IMPACT OF OCCUPATIONAL THERAPY INTERVENTIONS ON ACTIVITIES OF DAILY LIVING IN MIDDLE CHILDHOOD

Abstract

The goal of the research is to assess the effectiveness of occupational therapy in improving self-care skills and quality of life in children of middle childhood with the hemiparetic form of cerebral palsy.The study included 40 children aged 9–12 years, comprising 18 boys and 22 girls. The participants were assigned to two groups. The control group (CG) followed a nine-week standard rehabilitation program, receiving services from an occupational therapist, physical therapist, speech therapist, and psychologist. The experimental group (EG) underwent constraint-induced movement therapy (CIMT) as part of their occupational therapy sessions.The effectiveness of the developed intervention algorithm was evaluated by analyzing changes in pROM, the self- care domain of the WeeFIM scale, and PedsQL scores reported by both parents and children. Occupational therapists performed assessments prior to the intervention and after three weeks of therapy.Results. The mean age of the children was 10.7 ± 0.98 years, with no statistically significant age differences between the groups. Additionally, the initial assessment results revealed no significant differences between the groups.The mean ± SD self-care domain scores of the WeeFIM scale were 48.6 ± 0.52 in CG and 44.4 ± 1.25 in EG.The mean ± SD total PedsQL scores reported by parents were 73.5 ± 0.76 in CG and 71.2 ± 1.25 in EG, while the PedsQL scores reported by children were 75.9 ± 1.26 in CG and 72.4 ± 1.35 in EG. A comparison between the groups revealed statistically significant differences.Following the follow-up assessment, statistically significant differences were confirmed between the groups (p < 0.05).The mean ± SD WeeFIM scale scores were 51.7 ± 0.85 in CG and 50.6 ± 1.24 in EG. The PedsQL scores reported by parents were 79.7 ± 1.94 in CG and 83.6 ± 1.57 in EG, while the PedsQL scores reported by children were 79.8 ± 2.37 in CG and 83.0 ± 1.98 in EG.Conclusions. A comparison of the follow-up assessment results between the experimental group (EG) and the control group (CG) demonstrated a statistically significant improvement in both groups. Statistical analysis of the initial and follow-up assessments indicated that children in the EG, who received CIMT for 3 weeks, exhibited greater improvements in upper extremity (UE) functionality, daily living skills, and quality of life compared to the CG, which received occupational therapy interventions without constraint of the unaffected UE, focusing primarily on enhancing self-care skills.These findings confirm the effectiveness of CIMT in promoting greater independence and functional recovery in children with hemiparetic cerebral palsy.