Impact Of Interventional Therapies On The Quality Of Life In Children With Cerebral Palsy: A One Year Hospital Based Interventional Study

Abstract

Introduction: Cerebral palsy(CP) denotes a group of heterogeneous disorders with permanent ailments of tone and posture causing activity limitation. It’s a debilitating disease of childhood with varied co-morbidities, which have a grave effect on the economy, psycho-social aspects and quality of life of these children, family and society at large. Because of the notion that CP is a non treatable disease, most of these children are not provided with adequate care and treatment. Objectives: the primary objective of this study was to assess the impact of interventional therapies on the Quality of life in children living with cerebral palsy. This study also looks at the co-relation of different modalities of effective interventional therapies with respect to various types of cerebral palsy and also assesses the impact of co-morbidities on quality of life in children with CP. Methods: This study was conducted in the child development clinic(CDC) of KLES Dr Prabhakar Kore hospital and Medical research centre. All newly registered and treatment naïve children with CP attending CDC from January 2018 to September 2018 were enrolled. After taking appropriate history and thorough neurological and other systematic evaluation they were classified into respective type of CP. They were subjected to necessary interventional therapies like physiotherapy, speech therapy, oro-motor stimulation, medications and treatment of co-morbidities for 6 months. The patients were followed up every month for a duration of 6 months. The Quality of life(QoL) was assessed based on Lifestyle assessment Questionnaire(LAQ-CP) pre and post interventions. Results: 51 patients were enrolled in our study(M:F=1.8:1). Dystonic Quadriplegic CP was the most common type with 18 patients(35.2%) with perinatal asphyxia being the commonest cause in 22(50.8%). Majority patients i.e 25(49.01%) had moderate disability LAQ-CP scores. The mean final LAQ-CP score pre and post intervention were 52.78 and 46.91 respectively(p<0.0001). The median number of co-morbidities reduced from 9.5 to 5.5 after interventions. Drooling of saliva reduced in 27/28 patients followed by seizures which showed reduction in 20/23 patients. Conclusion: There is a notion that CP is non-treatable disease. Many of these children are neglected both by parents and treating physicians. Our study shows that timely and appropriate interventions can significantly improve the Quality of life of these children.