Physical therapists' perceptions of factors influencing the acquisition of motor abilities of children with cerebral palsy: implications for clinical reasoning.
OBJECTIVE
Evidence supporting factors predicting motor change for children with cerebral palsy is minimal. A consensus exercise using focus groups and survey methods was conducted to identify factors perceived to affect the acquisition of basic motor abilities among children with cerebral palsy from the time of diagnosis to 7 years of age.


METHODS
Fifty-seven physical therapists participated in one of 12 focus groups, and 60 physical therapists participated in a follow-up questionnaire survey via mail.


METHODS
The nominal group technique was used to conduct the focus groups.


RESULTS
Participants reached consensus about 12 factors in 4 constructs, which we called: (1) primary impairments (muscle tone/movement patterns, distribution of involvement, balance, and sensory impairment), (2) secondary impairments (range of motion/joint alignment, force production, health, and endurance), (3) personality characteristics (motivation), and (4) family factors (support to child, family expectations, and support to family).


CONCLUSIONS
The recognition of potential determinants of motor change could assist in the clinical reasoning that physical therapists use when planning interventions for children with cerebral palsy. Participants identified a set of variables, some of which are found in the literature, that can provide foundation knowledge for decision making and research on factors that bring about change in motor ability among children with cerebral palsy.
Bartlett
Doreen J
DJ
School of Physical Therapy, Faculty of Health Sciences, 1588 Elborn College, The University of Western Ontario, London, Ontario, Canada N6G 1H1. djbartle@uwo.ca
Palisano
Robert J
RJ
D001291:Attitude of Health Personnel; D002547:Cerebral Palsy / Q000503:physiopathology*; D003657:Decision Making; D005190:Family; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009043:Motor Activity; D010551:Personality; D026761:Physical Therapy Specialty; D011379:Prognosis