Use of physiotherapy and alternatives by children with cerebral palsy: a population study.
OBJECTIVE
To describe the use of physiotherapy services and alternative therapies by a population of children with moderate to severe cerebral palsy (CP).


METHODS
Descriptive cross-sectional survey.


METHODS
A total of 212 parents of children aged 4-14 years with moderate to severe CP were identified from the Northern Ireland Cerebral Palsy Register (NICPR) and a random subsample of their paediatric physiotherapists.


METHODS
A standardized description of motor impairment or assessment form; a postal questionnaire to parents and paediatric physiotherapists (to validate parents' reports of service use). RESPONSE RATES: In total, 85% of parent questionnaires were returned and 100% of paediatric physiotherapists responded.


RESULTS
Service use among families was high; on average the families had contact with approximately seven services in a 6-month time interval. The overwhelming majority of children (96%) received physiotherapy during the school term and most (59%) received treatment at least twice a week for 30 min; 43% of children had their physiotherapy discontinued over the summer holidays. Over one-quarter (28%) of families had opted out of the NHS and bought alternatives like conductive education (21%) or private forms of conventional physiotherapy (16%). Children with more severe forms of CP, in special education, particularly at schools for physical disability, were high-intensity users of the physiotherapy service. Despite this, 74% of parents wanted more physiotherapy for their child.


CONCLUSIONS
The demand for physiotherapy services is likely to continue given the relatively stable prevalence rate of CP, the proportion of children with disabling CP and the level of parent interest in the service. A number of quality aspects and gaps in the service have been identified.
Parkes
J
J
Health & Social Care Research Unit, The Queen's University of Belfast, Belfast, UK. j.parkes@qub.ac.uk
Donnelly
M
M
Dolk
H
H
Hill
N
N
D000293:Adolescent; D000553:Ambulatory Care; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009660:Northern Ireland; D009819:Office Visits / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires