Effects of a Multimodal Neurorehabilitation Program on Gross Motor Function and Activity and Participation Performance in Children With Cerebral Palsy: A 9-Month Longitudinal Study

Abstract

Introduction: Long-term physiotherapy is essential to enhance motor and functional development in children with cerebral palsy (CP). The aim of this study was to analyze the effects of multimodal neurorehabilitation in children with CP by evaluating its effectiveness over time at all levels of the Gross Motor Function Classification System (GMFCS) on gross motor function, activity and participation. Methods: This prospective, longitudinal cohort study aimed to characterize a sample and evaluate the effectiveness of multimodal neurorehabilitation over a 9-month period. Gross motor function was assessed using the Gross Motor Function Measure (GMFM-66), and performance in activity and participation was assessed using the Pediatric Evaluation of Disability Inventory (PEDI). The assessments were performed at four assessment points. Results: 29 children diagnosed with CP aged 11 months to 12 years and from all GMFCS levels were included in the study. Neurorehabilitation improved gross motor function in both groups in the total score. Groups IV and V improved only in dimension B (sitting), while groups I, II and III showed significant changes in dimensions D (standing) and E (walking, running and jumping). Regarding mobility and social function, only levels I, II and III showed significant differences. Conclusion: These findings reinforce that a multimodal neurorehabilitation program, when structured within a standardized clinical protocol and tailored to the functional profile of each GMFCS level, may contribute meaningfully to motor development in children with CP. Furthermore, it promoted advances in mobility and social function at levels I, II, and III. At the more severe levels (IV and V), specific improvements in sitting posture were observed.