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Goals of children with unilateral cerebral palsy in a brain stimulation arm rehabilitation trial
Author(s) -
Metzler Megan J,
Haspels Eva,
Brunton Laura,
Andersen John,
Pritchard Lesley,
Herrero Mia,
Hodge Jacquie,
Kirton Adam
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14763
Subject(s) - cerebral palsy , physical therapy , occupational therapy , psychology , rehabilitation , physical medicine and rehabilitation , international classification of functioning, disability and health , activities of daily living , randomized controlled trial , transcranial magnetic stimulation , medicine , stimulation , surgery , neuroscience
Aim To explore relationships between category classifications for children’s rehabilitation goals, outcomes, and participant characteristics. Method Children with hemiparetic cerebral palsy due to perinatal stroke rated self‐selected goals with the Canadian Occupational Performance Measure (COPM) and completed the Assisting Hand Assessment (AHA) and Box and Block Test (BBT), at baseline and 6 months, in a randomized, controlled 10‐day neuromodulation rehabilitation trial using repetitive transcranial magnetic stimulation. Goals were classified with the Canadian Model of Occupational Performance and Engagement and the International Classification of Functioning, Disability and Health. Analysis included standard linear regression. Results Data for 45 participants (mean age 11y 7mo, SD 3y 10mo, range 6–19y, 29 males, 16 females) on 186 goals were included. Self‐care goal percentage corresponded with baseline BBT by age (standardized ß=–0.561, p =0.004). Leisure goal percentage corresponded with baseline BBT (standardized ß=0.419, p =0.010). AHA change corresponded with productivity goals (standardized ß=0.327, p =0.029) and age (standardized ß=0.481, p =0.002). COPM change corresponded with baseline COPM and age by AHA change ( p <0.05). Interpretation Younger children with lower motor function were more likely to select self‐care goals while those with better function tended to select leisure goals. Functional improvement corresponded with older age and productivity goals. COPM change scores reflected functional improvement among older children. Children chose functionally and developmentally appropriate goals. Consequently, children should be free to set goals that matter to them. What this paper adds Children in a brain stimulation trial chose divergent upper extremity functional goals. Younger children with lower ability chose more self‐care goals. Children with higher ability chose more leisure goals. Older children’s goal ratings reflected objective functional motor gains. Children chose goals appropriate to their function and level of development.