Functional and environmental predictors of health-related quality of life of school-age children with cerebral palsy: A cross-sectional study of caregiver perspectives

BACKGROUND

Caregivers' reports often serve as a decision-making guide in the treatment and rehabilitation of children with cerebral palsy (CP). This study identified predictors of the caregiver-reported health-related quality of life (HRQoL) of school-age children with CP.

METHODS

A cross-sectional study was conducted using the convenience sample of 108 children with CP (60 males; aged 7-18 years; mean age 12 years 8 months [SD 3 years 5 months]). Caregivers reported their child's HRQoL using KIDSCREEN-27. Standard multiple regression analyses were conducted to test if the child characteristics (gender, age, Gross Motor Function Classification System-Expanded & Revised [GMFCS-E&R], Manual Ability Classification System [MACS], intellectual disability, health problems, communication, social skills, behavioural difficulties); family characteristics (income, type, home adaptation); physical, social and attitudinal barriers; environmental features; and family-centeredness of service delivery significantly predicted HRQoL.

RESULTS

Fine manual abilities, home adaptation and the magnitude of barriers predicted physical well-being. The child's challenging behaviour, the magnitude of barriers and the barriers related to different policies predicted psychological well-being. The home adaptation level and provision of general information about the child's disability and available types of services predicted HRQoL domain related to interactions and relationships with parents. Children with behavioural difficulties and more severe limitations in communication had less social support from friends and peers. The social skills and intellectual functioning combined with the parental ratings of the child's behaviour, other people's attitudes towards the child and the lack of support predicted HRQoL in the School Environment domain. The magnitude and frequency of barriers were the strongest predictors of general HRQoL.

CONCLUSION

From the caregivers' perspective, home adaptation, supportive laws and policies and family-centred rehabilitation care that meets the family needs may promote children's HRQoL. Specific interventions addressing modifiable environmental features and continuous support to children in improving their fine motor abilities, communication and social skills and families in managing behavioural difficulties may be relevant for HRQoL of school-age children with CP.

Virtual Reality-Based Framework to Simulate Control Algorithms for Robotic Assistance and Rehabilitation Tasks through a Standing Wheelchair

The implementation of control algorithms oriented to robotic assistance and rehabilitation tasks for people with motor disabilities has been of increasing interest in recent years. However, practical implementation cannot be carried out unless one has the real robotic system availability. To overcome this drawback, this article presents the development of an interactive virtual reality (VR)-based framework that allows one to simulate the execution of rehabilitation tasks and robotic assistance through a robotic standing wheelchair. The virtual environment developed considers the kinematic and dynamic model of the standing human–wheelchair system with a displaced center of mass, since it can be displaced for different reasons, e.g.,: bad posture, limb amputations, obesity, etc. The standing wheelchair autonomous control scheme has been implemented through the Full Simulation (FS) and Hardware in the Loop (HIL) techniques. Finally, the performance of the virtual control schemes has been shown by means of several experiments based on robotic assistance and rehabilitation for people with motor disabilities.