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Rehabilitation of 190 non-ambulatory children with cerebral palsy in structures of care or in liberal sector
Authors:I Poirot  V Laudy  M Rabilloud  S Roche  T Ginhoux  I Joubrel  E Porsmoguer  E Grimont  C Vuillerot  B Kassaï
Institution:1. Service de médecine physique et réadaptation pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, 69677 Bron, France;2. Centre d’investigation clinique 201, hospices civils de Lyon, 69677 Bron, France;3. Service de biostatistiques, hospices civils de Lyon, 69424 Lyon, France;4. Service de médecine physique et réadaptation pédiatrique, centre médical infantile de Romagnat, 63540 Romagnat, France;5. Service de pédiatrie, hôpital San Salvadour, 83400 Hyères, France
Abstract:AimsTo describe the rehabilitation of non-ambulatory children with cerebral palsy and to explore adjustability on their individual needs.Material and methodData described are extracted from an on-going national cohort study, following during 10 years 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 6 years 10 months (SD 2.0), 111 boys), focusing on physiotherapy, ergotherapy, psychomotility and speech therapy in medico-social and liberal sectors.ResultsIn medico-social sector, duration of paramedical care is significantly more important than in liberal sector (structure of care: median = 4.25 h/week, liberal sector: median = 2.00 h/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).InterpretationRehabilitation 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  Rehabilitation  Children  Structure of care  Liberal sector
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