ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Neurology
This article is part of the Research TopicExercise Interventions: Empowering Individuals with Neurological ConditionsView all 5 articles
Changes in gross motor function in children with cerebral palsy following repeated intensive rehabilitation periods: A longitudinal study
Provisionally accepted
Viktoria Opheim1Camilla Skagen2Kine Melfald Tveten3
Stian Lydersen4Gunfrid Vinje Størvold5
Rannei Sæther6*- 1Department of Physiotherapy Services for Children and Youth, Interdisciplinary Resource Team,, Tromso kommune, Tromsø, Norway
- 2Children’s Physiotherapy Center,, Bergen, Norway
- 3Department of Health and Functioning, Faculty of Health and social science, Hogskulen pa Vestlandet, Bergen, Norway
- 4Department of Mental Health, Faculty of Medicine and Health Sciences, Norges teknisk-naturvitenskapelige universitet, Trondheim, Norway
- 5Department of habilitation, Sykehuset Levanger, Levanger, Norway
- 6Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
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Purpose: To evaluate changes in gross motor function in children with cerebral palsy (CP), following multiple intensive rehabilitation periods. Materials and methods: In this retrospective longitudinal study, we assessed 46 children with CP, aged 2-12 years, Gross Motor Function Classification System (GMFCS) levels I-V. Participants underwent 2-12 intensive rehabilitation periods, incorporating goal-directed group activities. Long-term change in gross motor function was analyzed using a linear mixed model based on reference percentiles for the Gross Motor Function Measure-66 (GMFM-66). Comparisons were made between GMFCS levels and age groups. Results: GMFM-66 scores increased during each intensive rehabilitation period, with significant improvements in period 1-4. The number of participants decreased as the number of periods increased. GMFM-66 percentiles increased by 10.9 (p<0.001) per period, with an additive gain of 2.4 (p=0.124) GMFM-66 percentiles per added intensive rehabilitation period. A decrease in percentiles was observed between periods. Gross motor function enhanced across all GMFCS levels, particularly levels I and V. Children under six years showed greater improvements than older children. Conclusions: Intensive rehabilitation may be associated with improved gross motor function in children with CP, irrespective of GMFCS levels. Repeated periods appear especially beneficial in early childhood, supporting their strategic use in long-term rehabilitation.
Keywords: Cerebral Palsy, GMFM-66, Intensive rehabilitation, Gross motor function, Group training, longitudinal study
Received: 28 May 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Opheim, Skagen, Tveten, Lydersen, Størvold and Sæther. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rannei Sæther, rannei.sather@ntnu.no
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