and after treatments, using the Thai-version Gross Motor Function Measure (GMFM-66), CP-Quality of Life (CP-QOL), caregiver burden, and home program compliance.

Results: After the treatments, the GDT group showed significant improvements in GMFM-66, CP-QOL, and caregiver burden, while the CT group revealed improvements in caregiver burden and some domains of the GMFM, including sitting and crawling & kneeling. Comparisons between groups found GDT was more effective than CT in improving GMFM-66 and CP-QOL. Home program compliance was higher in the GDT (69%) than the CT group (42%).

Conclusion: GDT demonstrated clear gains for children with CP regarding gross motor function and QOL improvements. Team communication toward a customized goal was crucial, empowering the children and their caregivers to comply with home programs to achieve the set goal.

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