The use of night orthoses in cerebral palsy treatment: sleep disturbance in children and parental burden or not?

In this study, we investigated whether (1) children with cerebral palsy (CP) using night orthoses experience more sleep disturbance than those not using night orthoses, (2) parental personality is related to the experienced parental burden of night orthoses, and (3) parental sense of competence in the parenting role mediates the relation between parental personality and parental burden. Eighty-two Flemish children with CP (55 using/27 not using night orthoses) with a mean age of 9 years and 10 months (GMFCS level I-V) participated in this cross-sectional questionnaire study, using the Sleep Disturbance Scale (SDSC), Parenting Stress Index (PSI), Big Five Inventory (BFI) and a newly developed inventory to assess the parental burden of night orthoses. Multivariate analysis of covariance revealed no statistical significant differences in sleep disturbance between children using/not using night orthoses. These findings are positive as the use of night orthoses are presumed to be important in providing adequate postural care in children with CP. Extraverted and emotionally stable parents experienced less parental burden. Mediation analysis revealed that parental sense of competence partially mediated the relation between parental personality and the parental burden. These results suggest that integrating parental sense of competence in treatment programs can improve the understanding of experienced burden. Implications of such integrations for therapy are discussed.