Research examines factors inhibiting patients with cerebral palsy from participating in rehabilitation therapy

If you have cerebral palsy (CP), rehabilitation therapy is vital to improving mobility, balance and muscle strength, essential factors you need in daily living. International guidelines for recommended doses of therapy exist, yet patients in both developing countries, and developed ones like the United States, have trouble meeting them.

A group of researchers in the Department of Physical Therapy at The Ohio State University completed a study titled “Rehabilitation and Dosing Practice for Individuals with Cerebral Palsy in Indonesia: A Survey of Physiotherapists and Occupational Therapists,” that compares therapy dosage in this location where prevalence is high and practice is understudied. It was just published in Disability and Rehabilitation.

Suci Anatasia Nazier, a PhD student in the Department of Physical Therapy at The Ohio State University and the study’s first author, says they developed an anonymous online survey based on existing literature. A total of 233 Indonesian physiotherapists and occupational therapists completed it, capturing and correlating dosage perceptions and perceptions of service-related factors. Experts then validated the data using descriptive statistics and correlations.

Findings show that: 

• Therapists reported using both recommended, evidence-based practices (EBP) like mobility training and non-recommended practices like neurodevelopmental therapy, in one to two sessions per week lasting 30-45 minutes.
• Therapists reported limited agreement on strong patient exposure to EBP, having adequate workforce and families’ financial readiness to commit to therapy, but did agree that these factors need to be addressed to increase therapy delivery.
• Therapy time correlated with positive perceptions of EBP exposure, skill set, infrastructure and workforce.
• Institutional support for training showed the strongest association with greater EBP exposure. 
• Future research that performs qualitative interviews with patient caregivers could reveal real-world constraints and consequences, including barriers such as travel distance or lack of finances to cover costs, which provide a more comprehensive understanding of these low dosing issues.

Elizabeth Maus, DPT, says Nazier’s thoughtful perspective and “why” questions push the team’s clinical and research assumptions in productive and novel ways which will broaden research to expand healthcare access for children with disabilities in Indonesia and beyond. Working together in the Pediatric Assessment and Rehabilitation (PEARL) Laboratory at The Ohio State University College of Medicine under the mentorship of lab director Jill Heathcock, MPT, PhD, has helped these researchers cultivate a space for professional and personal growth that validates the challenges of navigating a demanding academic path.