An Examination of the Role of Postural Care in Participation and Meaningful Occupation for Children with TBI

Abstract

Background: Postural care, as described by the UK Government (2018), is a strategy to help maintain or restore body shape/muscle tone for individuals who are challenged with movement difficulties. It is a widely accepted therapeutic intervention that has been successful in other populations, such as those with learning disabilities who have movement challenges (PAMIS 2021, MENCAP 2021), however it has not been a common intervention in the TBI population. High (et al. 2005) maintains that the paediatric population has not been adequately studied in relation to TBI, intervention or occupational participation. This is what the researcher hopes to explore in the following literature review and study. Literature Review Findings: The Literature review found that there was a significant lack of research done in a child-centred, holistic manner with children in general and in particular with children who have a TBI. It also revealed that postural care, while a successful intervention for other populations with movement difficulties, it had not been studying in any great depth regarding children with TBI or the TBI population as a whole. This presented a gap in which this intervention could be implemented to see if it has any impact on occupational participation. Additionally, it was highlighted that children with TBI face substantial limitations and restrictions when it comes to occupational participation and opportunities in all major occupational environments, and most significantly, in the community setting which could be contributing to occupational deprivation in this group. Research Proposal: A mixed methodology was planned to examine how a child, who has a TBI and subsequent movement challenges, could benefit from postural care intervention, and engages in daily occupations and how they feel about their ability to participate. The research proposed would extend over eight weeks, with the researcher attending the hospital or clinic to implement the postural care intervention and conduct semistructured interviews to determine the children’s perspectives on the therapy process. Employing the framework method and paired sample t-tests, the researcher will analyse the data to determine if there is a significant correlation between postural care intervention and improved occupational participation. The researcher will also take into account the children’s perspectives by analysing the COPM scores on the pre and post test to determine if the children feel their occupational performance is improved within their chosen daily occupations. Conclusions: Children who have been diagnosed with a TBI and have accompanying movement difficulties could benefit from participation in postural care as it may enable reduced limitations or restrictions to occupational participation in the child’s daily activities and promote a better quality of life.