Quality of Life in Children with Cerebral Palsy: The Role of Having Access to Rehabilitation Services

Background: Cerebral palsy (CP) is a neurological motor disability, and children with CP should receive rehabilitation services to achieve their full potential. Objectives: The purpose of this study was to explore the quality of life (QOL) of children with CP across various domains and to assess the role of access to rehabilitation services on their QOL. Methods: We conducted a cross-sectional study involving all 126 children aged 4 - 12 with CP and their parents in Saqqez county, Kurdistan province, Iran. The "Physical Rehabilitation Accessibility Assessment Questionnaire" and the "Parental Proxy CP QOL-Child questionnaire" were used to measure the main variables. The analysis performed separately for two subpopulations: 27 children aged 4 - 6 years and 99 children older than six, using SPSS version 23. After prforming Kolmogorov-Smirnov test, the Spearman correlation coefficient was employed to identify correlations. Results: The average age of the participants was 8 ± 2.36 years, with 51 (40.5%) being girls. Of the 126 children with CP, 45 (35.7%) had independent mobility function (GMFCS levels I and II). The mean CP QOL-Child domain scores ranged from 35.3 ± 25.1 in the 'access to services' domain to 74.5 ± 16.1 in the 'Emotional well-being and self-esteem' domain. The average accessibility score was 53.8 ± 22.1. Among children older than 6 years, access to rehabilitation services showed a significant correlation with all CP QOL-Child domain scores (P < 0.05), except for 'social well-being and acceptance.' In children aged 4 - 6 years, only the Family Health domain score was significantly correlated with access to rehabilitation services (r = 0.44, P = 0.021). Conclusions: Access to rehabilitation services is a significant predictor of QOL in children older than 6 years. Further experimental research is needed to examine changes in various aspects of QOL in children with CP following improved access to rehabilitation services.