IMPACT OF COMMUNITY-BASED PHYSIOTHERAPY ON FUNCTIONAL OUTCOMES IN ORTHOPEDICALLY HANDICAPPED RURAL CHILDREN POST-SURGERY

Background and Purpose: Orthopedic disabilities in rural Indian children, often due to congenital conditions, neglected trauma, or cerebral palsy sequelae, frequently result in delayed surgical intervention and limited post-operative rehabilitation access. Community-based physiotherapy offers a promising, low-cost solution to improve functional outcomes in resource-constrained settings. This study aimed to evaluate the impact of a 6-week community-based physiotherapy program on gross motor function, functional independence, pain, and quality of life in rural orthopedically handicapped children post-surgery. Methods: A single-group quasi-experimental pre-post design was conducted in rural Andhra Pradesh, with 45 children (aged 5–18 years) completing the protocol. Participants received bi-weekly home visits, weekly group sessions, and caregiver training aligned with WHO CBR guidelines. Outcomes were assessed using GMFM-88, WeeFIM, VAS for pain, and PedsQL at baseline and 6 weeks, analyzed via paired t-tests/Wilcoxon tests and regression models. Results: Significant improvements were observed: GMFM-88 increased by 15.69 points (d=1.90), WeeFIM by 21 points (d=1.57), VAS pain decreased by 3.45 points (d=–2.59), and PedsQL rose by 16.11 points (d=1.72) (all p<0.001). Pre-scores strongly predicted post-scores (adjusted R² 0.755–0.903) with minimal confounding. Conclusion: A short-term community-based physiotherapy program yields substantial functional and quality-of-life gains in rural post-surgical pediatric orthopedic cases, supporting its integration into rural healthcare systems.