Exploring Physiotherapists' Use of Motor Learning Strategies in Gait-Based Interventions for Children with Cerebral Palsy

Aim: This study investigated physiotherapists' experiences using motor learning strategies (MLS) in gait-based interventions for children with cerebral palsy (CP). The objectives were to explore how child characteristics, physiotherapist decision-making, and treatment approach influenced intentional MLS use. Methods: Semi-structured interviews were conducted with eight physiotherapists who provided gym- and/or Lokomat-based treatment to children with CP. Interviews were analyzed using directed content analysis and a modified constant comparison method. Results: Three themes described their experiences: (1) MLS use is driven by the unique aspects of the child, physiotherapist, and intervention; (2) The use and description of motor learning content varies among physiotherapists; and (3) The Lokomat is "the same but different." Child characteristics were at the forefront of MLS selection in both interventions. The terminology used to describe MLS use varied considerably among therapists. They used similar clinical decision-making in gym- and Lokomat-based interventions. Conclusions: Conscious reflection on the factors affecting MLS use could facilitate related clinical decision-making in physiotherapy interventions for children with CP. Increased awareness of MLS and use of a structured framework for reporting MLS are required to promote intentional MLS use and generate CP-specific evidence-based MLS research.