Efficacy of the comprehensive intervention model for children &lt;6 years of age with spastic cerebral palsy

Hoang,Khanh Chi; Pham,Van Minh

doi:10.3892/wasj.2025.336

Efficacy of the comprehensive intervention model for children <6 years of age with spastic cerebral palsy

Authors:
- Khanh Chi Hoang
- Van Minh Pham
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Affiliations: Department of Pediatrics, Hanoi Rehabilitation Hospital, Hanoi 100000, Vietnam
Published online on: March 19, 2025 https://doi.org/10.3892/wasj.2025.336
Article Number: 48
Copyright : © Hoang et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

It is estimated that 30-40% of the disabilities in children are attributed to cerebral palsy, resulting in a marked psychological and economic burden for families and society. Early interventions and a comprehensive intervention model are recommended for young children with cerebral palsy; however, the effectiveness of this model in children with spastic cerebral palsy has yet to be studied. Therefore, the present study conducted an uncontrolled prospective study on 50 children aged <6 years with spastic cerebral palsy. A comprehensive, goal-oriented and family-centered rehabilitation model was developed, and participants received the intervention for 6 months from January, 2019 to December, 2022. Following the intervention period, 616/771 Goal Attainment Scaling goals in physical therapy, occupational therapy and speech therapy were achieved. The children exhibited a significant improvement in gross motor functions, mobility, self-care and social skills after 6 months (P<0.05). The Gross Motor Function Classification System level and the type of paralysis were found to be associated with an improvement in the Gross Motor Function Measure (GMFM) 66 score (P<0.05). There was positive correlation between the improvement of the Pediatric Evaluation of Disability Inventory (PEDI) mobility functional skills score and the GMFM 66 score (r=0.75; P<0.001), and the PEDI mobility functional skills score and the PEDI self-care functional skills score (r=0.55; P<0.001). On the whole, the present comprehensive, goal-directed and family-centered rehabilitation model effectively improved gross, mobility, self-care and social skills and perhaps it could be expanded to rehabilitation centers.

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1	Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B and Jacobsson B: A report: The definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 109:8–14. 2007.PubMed/NCBI
2	Chauhan A and Singh M, Jaiswal N, Agarwal A, Sahu JK and Singh M: Prevalence of cerebral palsy in Indian Children: A systematic review and Meta-analysis. Indian J Pediatr. 86:1124–1130. 2019.PubMed/NCBI View Article : Google Scholar
3	McManus V, Guillem P, Surman G and Cans C: SCPE work, standardization and definition-an overview of the activities of SCPE: A collaboration of european CP registers. Zhongguo Dang Dai Er Ke Za Zhi. 8:261–265. 2006.PubMed/NCBI
4	Sellier E, Platt MJ, Andersen GL, Krägeloh-Mann I, De La Cruz J and Cans C: Surveillance of Cerebral Palsy Network. Decreasing prevalence in cerebral palsy: A Multi-site European population-based study, 1980 to 2003. Dev Med Child Neurol. 58:85–92. 2016.PubMed/NCBI View Article : Google Scholar
5	Liptak GS and Accardo PJ: Health and social outcomes of children with cerebral palsy. J Pediatr. 145 (2 Suppl):S36–S41. 2004.PubMed/NCBI View Article : Google Scholar
6	Khandaker G, Van Bang N, Dung TQ, Giang NTH, Chau CM, Van Anh NT, Van Thuong N, Badawi N and Elliott EJ: Protocol for hospital based-surveillance of cerebral palsy (CP) in Hanoi using the paediatric active enhanced disease surveillance mechanism (PAEDS-Vietnam): A study towards developing Hospital-based disease surveillance in Vietnam. BMJ Open. 7(e017742)2017.PubMed/NCBI View Article : Google Scholar
7	Department of Medical Service Administration: Guidelines for Diagnosis, Treatment, and Functional Rehabilitation for Children with Cerebral Palsy-Guidelines on Physical Therapy. J 2018.
8	Novak I, McIntyre S, Morgan C, Campbell L, Dark L, Morton N, Stumbles E, Wilson SA and Goldsmith S: A systematic review of interventions for children with cerebral palsy: State of the evidence. Dev Med Child Neurol. 55:885–910. 2013.PubMed/NCBI View Article : Google Scholar
9	Goal Attainment Scaling: Applications, Theory, and Measurement. Psychology Press, New York, 2014.
10	Hurn J, Kneebone I and Cropley M: Goal setting as an outcome measure: A systematic review. Clin Rehabil. 20:756–772. 2006.PubMed/NCBI View Article : Google Scholar
11	Turner-Stokes L: Goal attainment scaling (GAS) in rehabilitation: A practical guide. Clin Rehabil. 23:362–370. 2009.PubMed/NCBI View Article : Google Scholar
12	Berg M, Jahnsen R, Froslie KF and Hussain A: Reliability of the pediatric evaluation of disability inventory (PEDI). Phys Occup Ther Pediatr. 24:61–77. 2004.PubMed/NCBI View Article : Google Scholar
13	Berg MM, Dolva AS, Kleiven J and Krumlinde-Sundholm L: Normative scores for the pediatric evaluation of disability inventory in norway. Phys Occup Ther Pediatr. 36:131–143. 2016.PubMed/NCBI View Article : Google Scholar
14	Schwabe AL: Comprehensive care in cerebral palsy. Phys Med Rehabil Clin N Am. 31:1–13. 2020.PubMed/NCBI View Article : Google Scholar
15	Department of Medical Service Administration: Guidelines for Early Detection-Early Intervention for Children's Disabilities. J 2023.
16	Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, et al: State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep. 20(3)2020.PubMed/NCBI View Article : Google Scholar
17	Johnston MV: Plasticity in the developing brain: Implications for rehabilitation. Dev Disabil Res Rev. 15:94–101. 2009.PubMed/NCBI View Article : Google Scholar
18	Department of Medical Service Administration: Guidelines for Diagnosis, Treatment, and Functional Rehabilitation for Children with Cerebral Palsy. General Guidelines. J 2018.
19	Department of Medical Service Administration: Guidelines for Diagnosis, Treatment, and Functional Rehabilitation for Children with Cerebral Palsy. Guidelines on Occupational Therapy. J 2018.
20	Department of Medical Service Administration: Guidelines for Diagnosis, Treatment, and Functional Rehabilitation for Children with Cerebral Palsy. Guidelines on Speech Therapy. J 2020.
21	Pham VM, Hoang TL, Hoang KC, Nguyen NM, DeLuca SC and Coker-Bolt P: The effect of constraint-induced movement therapy for children with hemiplegic cerebral palsy in Vietnam. Disabil Rehabil. 47:912–918. 2025.PubMed/NCBI View Article : Google Scholar
22	Wallace SJ: Epilepsy in cerebral palsy. Dev Med Child Neurol. 43:713–717. 2001.PubMed/NCBI View Article : Google Scholar
23	National Institute for Health and Care Excellence: Cerebral palsy in under 25s: Assessment and management (NG62). https://www.nice.org.uk/guidance/ng62.
24	Hanna SE, Bartlett DJ, Rivard LM and Russell DJ: Reference curves for the Gross Motor Function Measure: Percentiles for clinical description and tracking over time among children with cerebral palsy. Phys Ther. 88:596–607. 2008.PubMed/NCBI View Article : Google Scholar
25	Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Ohrvall AM and Rosenbaum P: The manual ability classification system (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability. Dev Med Child Neurol. 48:549–554. 2006.PubMed/NCBI View Article : Google Scholar
26	Lowing K, Bexelius A and Brogren Carlberg E: Activity focused and goal directed therapy for children with cerebral palsy-do goals make a difference? Disabil Rehabil. 31:1808–1816. 2009.PubMed/NCBI View Article : Google Scholar
27	Storvold GV and Jahnsen R: Intensive motor skills training program combining group and individual sessions for children with cerebral palsy. Pediatr Phys Ther. 22:150–159. 2010.PubMed/NCBI View Article : Google Scholar
28	Rahlin M, Duncan B, Howe CL and Pottinger HL: How does the intensity of physical therapy affect the Gross Motor Function Measure (GMFM-66) total score in children with cerebral palsy? A systematic review protocol. BMJ Open. 10(e036630)2020.PubMed/NCBI View Article : Google Scholar
29	Arpino C, Vescio MF, De Luca A and Curatolo P: Efficacy of intensive versus nonintensive physiotherapy in children with cerebral palsy: A meta-analysis. Int J Rehabil Res. 33:165–171. 2010.PubMed/NCBI View Article : Google Scholar
30	Ahl LE, Johansson E, Granat T and Carlberg EB: Functional therapy for children with cerebral palsy: An ecological approach. Dev Med Child Neurol. 47:613–619. 2005.PubMed/NCBI
31	Bower E and McLellan DL: Effect of increased exposure to physiotherapy on skill acquisition of children with cerebral palsy. Dev Med Child Neurol. 34:25–39. 1992.PubMed/NCBI View Article : Google Scholar
32	Sorsdahl AB, Moe-Nilssen R, Kaale HK, Rieber J and Strand LI: Change in basic motor abilities, quality of movement and everyday activities following intensive, goal-directed, activity-focused physiotherapy in a group setting for children with cerebral palsy. BMC Pediatr. 10(26)2010.PubMed/NCBI View Article : Google Scholar
33	Han T, Gray N, Vasquez MM, Zou LP, Shen K and Duncan B: Comparison of the GMFM-66 and the PEDI Functional Skills Mobility domain in a group of Chinese children with cerebral palsy. Child Care Health Dev. 37:398–403. 2011.PubMed/NCBI View Article : Google Scholar