Disrupted Access to Therapies and Impact on Well-Being During the COVID-19 Pandemic for Children With Motor Impairment and Their Caregivers

Am J Phys Med Rehabil. 2021 Sep 1;100(9):821-830. doi: 10.1097/PHM.0000000000001818.

Abstract

Objectives: The aim of this study was to determine the impact of the COVID-19 pandemic on access to rehabilitation therapies and the impact of changes in therapy access on the physical and mental well-being of children with motor impairment and their caregivers.

Design: Caregivers of children younger than 18 yrs with childhood-onset motor impairment (primarily cerebral palsy) completed an anonymous survey through the online platform REDCap between May 5 and July 13, 2020.

Results: The survey was completed by 102 participants. Before the pandemic, 92 of 102 children (90%) were receiving one or more therapies; at the time surveyed, 55 children (54%) were receiving any therapies (P < 0.001). More than 40% of the sample reported increased child stress, decreased physical activity, and/or decline in mobility/movement. Participants who reported a decrease in number of therapies at the time surveyed more frequently reported lower satisfaction with treatment delivery (P < 0.001), a decline in child's mobility (P = 0.001), and increased caregiver stress (P = 0.004). Five qualitative themes were identified from open-ended question responses related to therapies and well-being.

Conclusions: Access to pediatric rehabilitation therapies was disrupted during COVID-19. Disrupted access may be related to impact on physical and mental health. With the expansion of telehealth, caregiver and child feedback should be incorporated to optimize benefit.

MeSH terms

  • Adolescent
  • Adult
  • COVID-19*
  • Caregiver Burden / epidemiology
  • Caregivers / psychology
  • Cerebral Palsy / psychology
  • Cerebral Palsy / rehabilitation*
  • Child
  • Continuity of Patient Care / statistics & numerical data
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Mobility Limitation
  • Movement Disorders / psychology
  • Movement Disorders / rehabilitation*
  • Qualitative Research
  • Quarantine / psychology*
  • SARS-CoV-2
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology
  • Surveys and Questionnaires