Assessing Motivation in Cerebral Palsy During Rehabilitation: A Systematic Review

Area of Science:

• Pediatric Neurorehabilitation
• Child Psychology
• Rehabilitation Medicine

Background:

• Motivation significantly impacts learning and rehabilitation outcomes in children with cerebral palsy (CP).
• Systematic assessment of motivation is infrequent in pediatric neurorehabilitation.
• There is a lack of consensus on appropriate outcome measures for motivation in this population.

Purpose of the Study:

• To systematically map how motivation-related constructs are assessed in rehabilitation studies for children with CP.
• To identify instruments used for motivation assessment.
• To evaluate the explicit measurement of motivation across diverse rehabilitation settings.

Main Methods:

• Systematic mapping review following PRISMA guidelines, registered in PROSPERO.
• Searched PubMed and Scopus databases for studies published between 2013 and 2025.
• Included studies on rehabilitation interventions for children with CP featuring defined motivation-related outcomes; assessed quality using JBI tools and RoB 2.

Main Results:

• Nine studies with 109 subjects (RCTs, case series) met inclusion criteria, primarily involving children with mild-to-moderate motor impairment (GMFCS/MACS I-II).
• Motivation was assessed using varied approaches: self-efficacy, mastery motivation, participation, adherence, and intrinsic motivation.
• Data collection involved children, parents, therapists, or dyads, indicating heterogeneous assessment methods.

Conclusions:

• Despite recognition of motivation's importance in pediatric CP rehabilitation, its assessment is inconsistent and fragmented.
• The current evidence base is limited and heterogeneous.
• There is a critical need for standardized, validated, and developmentally appropriate tools to measure motivation in pediatric CP rehabilitation.