Children's and parents' beliefs regarding the value of walking: rehabilitation implications for children with cerebral palsy

Authors


Barbara E. Gibson, PhD, PT, Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, Ontario, Canada M5G 1V7, E-mail: barbara.gibson@utoronto.ca

Abstract

Background  Walking for children with cerebral palsy (CP) has physiological and functional benefits, but also holds symbolic significance that largely remains unexplored. The aims of this pilot study were to describe beliefs about the value of walking held by children with CP and their parents, and to examine how these beliefs inform rehabilitation choices and perceptions of ‘success’.

Methods  A critical qualitative design was employed. Six parents and six children with CP (Gross Motor Function Classification System III or IV, aged 9 to 18 years) each participated in a private interview. Analyses examined the relationship between dominant social beliefs regarding walking and participants' accounts.

Results  Parents' accounts revealed that all adopted a stance of doing something/trying anything as part of being a ‘good parent’ and maintaining hope. Tapering of walking interventions contributed to feelings of guilt and doubt. Children primarily viewed walking as exercise rather than functional. Their accounts also demonstrated how they internalized negative attitudes towards disability and judged themselves accordingly.

Conclusions  The results of this pilot study provide provisional evidence regarding how dominant social values regarding walking and disability are taken up by parents and children. They suggest that rehabilitation programmes need to consider how they may unintentionally reinforce potentially harmful choices, and how best to engage families in discussions of their evolving values and treatment priorities. Further research is needed with a larger sample.

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