Content identification of the interdisciplinary assessment of cerebral palsy using the International Classification of Functioning, Disability and Health as reference

Narrative Review of the Theoretical-Methodological Foundations of the TREINI Program

Scientific knowledge has advanced in the implementation of safe and beneficial interventions for children and adolescents with cerebral palsy (CP). Although the importance of interdisciplinary interventions that integrate all components of the International Classification of Functioning, Disability and Health (ICF) into family-centered practices is widely recognized, this approach is not yet widely adopted. Instead, many programs remain focused on isolated domains. This study presents the theoretical and methodological foundation of TREINI, an interdisciplinary and family-centered program developed for children and youth with CP and other neurodevelopmental disorders. TREINI incorporates intervention strategies that address all ICF domains. It is grounded in the biopsychosocial model of health and utilizes principles based on the best evidence in pediatric rehabilitation, including intensive training, task-oriented training, and a naturalistic learning environment. Unlike traditional rehabilitation approaches, the care provided by the TREINI program is delivered through an intensive and interdisciplinary approach, by a team working collaboratively in a single location. In addition to including evidence-based interventions, the TREINI program features two innovative components: the "City of Tomorrow", a naturalistic learning environment, and the "TREINI Exoflex" therapeutic suit, specifically designed to address deficiencies in the body functions and structures of children with CP and other neurodevelopmental disorders. This program has been carefully designed to support the process of neurological re-education and rehabilitation for children and adolescents with neuropsychomotor developmental delays.

A qualitative investigation of the role of paediatric rehabilitation professionals in rural South Africa: Rehabilitation professionals' perspectives

Purpose

To investigate the role that rehabilitation professionals play in the rehabilitation of children with disabilities in the rural and under-resourced community of Giyani in South Africa.

Method

A qualitative, exploratory and descriptive approach was used. Semi-structured face-to-face interviews were used to collect data from a convenient sample of eight rehabilitation professionals. Data were transcribed verbatim by two trained students and verified by the main researcher. An inductive approach to qualitative data analysis was used. In vivo and open coding were used to generate codes.

Results

Analysis of data resulted in 21 codes, 9 subcategories, 5 categories and 1 theme. The role of rehabilitation professionals was described in terms of the five categories which are to examine newborn babies and children at risk, support caregivers of children with disabilities, impart skills training for caregivers of children with disabilities, rehabilitate children with disabilities and conduct follow-ups in communities where the children with disabilities reside.

Conclusion

The role that rehabilitation professionals play in the rural and under-resourced community of Giyani in South Africa is similar to the role played in high-income countries. The role that rehabilitation professionals play is not only focused on the child but also on the family.

Work process related to cerebral palsy of neurological rehabilitation centers

OBJECTIVE

To evaluate the work process for CP cases in different rehabilitation centers according to Brazilian health policies and recommendations from the "World Report on Disability".

METHODS

A questionnaire - Evaluation Process of Rehabilitation of Children with CP was applied to the Coordinators of 13 services. This instrument has a maximum score of 108 points.

RESULTS

The results of the questionnaire varied from 28 to 64 points. The mean and SD were 43.5 and 10.9, respectively. The main administrative difficulties were: (a) presence of unmet demand, (b) patient absenteeism, (c) referral to primary care services, (d) inadequate physical facilities, (e) the scarce provision of prosthetics and orthotics, (f) insufficient financial resources, (g) human resources training, (h) difficulties with the use of the information system and (i) transportation difficulties for patients.

CONCLUSION

Administrative and clinical guidelines are needed for uniformity of the work process of the rehabilitation centers.

Assessing Children With Disabilities Using WHO International Classification of Functioning, Disability and Health Child and Youth Version Activities and Participation D Codes

AIM

Evaluation of the International Classification of Functioning, Disability and Health child and youth version (ICF-CY) activities and participation d code functions in clinical practice with children across diagnoses, disabilities, ages, and genders.

METHODS

A set of 57 codes were selected and worded to describe children's support needs in everyday life. Parents of children aged 1 to 15 years participated in interviews to discuss and rate their child's disability.

RESULTS

Of 367 invited parents, 332 (90.5%) participated. The mean age of their children with disability was 9.4 years. The mean code scores were 50.67, the corrected code-total correlations were .76, intercode correlations had the mean of 0.61, and Cronbach's α was .98. As a result of Rasch analysis, graphical data for disability measures paralleled clinical expectations across the total population of 332 children.

CONCLUSION

The World Health Organization International Classification of Functioning, Disability and Health child and youth version d code data can provide a coherent measure of severity of disability in children across various diagnoses, ages, and genders.

