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. 2025 Jun;92(2):85-93.
doi: 10.1177/00084174241274743. Epub 2024 Sep 5.

Preparing Adults with Cerebral Palsy to Move from Assisted to Independent Living

Lori Rosenberg, Shira Zecharia, Yafit Gilboa, Anat Golos

Preparing Adults with Cerebral Palsy to Move from Assisted to Independent Living

Lori Rosenberg et al. Can J Occup Ther. 2025 Jun.

Abstract
in English, French

Background. To evaluate effectiveness of The Greenhouse for autonomy and independence to prepare adults with severe cerebral palsy (CP) for the transition from assisted to independent living. The intervention combines weekly individual sessions using Pathways and Resources for Engagement and Participation together with weekly group sessions. Method. Seven adults with severe CP ages 23-45 years (M = 35; SD = 10) participated in the 20-week program. An Interrupted Time Series quasi-experimental design was used, assessing the intervention effect over time. The Canadian Occupational Performance Measure was administered bi-weekly from baseline to post-intervention to assess activity performance. Functional Independence Measure (FIM), Wheelchair use Confidence scale (WheelCon) and Impact on Participation and Autonomy (IPA) were administered baseline (4 weeks pre-intervention), mid and post-intervention, using Freidman test. Interviews were conducted four weeks after intervention. Findings. All participants' activity performance improved over time with significant clinical improvement in 95% of COPM goals. Significant improvement was seen in FIM (χ2 = 8.07, p = .018) and WheelCon (χ2 = 7.18, p = .028) though not in IPA. Participants described being better prepared, however more aware of challenges. Conclusion. The findings suggest the program may be effective to help adults with severe CP attain goals related to independent living and enhance function.

Description. Évaluer l'efficacité de The Greenhouse for autonomy and independence pour préparer les adultes atteints de paralysie cérébrale grave à la transition d'une vie assistée à une vie indépendante. L'intervention combine des sessions individuelles hebdomadaires utilisant Pathways and Resources for Engagement and Participation avec des sessions de groupe hebdomadaires. Méthodologie. Sept adultes atteints de paralysie cérébrale grave âgés de 23 à 45 ans (M = 35 ; ET = 10) ont participé au programme de 20 semaines. Un modèle quasi-expérimental de série temporelle interrompue a été utilisé pour évaluer l’effet de l’intervention au fil du temps. La Mesure canadienne du rendement occupationnel a été administrée toutes les deux semaines entre le début et la fin de l'intervention afin d'évaluer le rendement de l'activité. La Mesure de l'indépendance fonctionnelle (MIF), l'Échelle de confiance pour l'utilisation d'un fauteuil roulant (WheelCon) et l'Impact sur la participation et l'indépendance (IPI) ont été évalués au départ (4 semaines avant l'intervention), à mi-parcours et après l'intervention, à l'aide du test de Freidman. Des entretiens ont été menés quatre semaines après l'intervention. Résultats. Les performances de tous les participants en matière d'activité se sont améliorées au fil du temps, avec une amélioration clinique significative dans 95% des objectifs de la MCRO. Une amélioration significative a été observée dans la MIF (χ2 = 8.07, p = .018) et le WheelCon (χ2 = 7.18, p = .028), mais pas dans l'IPI. Les participants se sont dits mieux préparés, mais plus conscients des défis à relever. Implications. Les résultats suggèrent que le programme peut être efficace pour aider les adultes atteints d'une PC grave à atteindre des objectifs liés à une vie indépendante et à améliorer leur fonction.

Keywords: Autonomie; Autonomy; Cerebral palsy; Participation; Transition; paralysie cérébrale; participation; transition.

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Figures

Figure 1.
Figure 1.
Flowchart of procedures.
Figure 2.
Figure 2.
Bi-weekly COPM (Canadian Occupational Performance Measure) performance scores over time per participants.
See this image and copyright information in PMC

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