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Neuropediatrics, 2020; 51(6): 407-416, PMID: 33065752

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

Year: 2020

Christina Stark Ibrahim Duran Kyriakos Martakis Karoline Spiess Oliver Semler Eckhard Schoenau
Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany


Background The efficacy of interventions for cerebral palsy (CP) has been frequently
investigated with inconclusive results and motor function measured by the Gross Motor Function Measure (GMFM-66) is common.
Objective In this observational analysis, we quantify the GMFM-66 change scores of
the second and third year of a multimodal rehabilitation program (interval rehabilitation
including home-based, vibration-assisted training) in children with CP.
Methods The study was a retrospective analysis of children with CP (2–13 years)
participating for a second (n ¼ 262) and third year (n ¼ 86) in the rehabilitation
program with GMFM-66 scores at start (M0), after 4 months (M4) of intensive training,
and after 8 months of follow-up (M12). A method was previously developed to differentiate between possible treatment effects and expected development under standard of care for GMFM-66 scores using Cohen’s d effect size (ES; size of difference).
Results After the treatment phase of 4 months (M4) in the second year, 125 of 262
children were responder (ES  0.2) and 137 children nonresponder (ES < 0.2);mean ES
for nonresponder was 0.212 (trivial) and for responder 0.836 (large). After M4 in the
third year, 43 children of 86 were responder (ES ¼ 0.881 [large]) and 43 nonresponder
(ES¼ 0.124 [trivial]).
Discussion and Conclusion Repeated rehabilitation shows a large additional treatment
effect to standard of care in 50% of children which is likely due to the intervention,
because in the follow-up period (standard of care), no additional treatment effect was
observed and the children followed their expected development.

GID: 5203; Last update: 05.10.2020