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Changes in gross motor function in children with cerebral palsy following repeated intensive rehabilitation periods:
Viktoria Opheim1, Camilla Skagen2, Kine Melfald Tveten2,3
1Department of Physiotherapy Services for Children and Youth, Interdisciplinary Resource Team, Tromsø, Norway.
Insights
Intensive rehabilitation improves gross motor function in children with cerebral palsy (CP). Repeated therapy periods are most beneficial for young children and enhance function across all GMFCS levels.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, impacting gross motor function.
- Intensive rehabilitation is a key intervention for children with CP, but the long-term effects of multiple rehabilitation periods require further investigation.
Purpose of the Study:
- To evaluate the changes in gross motor function in children with cerebral palsy (CP) after undergoing multiple intensive rehabilitation periods.
Main Methods:
- A retrospective longitudinal study analyzed 46 children (aged 2-12 years) with CP (GMFCS levels I-V) who underwent 2-12 intensive rehabilitation periods.
- Gross motor function was assessed using the Gross Motor Function Measure-66 (GMFM-66) and analyzed with linear mixed models.
- Comparisons were made based on GMFCS levels and age groups.
Main Results:
- GMFM-66 scores and percentiles significantly increased during intensive rehabilitation periods, particularly the first four.
- Gross motor function improved across all GMFCS levels, with notable gains in levels I and V.
- Children under 6 years demonstrated greater improvements compared to older children.
Conclusions:
- Intensive rehabilitation is associated with improved gross motor function in children with CP, regardless of GMFCS level.
- Repeated intensive rehabilitation periods show particular benefit in early childhood.
- Strategic implementation of repeated rehabilitation periods can support long-term functional gains in children with CP.
Purpose:
To evaluate changes in gross motor function in children with cerebral palsy (CP), following multiple intensive rehabilitation periods.
Materials And Methods:
In this retrospective longitudinal study, we assessed 46 children with CP, aged 2-12 years, Gross Motor Function Classification System (GMFCS) levels I-V. Participants underwent 2-12 intensive rehabilitation periods, incorporating goal-directed group activities. Long-term change in gross motor function was analyzed using a linear mixed model based on reference percentiles for the Gross Motor Function Measure-66 (GMFM-66). Comparisons were made between GMFCS levels and age groups.
Results:
GMFM-66 scores increased during each intensive rehabilitation period, with significant improvements in period 1-4. The number of participants decreased as the number of periods increased. GMFM-66 percentiles increased by 10.9 (p < 0.001) per period, with an additive gain of 2.4 (p = 0.124) GMFM-66 percentiles per added intensive rehabilitation period. A decrease in percentiles was observed between periods. Gross motor function enhanced across all GMFCS levels, particularly levels I and V. Children under 6 years showed greater improvements than older children.
Conclusions:
Intensive rehabilitation may be associated with improved gross motor function in children with CP, irrespective of GMFCS levels. Repeated periods appear especially beneficial in early childhood, supporting their strategic use in long-term rehabilitation.
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