How intensity of impairment and dose of occupational therapy services impact the outcome in cerebral palsy?

The present study aimed to evaluate the impact of the number of occupational therapy sessions, using the neurodevelopmental technique, (NDT) on gross motor function and other moving outcomes in children with cerebral palsy (CP). The present cross sectional study evaluated all patients who referred to the occupational therapy service centers in the private sector and welfare organizations in Shiraz, Iran in 2015. The studied patients were children of both genders affected by spastic CP. A total of 59 individuals met the inclusion criteria and were entered in the study. A researcher-made questionnaire including 66 questions of gross motor function measure (GMFM) was used. This questionnaire measured the gross motor function in 5 dimensions including lying down, and rolling, sitting, crawling and kneeling, standing and walking, running and jumping. A negative binomial regression model with logarithmic function was applied in STATA 11 software. 59.3% of the patients were boys. According to our results, 38.3%, 33.3% and 38.3% were affected by spastic diplegia, spastic hemiplegia and spastic quadriplegia respectively. Children at level one of gross motor function had 1.3 times higher achievement, compared to the individuals in other levels (P=0.003) and the subjects who participated in more than five sessions per week had 1.04 more achievement than the others (P=0.001). The results of this study showed that the more common occupational therapy sessions the children participated in, the more successful thegross motor function of children affected by level 1 CP of gross motor function classification was. Further investigations are required to assess other motor levels.