Konst, R.E. (2013) De beste zitvoorziening voor kinderen met ernstige cerebrale parese. thesis, Medicine.
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Abstract
Background: Cerebral Palsy (CP) is one of the most common causes of physical disability in childhood. Children with severe CP i.e., who function at level IV or V of the Gross Motor Function Classification system, have severe dysfunctions in postural control. Therefore they depend for function in daily life on adequate postural support provided by adaptive seating systems. From the point of view of the International Classification of Functioning Disability and Health, Children & Youth Version (ICF-CY), these children do not only have limitations in body structure and function, but also in activities en participation. According to the Centraal BegeleidingsOrgaan (CBO), provision of an adaptive seating system in children with severe CP should focus on its effects on the level of activities en participation of the ICF-CY. In this study we explored what professionals considered the most important factors which should be taken into account to create an optimal seating system for children with severe CP. In the evaluation special attention was paid to the levels of the ICF-CY. Methods: An internet questionnaire with 16 questions was designed. In order to avoid bias, the questions did not mention the framework of the ICF-CY. Professionals working with children with severe CP were invited by e-mail to participate in the study. The data were mainly analyzed by means of descriptive statistics. Results: One hundred and twenty professionals participated in this study: occupational therapists (52%), physiotherapists (21%), ‘AVG-doctors’ (14%), rehabilitation physicians (11%) and other professionals (3%). Hardly any professional was familiar with a guideline for adaptive seating systems for children with severe CP. Participants considered the most important factors to take into account when prescribing an adaptive seating system: comfort, posture, mobility and balance of the head, pain, position of the trunk in the sagittal plane direction and use of upper extremity in control of wheelchair and/or communication device. As least important factors were mentioned: cognition, facial expression, vision, position of the feet and pathological reflex activity. The majority of these factors does not belong to the level of activities and participation of the ICF-CY. Paramedic professionals (occupational therapists and physiotherapists) more often considered factors in the domain of body structures and functions important than medical professionals (rehabilitation physicians and ‘AVG-doctors’). Conclusion: This study showed that professionals involved in the subscription of adaptive seating systems of children with severe CP do not focus on factors belonging to the level of activities and participation of the ICF-CY, as prescribed by the CBO guideline. This relative neglect of activity and participation was more pronounced in paramedical than in medical professionals.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Hadders-Algra, Prof. dr. M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/528 |
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