Changing Perspectives and Practice in Habilitation in Norway. A Study of Physiotherapists' Assessment of Children with Cerrebral Palsy, Based on ICIDH-2, 1998

The project objective was to describe and discuss physiotherapists information gathering and decision making as a basis for assessing children with cerrebral palsy, based on ICIDH-2.

Over the last twenty years there have been beydelige changes in care ideologies and theoretical reference frames for habilitation. The study's first part, which is a literature review, shows that these changes are so extensive, and have so many common characteristics that they can be said to have created a new paradigm for physiotherapy assessment of children with neurological disorders - from function-oriented to participation oriented treatment.
The study's second part is an empirical study of a group of physiotherapists collection of information when studying children with cerebral palsy. The data has been collected in two ways: 1) through a postal survey based on WHO's "International Classification and Impairments, Activities and Participation" (ICIDH-2) and 2) through investigation reports from a sample of physiotherapists who participated in the survey. Since the study's key concepts are built around ICIDH-2 the system's suitability to describe the information physiotherapists collect are also discussed.
The core of the physiotherapist's assessments can be summarized in the concept of motion: motion assumptions, basic movement activities, movement quality and use of assistive devices that can compensate for reduced mobility.
The physiotherapists also frequently collect information on a wide range of other impairments and activities, while the extent of participation-oriented information seems to be less. The information is obtained from many different sources. Additional tests of the child on business premises is emerging as the primary source by collecting central information. The literature review showed that over the past ten years good assessment tool have been developed for children with cerebral palse. These are seldom used by physiotherapists in the material. Overall, it seems physiotherapist's information retrieval is rooted in functional rehabilitation, but it also includes elements that might be related to participation oriented habilitation.
The results indicate that the chapters and categories the study has drawn from ICIDH-2 capture essential parts of the information physiotherapists collect, and that most categories are operationalized so that they can be recognized in the physiotherapist's language.