Long-term change of gross motor function in children with cerebral palsy; an observational study of repeated periods of intensive physiotherapy in a group setting

Abstract

Purpose: To examine change in gross motor function in children with cerebral palsy (CP) following repeated periods of intensive physiotherapy in real-life group-settings, with expected motor development taken into consideration.

Material and methods: This prospective, observational study included 120 children with CP. They participated in 2–10 periods of intensive goal-directed, activity-focussed group training. The intervention model was pragmatic, taking GMFCS-level and other knowledge of the participating children into consideration. They typically attended groups of 4–6 children, lasting 2–2.5 h/d, 3 d a week over 6 weeks. Fifty children participated in at least four successive training periods. They were included in the analysis of longitudinal change, assessed by the Gross Motor Function Measure (GMFM-66), and analysed by repeated analysis of variance and multiple regressions.

Results: Mean scores relative to age-related development curves improved after separate intensive training periods, but dropped somewhat between periods. Longitudinal change was explored in a subsample of 50 children who participated in at least four successive training periods. Statistical significant improvement (p < .05) in pre-test scores beyond age-related development curves was demonstrated from period 1–3, and 1–4 (mean 25 months, SD 11), including children at all levels of the Gross Motor Function Classification System (GMFCS).

Conclusions: At least two periods of intensive group training was needed in children with CP to obtain improvement of gross motor function above what can be expected from natural development over time.

Keywords:

• Intensive physiotherapy
• specific training
• CP
• group training
• longitudinal study

Acknowledgements

The first author, Anne Brit Sørsdahl, very sadly passed away before the article was finished. She was the project leader and coordinated the collaboration between physiotherapy colleagues at the different habilitation sites in Western Norway, and made a substantial intellectual and practical contribution to the study.

Disclosure statement

There are no competing interests.