Functioning and activity outcomes of the Akwenda Intervention Program for children and young adults with cerebral palsy in Uganda: A cluster‐randomized trial

Author:

Asige Elizabeth1,Saloojee Gillian2ORCID,Andrews Carin34ORCID,Namaganda Lukia H.5,Kakooza‐Mwesige Angelina13ORCID,Damiano Diane L.6ORCID,Forssberg Hans37ORCID

Affiliation:

1. Department of Pediatrics and Child Health Makerere University Kampala Uganda

2. Department of Physiotherapy, Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa

3. Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden

4. SWEDESD, Department of Women's and Children's Health Uppsala University Uppsala Sweden

5. Department of Epidemiology and Biostatistics Makerere University School of Public Health Kampala Uganda

6. Rehabilitation Medicine Department Clinical Center, National Institutes of Health Bethesda MD USA

7. Astrid Lindgren Children's Hospital Stockholm Sweden

Abstract

AbstractAimTo evaluate the efficacy of the Akwenda Intervention Program on motor, self‐care, and social function of children and young people with cerebral palsy (CP).MethodThis was a cluster‐randomized, controlled, single‐blinded, intervention study of 100 participants with CP (2–23 years; 52 males) in rural eastern Uganda. Half were allocated to the intervention program, the remainder served as waitlist controls. Gross Motor Function Measure‐66 (GMFM‐66) and the Ugandan version of Pediatric Evaluation of Disability Inventory (PEDI‐UG) were collected before group allocation and after intervention. General linear models and t‐tests were used to compare changes within and between groups. Cohen's d estimated the effect size of group differences. Change scores were evaluated by age and mobility subgroups.ResultsSignificant group by time interactions were found for GMFM‐66 (p =0.003) and PEDI‐UG outcomes (p <0.001), except mobility, with the intervention group demonstrating greater changes. Both groups increased their scores on the GMFM‐66 and child PEDI‐UG, while only the intervention group had significant increases in caregiver assistance scores and across all age and mobility subgroups. Cohen's d showed large effect sizes (d >0.8) of differences for PEDI‐UG outcomes except mobility.InterpretationThe Akwenda Intervention Program had a large positive impact on functioning and activity across age and mobility levels.

Funder

Vetenskapsrådet

Stiftelsen Frimurare Barnhuset i Stockholm

Stiftelsen Sunnerdahls Handikappfond

Stiftelsen Promobilia

Publisher

Wiley

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