Caregiver Satisfaction for Orthotic Management of a Severely Involved Child with Cerebral Palsy Seen at Age 7 Years and 19 Years

Audrey Yasukawa*, Bryan S Malas, Patricia Martin

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Introduction A single-subject case report of a female with a diagnosis of cerebral palsy (CP) was undertaken to determine the long-term compliance and satisfaction with orthoses used to manage elbow contractures, as well as to determine the status of elbow range of motion (ROM) after the initiation of treatment 12 years ago. The subject, now aged 19 years, was part of an earlier pilot study conducted in 2003. Methods The evaluation before receiving the Ultraflex elbow wrist hand orthoses (EWHOs) and at the end of the study consisted of passive ROM (PROM) of the elbows and wrists and the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) section on personal care activities of daily living. Botulinum toxin type A (BTX) was administered into the biceps, brachioradialis, and wrist flexors in both upper limbs. The subject (K.D.) was casted to both wrists over a 3-month period. K.D. was then measured by the orthotist for bilateral custom-fitted EWHOs. Results The personal care/activities of daily living total score was 42.5. The score was unchanged before and after the study. Her mother continued to struggle with upper-limb dressing for K.D. There was minimal change in elbow PROM, although there was greater improvement in wrist PROM. Conclusions The primary caregiver is the key regulating factor in determining orthotic compliance outcomes. For an aging caregiver, with a young adult dependent in self-care, a daily wearing schedule may be an unrealistic goal. An alternative orthosis or wear schedule may be needed to assist with caregiver compliance.

Original languageEnglish (US)
Pages (from-to)78-82
Number of pages5
JournalJournal of Prosthetics and Orthotics
Volume28
Issue number2
DOIs
StatePublished - Apr 1 2016

Keywords

  • Cerebral palsy
  • compliance
  • muscle contracture
  • upper-limb orthoses

ASJC Scopus subject areas

  • Biomedical Engineering
  • Rehabilitation
  • Orthopedics and Sports Medicine

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