Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study

Abstract

Background: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. Objective: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. Methods: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. Results: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). Conclusions: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.

Feasibility of Developing Audiovisual Material for Training Needs in a Vietnam Orphanage: A Mixed-Method Design

“…Children, especially those living in orphanages, are often the highest priority, because there is limited capacity to take care of their basic needs such as feeding and clothing, as well as other needs such as therapeutic and physical treatments [ 9 ]. Therefore, the prevention and early treatment of childhood diseases in low-income countries is of vital importance as it will improve health conditions, both for the children and for their families [ 10 , 11 ]. In this way, most rehabilitation programs implemented in NGO projects, in the field of disability, focus on personal needs, making the involvement of all stakeholders (people with disabilities, caregivers, and their representative organizations) necessary [ 11 ].…”

“…Therefore, the prevention and early treatment of childhood diseases in low-income countries is of vital importance as it will improve health conditions, both for the children and for their families [ 10 , 11 ]. In this way, most rehabilitation programs implemented in NGO projects, in the field of disability, focus on personal needs, making the involvement of all stakeholders (people with disabilities, caregivers, and their representative organizations) necessary [ 11 ].…”

“…Additionally, Hermenau et al [ 14 ] evaluated the mental health problems of children who lived in orphanages considering the need for specialized knowledge and clinical competence for assessment and treatment of these problems by clinicians [ 15 ]. Regarding rehabilitation projects implemented in IC, Garrido-Ardila et al [ 11 ] conducted an online questionnaire for professionals in the field of physical therapy to learn about orthopedic treatment for children with cerebral palsy.…”