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The Use of Evidence-Based Practice (EBP) to Treat Children with Cerebral Palsy: A Descriptive Study

Xavier University Department of Occupational Therapy Spring 2021

Aminah Baig, Ellie Cecala, Alaina Gallagher, and Elizabeth Gick

Anonymous Electronic Survey  16,000 OTs and PTs licensed in the state of Ohio were sent the survey via email. 174 OTs and PTs completed the survey.  Inclusion Criteria OTs and PTs licensed in the state of Ohio. Treat young children, ages 0-3 years, who are diagnosed with CP, or who may have CP but are undiagnosed.  Methods & Procedures:  Pilot test   IRB Approval  Survey Email Dissemination  Reminder Email Dissemination x2  Survey Closure

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EBP Use Majority of OTs and PTs view EBP as important     (93%), however:  44% of OTs and PTs always implement EBP 37% sometimes implement EBP 19% never implement EBP More OTs (96%,) than PTs (91%) view EBP positively  Participants with 16 years in practice (89%) view EBP as less important than those with <10 years in practice (100%) Barriers to EBP Use Time to search for, read, and appraise the evidence (72%) Facilitators to EBP Use Motivation to use EBP (89%) Access to the literature via databases (78%) Possess the skills to implement EBP (83%) Note.  Not all respondents answered each question, thus the sample size per question varies.

Occupational therapists (OTs) and physical therapists (PTs) are faced with the task of providing efficient, and research-supported interventions (Anaby et al., 2017). Evidence supports that OTs and PTs may not be using the latest evidence when treating young children with cerebral palsy (CP) (Fridest et al., 2016). In the last seven years, the number of evidence-based motor interventions for CP has rapidly expanded, providing clinicians with more effective interventions (Novak et al., 2020). The rate of neuroplasticity peaks during the first few years of life (Gelkop et al. 2015). Thus, when treating infants and toddlers with CP, OTs and PTs must use evidence-based interventions that effectively enhance motor outcomes (Marr, 2019).

OTs and PTs must be aware of the levels of evidence to in the treatment of infants with CP maximize the effectiveness of intervention CIMT, bimanual training, goal-directed task-specific motor training, home activity programs, parent coaching, and environmental modifications  OTs and PTs possess EBP skill sets, but experience workplace barriers to implementation  Facilities and managers should provide motivation, incentives, and time What This Study Adds to the Literature  OTs and PTs positively view EBP but 56%  of respondents are unlikely to implement it More advanced degrees & less time in clinical practice increase positive view of EBP Ohio OT’s & PTs report having access to literature and the skills to perform EBP

High Evidence CIMT          43% Bimanual Therapy       57%  Moderate: Recommended GAME         40% Baby CIMT 29% Moderate: Not Recommended NDT            63% Conductive Education    14% Sensory Regulation/ Processing  83% Home Modifications 94% Home Activity 96%

How frequently do OTs and PTs utilize EBP interventions? What EBP interventions do OTs and PTs use? What are the facilitators and barriers to EBP use?

n= 174 33% OT 67% PT 31% practice in Early Intervention 42% Practice in Outpatient 62% with a Masters degree or higher 96% Female 63% in practice for 16+ years

Note.  Values indicate the percentage of respondents who report sometimes to always using the above interventions. Listed interventions are for the enhancement of motor outcomes, as cited in Novak (2020).

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EBP Use Majority of OTs and PTs view EBP as important (93%), however:  44% of OTs and PTs always implement EBP 37% sometimes implement EBP 19% never implement EBP More OTs (96%,) than PTs (91%) view EBP positively  Participants with 16 years in practice (89%) view EBP as less important than those with <10 years in practice (100%) Barriers to EBP Use Time to search for, read, and appraise the evidence (72%) Facilitators to EBP Use Motivation to use EBP (89%) Access to the literature via databases (78%) Possess the skills to implement EBP (83%) Note.  Not all respondents answered each question, thus the sample size per question varies.

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High Evidence CIMT             43% Bimanual  Therapy          57%  Moderate: Recommended GAME           40% Baby CIMT    29% Moderate: Not Recommended NDT               63% Conductive Education       14% Sensory Regulation/ Processing      83% Home Modifications 94% Home Activity 96%

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OTs and PTs must be aware of the levels of evidence to in the treatment of infants with CP maximize the effectiveness of intervention CIMT, bimanual training, goal-directed task-specific motor training, home activity programs, parent coaching, and environmental modifications  OTs and PTs possess EBP skill sets, but experience workplace barriers to implementation  Facilities & managers should provide motivation, incentives, and time What This Study Adds to the Literature  OTs and PTs positively view EBP but 56%  of respondents are unlikely to implement it More advanced degrees & less time in clinical practice increase positive view of EBP Ohio OT’s & PTs report having access to literature and the skills to perform EBP

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Aminah Baig:  baiga@xavier.edu Ellie Cecala:  cecalae@xavier.edu Alaina Gallagher:  gallaghera4@xavier.edu Elizabeth Gick:  gicke@xavier.edu

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 Aminah Baig:  baiga@xavier.edu Ellie Cecala:  cecalae@xavier.edu Alaina Gallagher:  gallaghera4@xavier.edu Elizabeth Gick:  gicke@xavier.edu  

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