Impact of the Akwenda Intervention Program for cerebral palsy on caregiver-perceived burden, stress, and psychosocial functioning: A cluster-randomized trial in Uganda.

The intervention was a complex package of five components (workshops, therapy sessions, devices, goal setting, advocacy). It is impossible to determine which specific element caused the improvements. Assessors were blinded, but the authors note that contextual factors like geography or seeing assistive devices might have compromised blinding. The study used a custom, unvalidated questionnaire for caregiver knowledge and a custom protocol for skill assessment. The sample size for the video-based skill assessment was very small, limiting statistical power. The control group received usual care, which in this setting may have been minimal, potentially exaggerating the relative benefit of the intensive intervention. The study did not measure positive aspects of caregiving, only the reduction of negative burden.

Funded by Stiftelsen Promobilia, Vetenskapsrådet, and Stiftelsen Sunnerdahls Handikappfond. No specific conflicts of interest are declared by the authors in the provided text.

Do not attribute the positive outcomes solely to the physical therapy or occupational therapy components. The intervention was a multi-component package including peer support and advocacy, and the study design cannot separate the effect of any single part.