Physiotherapy interventions for school-aged non-ambulatory children with cerebral palsy combined with intellectual disability – An integrative review

Physiotherapists in Aotearoa New Zealand, face challenges implementing evidence-based practice (EBP) for non-ambulatory children with cerebral palsy and intellectual disabilities (NACCPID) working within Hoffman’s model of EBP. Key challenges in the evidence component include limited NACCPID specific research. This project aims to review the literature on physiotherapy interventions for school-aged NACCPID to inform clinical practice and identify areas for future research within the Aotearoa New Zealand context. An integrative review was conducted, following Kutcher and LeBaron’s (2022) method. A systematic search, conducted in 2023, yielded 2,240 articles that were narrowed to 24 after applying inclusion criteria. Coding and thematic analysis were conducted in NVivo 12 following content analysis methods. Final codes were organised within the Te Whare Tapa Whā framework through collaborative review with a cultural advisor. This enabled a holistic view of health, addressing physical, mental, social, and spiritual wellbeing, incorporating Māori perspectives. Ten themes were generated relating to physiotherapy interventions for NACCPID: 1) individual needs; 2) self-esteem and positive emotions; 3) body systems; 4) optimising ability to move the body; 5) using the body to perform a task; 6) collaboration; 7) (in)dependence; 8) participation and inclusion; 9) resourcing; and, 10) accessible environments. Notably, power wheelchair training appears to have significant beneficial effects across all aspects of health, and it is important that the child and families’ individual needs, wants, likes, circumstances, and values are considered when choosing an intervention.