Rehabilitation of 190 non-ambulatory children with cerebral palsy in structures of care or in liberal sector

Abstract

Aims: To describe the rehabilitation of non-ambulatory children with cerebral palsy and to explore adjustability on their individual needs.

Material and method: Data described are extracted from an on-going national cohort study, following during 10years 385 children with cerebral palsy, aged from 4 to 10, Gross Motor Function Classification System IV and V. We analysed data from the first 190 patients (mean age 6years 10months (SD 2.0), 111 boys), focusing on physiotherapy, ergotherapy, psychomotility and speech therapy in medico-social and liberal sectors.

Results: In medico-social sector, duration of paramedical care is significantly more important than in liberal sector (structure of care: median=4.25h/week, liberal sector: median=2.00h/week) (P<0.0001). More than 4 different types of care per week are given in medico-social sector, while in liberal sector children benefit from only 2 different types of care a week. In investigators opinion, rehabilitation in structures of care is 71.65% adapted as opposed to 18.75% in the liberal sector (P<0.001). Children level V have less time of rehabilitation than the others (P=0.0424).

Interpretation: Rehabilitation of children with cerebral palsy who are not able to walk, with an objective to improve quality of life, is truly multidisciplinary and suitable in medico-social sector.

Keywords: Cerebral palsy; Children; Enfants; Liberal sector; Paralysie cérébrale; Rehabilitation; Rééducation; Secteur libéral; Structure de soin; Structure of care.