Single-center study of the effect of early rehabilitation in children with cerebral palsy based on gross motor function and manual skills classification systems
General Medicine, 2025, 27(5), 9-16.
G. Strikova, M. Bozhkova
Medical College, Medical University ‒ Plovdiv
Abstract. Background: Neurological disabilities in children, including cerebral palsy, represent a serious medical and social problem. The aim of this study is to report the results of rehabilitation therapy based on the functional profiles of children with cerebral palsy, according to established classification systems for the classification of gross motor function and manual abilities, taking into account the age at which the application of rehabilitation therapy began. Materials and Methods: In this retrospective study, conducted in the period September 2024–April 2025 at the University Multi-profile Hospital for Active Treatment „Sv. Georgi“, Plovdiv, 20 children aged from 2 to 15 years (60% boys and 40% girls) with a diagnosis of cerebral palsy confirmed by a specialist neurologist were included. All patients underwent rehabilitation treatment in hospital conditions, and a unified program was applied to them, including kinesitherapy using neurodevelopmental methods, joint movement training, as well as walking and gait exercises. For the purposes of the study, a systematic analysis of the medical documentation containing information on the type and duration of rehabilitation interventions (kinesitherapy, Bobath therapy, electrotherapy, etc.) was performed. The functional status of the children was assessed during rehabilitation treatment using the GMFCS (gross motor functions) and MACS (manual abilities) systems by a physiotherapist with over 30 years of clinical experience, and the observations of the parents in the home environment were also taken into account. The study was conducted in accordance with the Declaration of Helsinki. Results: Fifty percent of the participants were classified in I-II levels according to the Gross Motor Function System (able to move independently) and 55% – classified in I-II levels according to the Manual Ability System (able to handle objects independently). The most common functional profile of children with cerebral palsy in our study was with the subtype of spastic diplegia (87.50%) – „manual abilities better than gross motor skills“. Conclusion: Early rehabilitation of children with cerebral palsy is a major factor in improving the children motor function and functional independence. The results of our study showed that early intervention can lead to lower levels in GMFCS and MACS, which correspond to better motor and manual abilities. These systems provide an objective way to measure progress and limitations in motor and manual abilities of children with cerebral palsy. However, the success of these interventions is largely dependent on the individual characteristics of each child and the approaches used in the rehabilitation process.
Key words: cerebral palsy, early rehabilitation, functional profiles, gross motor function classification system, manual ability classification system
Address for correspondence: Gergana Strikova, e-mail: Gergana.Strikova@mu-plovdiv.bg