Goal-directed functional therapy: a longitudinal study on gross motor function in children with cerebral palsy.
OBJECTIVE
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.


METHODS
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 degrees , 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).


CONCLUSIONS
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.
Department of Woman & Child Health, Karolinska Institutet, Stockholm, Sweden.
Kristina
K
Löwing
Annemarie
A
Bexelius
Eva Brogren
EB
Carlberg
D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009128:Muscle Spasticity / Q000503:physiopathology; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies