Category: Pediatric Rehabilitation; Technology (e.g. robotics, assistive technology, mHealth)
To explore families' perceptions of the feasibility and outcomes of FES as an upper limb intervention for young children with hemiparesis due to a perinatal stroke.
Design : Exploratory, qualitative study.
Setting : General community.
Participants (or Animals, Specimens, Cadavers) :
Parents of 7 children with a history of perinatal stroke, impaired upper limb function (Manual Ability Classification System levels II and III), aged 3-6 years, and recent participation in FES intervention.
Interventions : Children participated in 36 hours (three one-hour sessions for 12 weeks) of FES (MyndMove®, MyndTec Inc.) for the hemiparetic upper limb.
Main Outcome Measure(s) :
Parents were interviewed within one week of their child completing the FES intervention. The interviewer used a semi-structured interview guide with open-ended questions that queried the goals, benefits and challenges of the FES intervention. Interviews were audio recorded, transcribed and analyzed using thematic analysis.
Results : Five themes were identified. 1) Perceived physical, psychological and functional improvements: e.g. increased confidence, strength and arm use. 2) Parents' expectations: e.g. initial apprehension about FES, valuing small improvements in arm function. 3) Experience with the structure of the intervention: positive (intensive, customized) and negative (travel, unfamiliarity with FES) aspects were recognized. 4) Strategies to facilitate participation: e.g. extended family support, increasing familiarization with FES. 5) Lack of access to FES, both in conventional therapy and the community. Perceptions across themes were modified by external and internal parent and child factors, such as travel distance, family support, initial parent goals, and motivation of child.
Parents perceived FES for the upper limb to be feasible and effective for their children with hemiparesis. Interest in improving access to FES highlights the positive perception of FES for children with hemiparesis.
Emma Swaffield– Masters of Science in Physical Therapy Student, University of Toronto, Toronto, Ontario
Jaynie Yang– Professor, University of Alberta, Edmonton, Alberta
Patricia Manns– Professor, University of Alberta, Edmonton, Alberta
Kristin Musselman– Scientist/Assistant Professor, KITE, Toronto Rehabilitation Institute-University Health Network; Dept. of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario