Rehabilitation needs of youth with arthrogryposis multiplex congenita: Perspectives from key stakeholders.

BACKGROUND: Arthrogryposis multiplex congenita is a term used to describe congenital contractures in at least two body parts with an overall prevalence of 1 in 3000 live births. It is often caused by lack of fetal movement in utero and presents as contractures of varying severity, which may affect the upper and lower extremities, the spine and jaw. Currently, no practice recommendations exist to inform best clinical practice for arthrogryposis multiplex congenita.

PURPOSE: To identify the needs surrounding rehabilitation as experienced by youth with arthrogryposis multiplex congenita, caregivers, and clinicians and to propose solutions to develop family- and client-centred rehabilitation recommendations.

MATERIALS AND METHODS: A modified experience-based co-design methodology was used where qualitative interviews were conducted with key stakeholders.

RESULTS: Twenty-seven participants completed the interviews and demographic information was collected where early-active rehabilitation began at birth in most cases and became less frequent through adolescence. Three overarching themes were determined for each stakeholder group.

CONCLUSIONS: All participants reported that early-active rehabilitation is beneficial as it helps determine future treatments. Transition times and participation need to be at the center of interventions to ensure that the needs of youth with arthrogryposis multiplex congenita are being met. The development a condition-specific outcome-measure and rehabilitation practice recommendations will assist clinicians in addressing the needs of youth with arthrogryposis multiplex congenita. Implications for rehabilitation Arthrogryposis multiplex congenita presents in at least two different areas of the body as multiple congenital contractures of varying severity which may affect the upper and lower extremities, spine and jaw. Youth with arthrogryposis multiplex congenita identified participation as an essential component of their life, however caregivers and clinicians did not emphasize this need. Gathering information from different stakeholders is important to ensure varying needs are addressed. Rehabilitation was reported to be beneficial from early childhood to late adolescence by youth, caregivers, and clinicians. Frequency of rehabilitation diminished over time, emphasizing the need for continued follow-up into adolescence.