AUTHORS :  kodjovi Roland Galokpo, PT, MSc¹ ; Emmanuel S. Sogbossi, PT, MSc ² ; Têtê Guedehoussou, MD, Maitre assistant³ ; Dieu donné Gnonlonfoun, MD, Professor⁴.

1.Physiotherapy Department of the National Rehabilitation Center of Lome, Togo.

2. School of Physiotherapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.

3. Department of Pediatrics, Faculty of Health Sciences, University of Lome, Lome, Togo.

4. Department of Neurology, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.

Abstract

CONTEXT AND OBJECTIVE:

The well-being of the parents of children with cerebral palsy (CP) is worth to care about when providing  care to their children. The HAMBISELA approach allows parents to better understand their children with CP, to know how to help them at home and above all, to break the prejudices and folk beliefs related to these developmental delays.

This work aims to evaluate the quality of life (QOL) of parents of children with CP following the HAMBISELA approach compared to control parents involved in conventional rehabilitation alone.

RELEVENCE : Is the QOL of the parents of children with CP following the HAMBISELA approach  better than that of the parents of the children following conventional rehabilitation alone?

PARTICIPANTS :

This study included 63 mothers of children with CP followed for at least 3 years in rehabilitation with or without the HAMBISELA approach in the Rehabilitation Centers of Lomé and Kara. The HAMBISELA group consisted of 32 mothers (, mean age (SD) = 37 years (6,48); children’s mean age (SD) = 6.72 years (2,19) with 69% GMFCS IV - V). The control group whose children were matched with the children in the HAMBISELA group  and following only conventional rehabilitation comprised 31 mothers(mean age (SD) = 35 years (6,78); children’s mean age (SD) = 6.58 years (2,13) with 68% GMFCS IV and V).

METHODS : This is a case-control study. Parents' QOL was assessed using the Visual Analogue Scale (VAS) and a 7-item questionnaire designed specifically for the socio-cultural context of the country. The functional level of the children was evaluated with the Gross Motor Function Measure (GMFM 88).

STATISTICAL ANALYZES : The scores of each item of the questionnaire were correlated with the total score to assess the internal consistency of the questionnaire (Spearman correlation). Then the questionnaire scores were correlated with the VAS scores to assess the conceptual validity of the questionnaire (Spearman Correlation). The non-parametric WILCOXON test was used to compare the QOL level between both groups. The threshold of significance was 5%.

RESULTS

The item-level scores were significantly correlated with the total score of the questionnaire (correlation coefficient between 0.32 and 0.78, p <0.05). In addition, the questionnaire scores were significantly correlated with the VAS scores (ρ = 0.54, p <0.001). There was no significant difference of  the parents' QOL  between both groups (questionnaire, p = 0.07 ; VAS, p = 0.32); neither for the GMFM-88 (p = 0,28).

CONCLUSION : the QOL of parents in the HAMBISELA approach is not better than that of parents without HAMBISELA approach after three years of rehabilitation. It is worth to conduct a randomized controlled trial to assess the impact of the HAMBISELA approach on parents' QOL and / or children's functional autonomy.

CLINICAL INVOLVEMENT: Identify specific tools to appreciate the QOL of parents of children with CP  and think about their accompaniment in the children’s rehabilitation process.