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Rovai G, Santana CAS, Brandão MDB, de Campos AC. Cross-cultural adaptation of the Rotterdam Transition Profile to Brazilian Portuguese: measuring autonomy in participation of Brazilian youth with cerebral palsy. Braz J Phys Ther 2024; 28:101080. [PMID: 38848627 DOI: 10.1016/j.bjpt.2024.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/14/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Autonomy in participation of young adults with cerebral palsy (CP) is not well understood due to the lack of appropriate instruments, especially for the Brazilian population. The Rotterdam Transition Profile (RTP) categorizes autonomy in Participation (education, employment, finances, housing, leisure, intimate relationships, sexuality, transportation) and Health Services (care demands, services and aids, and rehabilitation services) domains. OBJECTIVES To cross-culturally adapt the RTP for use in Brazil, and to describe the levels of autonomy in participation and associated factors of Brazilian youth with CP. METHODS RTP was translated and content validity was investigated through an expert panel (n = 4 researchers and n = 4 clinicians); 30 adolescents and young adults with CP provided data for construct validity and internal consistency analysis. To analyze influencing factors, 56 youth with CP, mean age 25 years (SD = 6.9 years), with good cognitive level remotely responded to the RTP, sociodemographic information, and functional classifications (gross motor, manual ability). RESULTS Following translation, content and construct validity were established, with changes made to improve the clarity of items. Cronbach's alpha (0.82) was considered good and test-reliability was fair to good for most items. High levels of autonomy were found in the areas of Leisure and Rehabilitation, with the lowest proportion of participants with autonomy in Housing, Intimate Relationships, and Finances. Autonomy in participation was associated with age, gross motor and manual ability classifications, and with context-related factors. CONCLUSION The Brazilian Portuguese version of the RTP was considered valid and reliable. Findings will support transition planning for young people with CP.
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Affiliation(s)
- Gabriela Rovai
- Child Development Analysis Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Camila Araújo Santos Santana
- Child Development Analysis Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Marina de Brito Brandão
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Carolina de Campos
- Child Development Analysis Laboratory, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
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Demont A, Gedda M, Lager C, de Lattre C, Gary Y, Keroulle E, Feuillerat B, Caudan H, Sancelme Z, Isapof A, Viehweger E, Chatelin M, Hochard M, Boivin J, Vurpillat P, Genès N, de Boissezon X, Fontaine A, Brochard S. Evidence-based, Implementable Motor Rehabilitation Guidelines for Individuals With Cerebral Palsy. Neurology 2022; 99:283-297. [PMID: 35750497 DOI: 10.1212/wnl.0000000000200936] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Cerebral palsy is a life-long condition that causes heterogeneous motor disorders. Motor rehabilitation interventions must be adapted to the topography of the symptoms, ambulatory capacity and age of the individual. Current guidelines do not differentiate between the different profiles of individuals with cerebral palsy, which limits their implementation. OBJECTIVES To develop evidence-based, implementable guidelines for motor rehabilitation interventions for individuals with cerebral palsy according to the age, topography of the cerebral palsy and ambulatory capacity of the individual, and to determine a level of priority for each intervention. METHODS We used a mixed methods design that combined a systematic review of the literature on available motor rehabilitation interventions with expert opinions. Based on the French National Authority for Health methodology, recommendations were graded as strong, conditional or weak. Interventions were then prioritized by the experts according to both the evidence and their own opinions on relevance and implementability to provide a guide for clinicians. All recommendations were approved by experts who were independent from the working group. RESULTS Strong recommendations as first-line treatments were made for gait training, physical activities and hand-arm bimanual intensive therapy for all children and adolescents with cerebral palsy. Moderate recommendations were made against passive joint mobilizations, muscle stretching, prolonged stretching with the limb fixed, and neurodevelopmental therapies for all children and adolescents with cerebral palsy. Strong recommendations as first-line treatments were made for gait training for all adults with cerebral palsy and moderate recommendations as moderate importance interventions for strengthening exercises and ankle-foot orthoses for motor impairment of the feet and the ankles. DISCUSSION These guidelines, which combine research evidence and expert opinion, could help individuals with cerebral palsy and their families to co-determine rehabilitation goals with health professionals, according to their preferences.
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Affiliation(s)
- Anthony Demont
- French National Authority for Health, Saint-Denis, France .,University of Paris, ECEVE, Inserm, U1123, Paris, France
| | - Michel Gedda
- French National Authority for Health, Saint-Denis, France.,University of Paris, ECEVE, Inserm, U1123, Paris, France
| | - Céline Lager
- Occupational therapy Clinic, Mouans Sartoux, France
| | | | - Yann Gary
- Bourgès Clinic, Castelnau-le-lez, France
| | - Elisabeth Keroulle
- Société d'études et de soins pour les enfants paralysés et polymalformés, Antony, France
| | | | | | | | - Arnaud Isapof
- Neuropediatrics Department, Hôpital Armand Trousseau, CRMR Neuromuscular pathologies, APHP, Paris, France
| | - Elke Viehweger
- Orthopedic department, Neuro-orthopedics Unit and Movement Analysis Center, Université Bâle, Suisse
| | | | | | | | | | | | - Xavier de Boissezon
- Physical and Rehabilitation Medicine Department, Neurosciences, CHU, Toulouse, France.,ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
| | | | - Sylvain Brochard
- Physical and medical rehabilitation department, CHRU Brest, Brest, France.,Paediatric physical and medical rehabilitation department, Fondation ILDYS, Brest, France.,University of Western Brittany, Laboratory of medical information processing, Inserm U1101, Brest, France
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