Le contact initial en masso-kinésitherapie avec les enfants atteints de paralysie cérébrale

Abstract

Background

A child with cerebral palsy or in the process of being diagnosed has numerous motor, sensory, cognitive and emotional impairments. These children need early medical intervention and rehabilitation to optimize their abilities. Physiotherapists are faced with several challenges right from the outset. The main objective of an initial session is to get the child and parents on board, and this is not always easy or intuitive when parents are in the process of mourning the loss of their ideal child, and when children are not always communicative, or even have certain cognitive and sensory impairments. So how do physios go about meeting a child with cerebral palsy? What methods facilitate this encounter and the patient/rehabilitator relationship?

Method

Human and social science research was carried out. Physiotherapists working with children with cerebral palsy in institutes or private practice were interviewed in individual semi-directive interviews following the COREQ guidelines. The interviews were transcribed and analyzed by recurring themes, using manual coding to highlight the results.

Results

The physiotherapist's environment would condition their approach to the child, notably through the presence of the parents. Each would use facilitating factors and mention obstacles to create positive engrams in children. There appeared to be a common understanding of the time needed for the child to grasp the environment and the physiotherapy objectives, as well as the freedom given to the child to adhere to or not to the proposed exercises.

Discussion

Even if the external validity of the results is not possible with five physiotherapists respondents, a comparison with current literature concerning certain theories is possible. Indeed, the notions of child observation and the importance of touch and sensoriality confirm and enrich the physiotherapists’ testimonies.

Conclusion

The aim of this first meeting is to establish a real therapeutic collaboration with the youngster and his family. Observation would be a facilitating factor. The importance of the first interaction with the child is crucial for physiotherapists and must be carefully considered by these professionals for the follow-up of this long-term rehabilitation.