Introduction
My capstone project was inspired by an experience while working with children during clinical rotations. During one rotation, I encountered children with cerebral palsy struggling with being overweight/obese, a factor which added to their often challenging lives. The impact of their weight on their ability to perform functional tasks was concerning, and the difficulty of addressing this issue with parents was a huge barrier in helping these children. With obesity being spotlighted in the media and by prominent political activists, this is a good time to address ways we can mitigate this problem for patients who already have some serious health concerns by incorporating overall health and wellness into our daily practice. It is also important we identify some of the materials than can help overcome the hurdles associated with this sensitive topic.
For my capstone I have done research on the relationship between obesity and cerebral palsy. I have created a presentation and handouts for clinicians along with materials for parents to help foster communication among clinicians, parents, and patients. I see a need for parental education, and I strongly believe that appropriate dialogue is the first step towards helping children with cerebral palsy overcome obesity.
Materials
For clinicians, I have created a PowerPoint lecture and a separate quick reference handout. The lecture contains information regarding current evidence on obesity and physical activity as they apply to children with cerebral palsy. Specifically, I address how obesity affects these children, the unique ways physical activity benefits them, and ways to incorporate physical activity goals into the plan of care. The presentation is designed to fit in with a typical outpatient clinic’s lunch schedule and be presented in approximately 30-45 minutes. Therapists who attend the presentation will be given a handout for future reference that includes some additional information that may be useful for therapists.
For parents, I have created two handouts dealing with obesity in children with cerebral palsy. One parent handout addresses parental beliefs on body weight and ways to determine a healthy weight for their child. This handout can also be used to educate the parents of any child who is struggling with weight. The second parent handout is specifically geared towards children with cerebral palsy, addressing the benefits of physical activity and stressing the positive effects on motor skills and ways to incorporate physical activity into their daily lives.
Closing
Through the use of these tools, it is hoped that we will be able to educate patients, parents, and clinicians on the issue of obesity in children with cerebral palsy. This information can help parents make better decisions to help their children and prevent obesity, and it can give additional assistance to clinicians when addressing obesity in children with cerebral palsy.
References
The primary references I used for my research can be found in my Evidence Table.
A complete listing of references can be found here.
Feedback
The presentation was given at the Cary office of Pediatric Therapy Associates. The group was asked to complete a feedback form. The feedback given was positive. The group liked the handouts, especially the one for parents that helps parents determine a healthy weight.
I want to thank my committee for their feedback!
5 Responses to “Counteracting Obesity with Physical Activity in Children with Cerebral Palsy”
Mike Gross
Susan- you have done a great job on all of hte outcome products. Children with CP, their parents, and their therapists will all benefit from these valaubel resources. I expecially like the way you have provided community resources for the children and their parents. Mike
Brian Gentry
Susan:
I wasn’t able to view the powerpoint until this weekend, so sorry about the late post. I read through the handouts and thought that most of the information was pretty good. One of the children that I see is a teenager and I would like to present some of this information to the family. There are many facets to take into consideration when it comes to obesity with CP, and it’s not all due to what many believe is the primary issue of eating too much or not eating healthy. These children are physically unable to do a great deal of exercise without specialized equipment and a great deal of assistance. That is where, as clinicians, it is important to be creative and interactive with children and their parents as a whole. I think your project touched on general childhood and obesity and CP and obesity–2 similar, but different things. I would have liked if the overall focus was moreso on CP and obesity, because these are the children who have that neuromuscular, physical limitation to being able to exericise as compared to a typically developing child. There seemed to be a lot of info on general childhood obesity, which is fine, but not the topic of this project. I think this was a great topic to tackle, and I applaud your efforts to help educate these families to the potential detrimental health effects that can and do occur in our society.
jdunigan
Hi Susan,
I was thoroughly impressed with your Capstone. I think it’s great that we have classmates that are really researching and thinking about some of the bigger issues of today’s healthcare, and childhood obesity is no exception. I for one have not seen a single patient with CP in my clinical rotations, but wanting to work in an outpatient setting in rural N.C., I’m sure I will. The PowerPoint was an excellent resource to refresh on the statistics of obesity in children, as well as understanding how patients with CP are at even higher risks for obesity. I especially like the use of specific research articles that used patients with CP performing progressive resistance training exercises. I for one don’t think this type of exercises is used enough in our pediatric population regarding of the presence of pathology. The handouts were excellent. I can absolutely see myself using this handout in conjunction with increased in exercise for these patients. Great job! We’re almost finished!
leighmcl
Susan, great work on this project! I think this topic is a very real issue and I am glad to see that you are making strides to help minimize the problem! I enjoyed reading through your clinician materials and handouts for parents. One interesting thing I took note of under the powerpoint comments was “the child most likely knows that weight is an issue.” From my limited experience working with children and families and from my personal experience I don’t think that is true in all cases. My first thought is about my younger brother who took after my father and wanted to just about everything the way he did and as a result picked up some adult-like habits. My brother ate bigger than kids’ sized portions and he gravitated toward the recreational/leisure activities that my arthritic dad enjoyed such as fishing and hunting that are sedentary. My brother did not have the self-schema that he was overweight until middle school and it took until high school to really understand what he could do about it. I have come to understand young children often have an untainted and naïve concept of outward appearances and thus are not concerned with or aware of issues of weight unless they are helped to understand them. I think weight issues are really hard for children to grasp because there isn’t an immediate or “noticeable” cause and effect; if they eat unhealthy foods it doesn’t hurt or it doesn’t cause a bad reaction that they can easily perceive and be trained to want to avoid. With this being said I truly applaud efforts to empower healthcare providers to address weight issues (rather than avoid the difficult conversation or expect some other healthcare provider to do it) and help parents become better informed and trained to talk with their child to manage their habits. I also greatly appreciate your targeted focus in on the cerebral palsy or developmental disability pediatric population. Families of children with motor difficulty may find it hard to integrate extra activity into the child’s routine or are afraid to ask the child to do more. This can be compounded with poor nutritional habits due to limited food preferences and allergies of the child or a parent who allows food to be a comfort or luxury to the child. So thank you for making an extra effort to reach this needing group. Great work, on all of it! Would you mind if I shared some of your great educational materials with my future patients and families? Best of luck on your presentation! I would love to be in attendance or hear how it goes!
Erin Rosner, PT
We do not have power point on our computers, so I was unable to view the Clinician Presentation. However, I was able to view all 3 handouts. I felt they contained appropriate information. The parent handouts were not too technical and provided useful information. I liked that the BMI equation and chart were included so parents could determine immediately if their child fell into an unhealthy group. I could see myself using both handouts with families at our clinic. I also liked the clincian handout and it would be a nice addition to keep on hand. The 6-minute walk test is a great addition and since families can be very sensitive talking about weight, it’s a nice way to demonsstrate that a child may be unhealthy without having to focus solely on the childs weight. Thanks for putting this together, very useful and I’m looking forward to the power point!