CONSENSUS STUDY “FACTORS INFLUENCING FUNCTIONAL RECOVERY IN CEREBRAL PALSY: A MODIFIED DELPHI CONSENSUS STUDY

Abstract

Importance: Functional recovery in cerebral palsy depends on various factors and to identify the factors that affects the recovery is essential as it would help in development of the predictive models and guiding the patient specific rehabilitation plans. Objective: The study aims at developing a expert consensus on factors affecting recovery in children with cerebral palsy using modified Delphi method. Study Design: Modified Delphi consensus study. Study setting: Electronic expert survey Participants and Interventions: Total 25 participants mainly the paediatricians, paediatric orthopaedic surgeons, physiotherapists working in the field of paediatrics having variety of experience participated in the study by filling the google form, which included the basic demographic details of the participants and various factors that could affect the recovery. Outcome measure: Various factors like epilepsy, prenatal factors, socioeconomic factors etc. were included and the experts rated these factors that were identified by the literature review and expert opinion. Consensus was classified with high consensus >65%, medium consensus 65% to 50% and low consensus < 50%. Results:The results identified that certain factors like maternal age at delivery, epilepsy episodes and family support have high consensus 100% and other factors like age of the child, socioeconomic condition, and age of the child at the time of onset of recovery, occupational and speech therapy interventions, orthopaedic and surgical management have medium consensus 92%. Conclusion and Relevance: The study identified key factors having high consensus affecting recovery and these would ultimately give future insight for the clinicians for the individualized rehabilitation strategy planning. Plain language summary:Cerebral palsy is a condition that occurs due to a non-progressive damage to the developing brain in the foetus or damage to the brain of infants. This causes the children with cerebral palsy to be dependent functionally. The recovery among these children also differs even thought they are taking similar treatment and there are various factors that affect the recovery. So to understand the factors that affect the recovery becomes utmost important as it would help the clinician to identify them and plan the treatment strategies accordingly. So in this study the factors that affect the recovery in cerebral palsy were identified by from the literature search and then electronic survey was done to get the consensus from the experts in the filed like paediatricians, paediatric orthopaedic surgeons, paediatric physiotherapists, physiotherapists. Than the consensus was analysed and the key factors that affected the recovery were identified. The key factors identified were the age of mother at the time of delivery, the age of the child at the onset of the treatment, the severity and type of cerebral palsy, the presence of epilepsy and socioeconomic condition of the child. Thus this would help clinician identify the children with prognosis of the condition and accordingly allocate the resources available for the use and help researchers to develop predictive models for the same.