The Impact of Gross Motor Stimulation Home Program on Family Empowerment and its Relationship with Functional Performance in Children with Cerebral Palsy

Background: Cerebral palsy (CP) is a lifelong condition of physical disability, a common complaint is the limitation of movement, posture, and coordination of movement. This condition impacts the child's ability to perform independent activities of daily living (ADLs), such as eating, dressing, toileting, and mobility, which has an impact on welbeing. In environmental situations that are difficult to access therapy and the lack of therapists causes the continuity of therapy to be hampered. The solution to overcome this situation is to optimize the family to stimulate child development. The results of many studies illustrate the effectiveness of family empowerment through structured home-based programs that primarily greatly increase family confidence and capacity to handle children and have a positive impact on the functional ability of children to carry out daily care effectively.  Objectives: The purpose of this study was to measure the effectiveness of a structured home program on the level of family empowerment, gross motor function, and ADL independence in children with cerebral palsy.  Methods: This study used a one-group pretest-posttest pre-experimental design involving 32 children with CP and their caregivers in Sukoharjo District, Central Java, Indonesia. The participants received a two-month structured gross motor stimulation program at home in the form of a gross motor handling guide module for children with CP at home, where, before use, an explanation of the use of the module was carried out so that the implementation of the home program was appropriate, and in its implementation, regular monitoring was carried out through monitoring sheets and WhatsApp groups to ensure that the home program was consistent. The instruments used in this study include the Family Empowerment Scale, Gross Motor Function Measure (GMFM-88), and Wee Functional Independence Measure (WeeFIM). Data were analyzed using the Wilcoxon Signed-Rank test and linear regression.  Conclusion: The results showed significant improvements in family empowerment (p = 0.000), gross motor function (p = 0.042), and ADL independence (p = 0.013) after the intervention. A strong positive relationship was found between gross motor function and ADL independence (R = 0.624; R2 = 0.390; p = 0.000), proving that improved motor ability significantly contributed to improved independence.