title: Perceived effectiveness and barriers to physical therapy services for families and children with Friedreich ataxia.
abstract: OBJECTIVE
  To describe the frequency, type, and perceived effectiveness of physical therapy interventions for children with Friedreich ataxia (FA); identify barriers to therapy; and solicit advice from parents.
  
  
  METHODS
  Parents of 30 children with FA participated in semistructured interviews. Qualitative and quantitative methods were used to analyze the data.
  
  
  RESULTS
  Sixty-seven percent of children received direct physical therapy service. Stretching and strengthening exercises were used most frequently, and their perceived usefulness increased as the children aged. Seventy-three percent received home exercise programs; 9% implemented these consistently. External barriers included a lack of expert providers and limited reimbursement. Internal barriers included limited time and energy, lack of awareness of services, and children's preferences not to be treated differently. Parents advised therapists to become experts, advocates, and use approaches based on family and child preferences.
  
  
  CONCLUSIONS
  Outcomes provide a starting point for developing further research, education, and effective interventions for children with FA.
authors.affiliation: Department of Physical Therapy and Health Care Services, George Washington University, Washington, DC, USA. maringj@gwu.edu
authors.forename: Joyce
authors.initials: J
authors.lastname: Maring
authors.forename: Earllaine
authors.initials: E
authors.lastname: Croarkin
authors.forename: Sylvia
authors.initials: S
authors.lastname: Morgan
authors.forename: Margaret
authors.initials: M
authors.lastname: Plack
mesh_terms: D000293:Adolescent; D002648:Child; D019988:Children with Disabilities / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology*; D005260:Female; D005621:Friedreich Ataxia / Q000534:rehabilitation*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D057240:Patient Preference; D026761:Physical Therapy Specialty / Q000379:methods*; D011368:Professional-Family Relations; D013997:Time Factors