title: Physiotherapeutic interventions and physical activity for children in Northern Sweden with cerebral palsy: a register study from equity and gender perspectives.
abstract: BACKGROUND
  Young people with disabilities, especially physical disabilities, report worse health than others. This may be because of the disability, lower levels of physical activity, and discrimination. For children with cerebral palsy, access to physiotherapy and physical activity is a crucial prerequisite for good health and function. To date, there is limited knowledge regarding potential gender bias and inequity in habilitation services.
  
  
  OBJECTIVE
  To map how physiotherapeutic interventions (PTI), physical leisure activity, and physical education are allocated for children with cerebral palsy regarding sex, age, level of gross motor function, and county council affiliation. This was done from a gender and equity perspective.
  
  
  METHODS
  A register study using data from the Cerebral Palsy follow-Up Program (CPUP). Data included 313 children ≤18 years with cerebral palsy from the five northern counties in Sweden during 2013. Motor impairment of the children was classified according to the expanded and revised Gross Motor Function Classification System (GMFCS).
  
  
  RESULTS
  In three county councils, boys received more physiotherapy interventions and received them more frequently than girls did. Differences between county councils were seen for frequency and reasons for physiotherapy interventions (p < 0.001). The physiotherapist was involved more often with children who had lower motor function and with children who had low physical leisure activity. Children with lower motor function level participated in physical leisure activity less often than children with less motor impairment (p < 0.001). Boys participated more frequently in physical education than did girls (p = 0.028).
  
  
  CONCLUSIONS
  Gender and county council affiliation affect the distribution of physiotherapy interventions for children with cerebral palsy, and there are associations between gender and physical activity. Thus, the intervention is not always determined by the needs of the child or the degree of impairment. A gender-bias is indicated. Further studies are needed to ensure fair interventions.
authors.affiliation: a Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.
authors.forename: Frida
authors.initials: F
authors.lastname: Degerstedt
authors.affiliation: a Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Wiklund
authors.affiliation: a Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.
authors.forename: Birgit
authors.initials: B
authors.lastname: Enberg
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D008297:Male; D009048:Motor Skills; D026741:Physical Therapy Modalities; D012042:Registries; D063507:Sexism; D013548:Sweden
keywords: CPUP registry; Disability; gender bias; habilitation; physiotherapy