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Abstract
Purpose. To investigate gross motor function and goal attainment in children with cerebral palsy before, during and after goal-directed functional therapy (GDT), to evaluate body functions, and explore relationships.
Method. Prospective longitudinal intervention study. Twenty-two children, uni- or bilateral CP, 1–6 years (mean: 46 months SD: 16 months), classified in GMFCS and MACS level I–IV participated. Outcome measures were Gross Motor Function Measure (GMFM-66), performed at seven occasions, Goal Attainment Scale, assessments of passive range of motion, spasticity and selective motor control (SMC). Baseline, the GDT-intervention and the follow-up period were 12 weeks each.
Results. Improvements were demonstrated in GMFM-66 during the intervention (mean difference: 5.07, CI: 3.8–6.4, p < 0.001). The baseline and follow-up assessments were stable. Evaluations of ankle dorsiflexion displayed small improvement (mean difference: 9°, CI: 5–13, p < 0.001). Estimations of spasticity and SMC did not demonstrate significant changes. Goal attainment to the expected level or higher was achieved in 93/110 goals and further improved at the long-term follow-up (103/110).
Conclusion. Gross motor function improved during GDT, and was maintained 12 weeks later. The goals were reached to a high extent, and the children gradually progressed towards their goals after the end of the intervention. The therapy did not induce any deterioration of body functions.
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Acknowledgements
We gratefully acknowledge all children and their families for participating. We also thank our colleagues at Handicap & Habilitation for their enthusiastic contribution. We are most grateful to Lanie Gutierrez-Farewik for extensive assistance and suggestions that improved this manuscript! The study was supported by major long-term contribution from Ad Infinitum Foundation. Grants were also received from Linnea & Josef Carlssons Foundation, Norrbacka-Eugenia Foundation, Pick-Up –Stockholm County Council, Sunnerdahl Foundation, Jerring Foundation, Odd Fellow Foundation, Majblomman Foundation and Jerring Foundation.