Trends observed in bilateral cerebral palsy during a thirty-year period: A cohort study with an ICF-based overview
Silvia Pizzighello1, Marinela Vavla1, Nadia Minicuci1
1Scientific Institute, IRCCS E. Medea, Department of Pieve di Soligo, Treviso, Italy.
Insights
Trends in bilateral cerebral palsy rehabilitation show reduced treatment duration and shifts in motor patterns over thirty years. While gross motor function slightly improved, communication abilities remained unchanged, with increased medical interventions.
Area of Science:
- Rehabilitation Medicine
- Neurology
- Pediatrics
Background:
- Bilateral cerebral palsy (CP) impacts motor function and development.
- Understanding long-term trends in CP patient characteristics and rehabilitation is crucial for improving care.
Purpose of the Study:
- To analyze demographic, clinical, and rehabilitation trends in patients with bilateral CP over three decades.
- To describe changes in patient functioning and treatment approaches using the International Classification of Functioning, Disability and Health (ICF) framework.
Main Methods:
- Retrospective analysis of 464 inpatients with bilateral CP born between 1967 and 1997.
- Data collected from medical reports, categorized according to ICF domains (Body Functions, Activity/Participation, Personal/Environmental factors).
- Trends analyzed across three birth decades (1967-1977, 1977-1987, 1987-1997).
Main Results:
- Rehabilitation treatment duration decreased significantly over the decades (from 16.2 to 12.3 years).
- Quadriplegia rates decreased, while diplegia rates increased; spasticity remained the dominant motor type.
- Musculoskeletal disorders primarily affected the lower body; psychiatric comorbidities decreased. Slight improvements in gross motor function and hand dexterity were noted.
- Increased use of pharmacological and surgical interventions for motor symptoms observed.
Conclusions:
- The study provides a comprehensive overview of functioning in Italian bilateral CP patients based on the ICF.
- Observed trends indicate shifts in clinical presentation and rehabilitation strategies over a 30-year period.
- Findings highlight the evolving landscape of bilateral CP management and patient outcomes.
Background:
To describe trends observed across thirty years in demographic and clinical characteristics and rehabilitation of patients with bilateral cerebral palsy.
Methods:
This retrospective study includes 464 (261 M and 203 F) inpatients with bilateral cerebral palsy, born from 1967 to 1997 and discharged from an outpatient rehabilitative facility from 1985 to 2015. Data concerning the health profile were collected from medical reports and organized in the domains of Body Functions and Structure; Activity and participation and Personal and Environmental factors as proposed in the International Classification of Functioning Disability and Health (ICF). The trend observed over the three birth decades was discussed.
Results:
The duration of the rehabilitative treatment decreased across decades approximately by two years per decade (from an initial 16.2 yrs to 12.3 yrs). Across the decades the rate of quadriplegia decreased, whereas rates of diplegia increased; spasticity was the prevalent observed motor type for all decades. The most frequent musculoskeletal disorder involved the middle inferior part of the body; among comorbidities a steady decrease in psychiatric disorders was found. With respect to the first decade a slight improvement was observed in the gross motor functioning and in the hand dexterity. No particular trend was observed concerning communication abilities. An increase in the use of pharmacological and surgical treatments for motor symptoms was observed.
Conclusion:
This study presents and describes the functioning of a large sample of Italian patients with bilateral CP on the basis of the ICF framework and it discussed the trend observed across decades.
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