Functional outcomes and barriers of assistive devices for children with cerebral palsy: a cross-sectional study in Rwandan rehabilitation contexts.

BACKGROUND: Cerebral palsy (CP) is a leading cause of physical disability worldwide, affecting approximately 2 -3 per 1,000 live births. In sub-Saharan Africa, access to assistive devices supporting participation in occupation remains constrained by inadequate rehabilitation services and limited evidence. This study examined the utilisation, perceived benefits and challenges associated with assistive devices use among children with CP attending rehabilitation centres in Rwanda. METHODS: We conducted a cross-sectional study at Gatagara Orthopaedic and Rehabilitation Hospital and Gahini Rehabilitation Centre among 50 caregivers of children with CP using assistive devices. Data were collected using a sociodemographic questionnaire and the World Health Organisation's Rapid Assistive Technology Assessment. Descriptive and analytical analyses were performed. RESULTS: Improved playing skills were associated with standing frame use (AOR = 2.8, p = 0.02). Self- feeding was associated with the use off adapted spoon use (AOR = 4.5, p = 0.03); while improved dressing was associated with orthosis use (AOR = 3.1, p = 0.047). Enhanced self-care was associated with higher caregiver education (AOR = 2.9, p = 0.04). Better attention span was associated with daily rather than weekly assistive device use (AOR = 3.2, p = 0.025). However, high device cost particularly among the poorest households, long travel distances, stigma, and lower parental education were associated barriers to the utilization of devices. CONCLUSION: Assistive devices improved play, self-care, dressing, and attention with caregiver support. However, persistent economic, geographic, and educational challenges limit equitable access, underscoring the need for affordability, context-approach, and community-based rehabilitation support.