Barriers and Facilitators of Home Programmes in Children With Cerebral Palsy: A Systematic Review and a Metasynthesis

Abstract

Introduction

One of the treatments with the greater scientific support for children with cerebral palsy (CP) are home programmes (HP). However, its implementation may be complex in some cases. A systematic review was conducted to explore the existing literature on the following question: What are the barriers and facilitators to implementing HP for children with CP?

Material and Methods

The articles were extracted from the Web of Science (WoS), Scopus, ERIC, PubMed and CINAHL databases. Inclusion criteria: articles based on therapies conducted at home, for children with CP aged 0–8 years and their families, published in English and Spanish. Exclusion criteria: reviews, studies of cases and controls and one-case studies. The risk of bias was assessed through Cochrane tools Risk of Bias (RoB) I, RoB 2 and RoB E.

Results

Twenty-one articles were selected from a total of 1.336, with 523 families and professionals. A qualitative research was carried out through content analysis using inductive coding and subsequent analytical categorization within an interpretative paradigm. Six themes were obtained: participation, personal cost and social support, family impact, training, professional role and efficacy. The quantitative results were analysed descriptively. They address HP research in a superficial manner.

Conclusions

Barriers: lack of time or availability to attend to the children one by one, poor economic and social support networks and sensitive emotional situation. Facilitators: training, adapted treatment objectives, activities within the daily routine and fluid family-professional communication. Limitation: Only one article could be found that analysed family variables, considering the possible confounding variables. There is no funding source for this review. Registered in PROSPERO with code number: CRD42023477735.