Feasibility of a Home-Based Occupational Positioning Program for Children With Spastic Cerebral Palsy: A Preliminary Study.

PURPOSE: The primary aim was to assess the feasibility of a home-based occupational positioning program for children with spastic cerebral palsy (SCP), focusing on compliance, dosage, and satisfaction. A secondary aim was to explore its preliminary effectiveness on self-care, mobility, social function, gross motor function, and goal attainment.

METHODS

This single-group feasibility study, conducted prior to a larger RCT, included five children aged 3.5-6 years with SCP (GMFCS III-IV) without severe intellectual disability, and aimed at assessing feasibility while exploring preliminary effects. The home-based occupational positioning program involved general and customized booklet-based training, two in-home sessions using Goal Attainment Scaling (GAS) to establish the home program, and 12 weekly remote sessions. Feasibility outcomes were assessed by compliance, dosage, and satisfaction, while preliminary effectiveness was evaluated using the PEDI (self-care, mobility, and social function), Gross Motor Function Measure (GMFM-88), and GAS.

RESULTS

All participants completed the study without adverse events or attrition. Mean compliance was 96.4% ± 4.93%, average satisfaction was 9.8 ± 0.44 on a 10-point scale, and the average daily program time was 5.35 ± 3.11 h. Significant improvements (p < 0.05) were observed by Wilcoxon signed-rank test in self-care, mobility, and social function, as well as in GMFM-88 and GAS scores.

CONCLUSION

The home-based occupational positioning program showed high feasibility, likely supported by family engagement, collaborative goal setting, real-life implementation, caregiver education, and consistent remote support. Preliminary findings suggested potential benefits for self-care, mobility, social function, gross motor function, and goal attainment.

TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20231012059697N1.