International Classification of Functioning, Disability and Health (ICF) as a framework for change: revolutionizing rehabilitation

The International Classification of Functioning, Disability and Health (ICF) utilizes domains of body functions and structures, activities and participation, as well as environmental and personal factors to fully encapsulate the concepts of health and disability. The International Classification of Functioning, Disability and Health provides a rich and holistic understanding of functioning that is particularly valuable in the setting of childhood disability and rehabilitation. With applicability that enhances a nuanced understanding of each child within their family, school, and community, the International Classification of Functioning, Disability and Health also ensures facile and meaningful communication between professionals. Use of the International Classification of Functioning, Disability and Health promotes improved treatment plans for individual children and for larger programmatic decisions. This article demonstrates how the International Classification of Functioning, Disability and Health has reinvented the language and understanding of childhood disability and rehabilitation.

Introduction to Special Issue: A Review of the International Classification of Functioning, Disability and Health and Physical Therapy over the Years

BACKGROUND AND PURPOSE

The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization was developed as a common framework to understand health and to describe the impact of health condition on functioning. The purpose of this paper is to summarize the literature on the use of the ICF in physical therapy practice and research.

METHODS

We performed a scoping-narrative review and searched for relevant English language articles from 2001 to 2012 in multiple databases that included MEDLINE, PsycINFO, PubMed and Physiotherapy Evidence Database. Our keywords for the search consisted of ['physical therapy' OR 'physiotherapy'] AND ['ICF']. All types of articles were considered.

RESULTS

We found 268 articles; out of which, 79 were reviewed. The years with most publications were 2011 (n = 16), 2008 (n = 15) and 2010 and 2012 (both with n = 13). Publications mostly came from the United States with 27% of the articles. The journal Physical Therapy leads with almost a third of ICF-related physical therapy publications. The ICF has been mostly used in studies of musculoskeletal and neuromuscular conditions. We found a wide array of application of the ICF in research, clinical practice and teaching (classroom and clinical education). Emerging topics included using the ICF in resource allocation and prevention and wellness.

CONCLUSION

The use of the ICF in physical therapy practice and research is promising and continues to evolve. With recent developments in ICF-based measurement and integration in assessment tools for use in the clinics, research and teaching, the need to show the added value of using the ICF in practice and research remains.

Association between executive/attentional functions and caries in children with cerebral palsy

The aim of the present study was to evaluate the existence of an association between attention/executive functions and the development of dental caries in individuals with cerebral palsy (CP). Seventy-six children with CP were selected from a physical rehabilitation center and a school serving children with disabilities. The control group was made up of 89 children without neurological impairment. Socioeconomic status, presence of teeth with cavities due to caries, degree of motor impairment and intellectual, executive and attentional functions were assessed. Mean age of participants was 8.9 years (SD=3.56). The CP group had a significantly lower performance (p<0.05, Mann-Whitney test) on the intelligence, attentional function and executive function tests in comparison to the control group. Controlling for the clinical diagnosis (CP or control group), motor impairment and intellectual function, the significant explanatory variables for the presence of teeth with cavities were performance on the Complex Rey figure test (OR=0.941) and the Digit Span subtest of the Wechsler Intelligence Scale for Children in backward order (OR=0.581). After controlling for intellectual function, clinical diagnosis and motor impairment, deficits in executive and attentional functions increased the odds of developing dental caries in children with cerebral palsy.

An ICF-based approach for cerebral palsy from a biopsychosocial perspective

OBJECTIVES

To integrate instruments to operationalize an ICF-based approach for cerebral palsy (CP); to assess differences in activity and participation among children with hemiplegia, diplegia and quadriplegia CP; to verify the facilitators or barriers to functioning; and to investigate the explanatory factors (cognitive and motor) for the type of school attended by children with CP (regular or special).

METHODS

Sixty children with CP were assessed using the Mini-Mental State Examination and an ICF-based instrument and their parents were interviewed. Data were analysed by Chi-Squared, Anova's and Kruskal-Wallis tests and multivariate logistic regression.

RESULTS

Significant differences between CP sub-groups were found for chewing, urinary function, cognitive function and activities and participation. Twelve environmental factors were identified as barriers. Multivariate regression identified cognitive function as a significant explanatory variable for the type of school attended, whereas motor function was not significant.

CONCLUSIONS

The ICF-based approach allows a comprehensive assessment, relevant for planning interventions.

Multidisciplinary perspective for cerebral palsy assessment after an international, classification of functioning, disability and health training

OBJECTIVE

To assess knowledge related to the ICF before and after an ICF training and to identify items to compose a monocentric rehabilitation ICF code set for cerebral palsy (CP).

METHODS

(a)

DESIGN

A cross-sectional study with a descriptive-explorative design. (b)

PARTICIPANTS

Professionals from the fields of physiotherapy, nutrition, dentistry, occupational therapy, psychology, social work, speech therapy and medicine. (c)

INSTRUMENT

A questionnaire to assess ICF's knowledge (total score = 17).

RESULTS

A high effect size of the ICF training was found (Cohen's d = 4.10). Ninety-one and 43 ICF categories were selected for a comprehensive evaluation and triage, respectively, for CP.

CONCLUSION

ICF categories were identified to compose a comprehensive evaluation and for triage through an ICF code sets for CP. Studies are needed to validate the instrument on the knowledge of the ICF and to test the impact of ICF's training for clinical rehabilitation of CP.