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.
Franciele Zardo, Daiane Bridi, Monique Schorn and 4 others
PMID 41431346WHAT IT FOUND
Children in GMFCS levels I–III improved gross motor function, mobility and social function over nine months.
Levels IV–V improved only in sitting, with no change in daily activity performance. Since all children received multiple therapies together, the specific contribution of any single treatment cannot be separated.
Key findings
01Children in GMFCS levels I, II and III showed significant improvements in gross motor function, specifically in standing and walking dimensions, as well as in mobility and social function.
02Children in GMFCS levels IV and V showed significant improvement only in the sitting dimension of gross motor function, with no significant improvement in self-care, mobility, social function or caregiver assistance.
03The study is a longitudinal cohort without a control group, and participants received a multimodal program including neurodevelopmental treatment, locomotor training, suit therapy, and other disciplines, preventing isolation of specific treatment effects.
STILL TO COME
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What it does not show
There was no control group, so it is impossible to know if the improvements were due to the specific multimodal program or just natural development and usual care. The sample was small (26 analysed) and selected by convenience, which limits how much these results can be generalised to other children with cerebral palsy. The intervention was a complex mix of therapies (NDT, treadmill, suits, etc.) delivered simultaneously, so the effect of any single component cannot be isolated. The study lasted nine months, which may not be long enough to see if these gains were sustained or if they led to further development.
The easy way to misread this
Do not assume this specific multimodal program caused the improvements. Without a control group, the gains could reflect natural development or the effects of usual care. Furthermore, the benefits for children with severe impairment (GMFCS IV–V) were limited to sitting stability, with no improvement in daily activities or caregiver burden.
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