Development, effectiveness, and usability of a home-based exercise education video on neck control among Nigerian children with cerebral palsy

Okonji, A. ORCID: https://orcid.org/0000-0001-5647-2347, Odetunde, M. ORCID: https://orcid.org/0000-0001-8130-7255, Ibrahim, R. ORCID: https://orcid.org/0009-0009-5904-8838 and Govender, P. ORCID: https://orcid.org/0000-0003-3155-3743 (2025) Development, effectiveness, and usability of a home-based exercise education video on neck control among Nigerian children with cerebral palsy. Bulletin of Faculty of Physical Therapy, 30 (1). 31. ISSN 2536-9660

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Abstract

Despite the many proven benefits of home programs, there are many challenges in their effective use and administration by caregivers for children with cerebral palsy (CP), leading to poor adherence and outcomes. This study aimed to develop and test the feasibility of a home-based exercise education video among caregivers of children with CP. This two-phase quasi-experimental study involved 24 purposively selected children with CP and their caregivers attending two randomly selected physiotherapy clinics in Nigeria. Ethical approval for the study was obtained from the Ethics and Research Committee, Obafemi Awolowo University Teaching Hospital, Nigeria (ERC/2024/02/23). An instructional video was developed and administered to caregivers for 6 weeks. Neck control was assessed using the Clinical Rating Scale for Head Control (CRSHC) and Gross Motor Function Measure-88 (GMFM-88). The usability of the video tool was assessed using a feasibility questionnaire. Data were analyzed using descriptive statistics and repeated-measure ANOVA. Alpha value was set at p < 0.05. Results of CRSHC showed significant improvements in neck control in prone (F = 5.32; p = 0.032), supine (F = 11.537; p = 0.000), and supported-sitting (F = 21.421; p = 0.000) positions. The GMFM-88 results also showed significant improvements in neck control in supine (lifts head 45⁰) (F = 7.15; p = 0.004), supine (pull to sitting) (F = 7.000; p = 0.004), prone (lifts head upright) (F = 12.571; p = 0.005) and supported-sitting (F = 18.192; p = 0.001) positions across time points. 12.571; p = 0.005) and supported-sitting (F = 18.192; p = 0.001) positions across time points. Caregivers found the neck exercise video content clear, relevant, and engaging. This study concluded that the video-based exercise tool had good usability among caregivers of children with CP and effectively improved neck control among children with CP.