Effect of Intensive Rehabilitation Programs on Motor and Cognitive Functions in Children with Cerebral Palsy

Abstract

Objective: This study aimed to investigate the impact of intensive rehabilitation programs (IRPs) on the motor and cognitive functions of children diagnosed with cerebral palsy (CP) who have undergone multi-level Botulinum toxin-A (BoNT-A) injections, aligning with their individualized treatment goals and clinical characteristics. Methods: In this prospective controlled clinical study, a cohort of 50 children aged 4-18 years diagnosed with CP and classified as level I-IV on the Gross Motor Function Classification System (GMFCS) participated. After multi-level BoNT-A injections, participants in the study group underwent a comprehensive IRP lasting for 3 weeks, with sessions conducted 5 days a week, either half or full day, tailored to the unique needs of each child. The evaluation of outcomes encompassed the Gross Motor Function Measure-66 (GMFM-66), Observational Gait Scale (OGS), and Goal Attainment Scale (GAS) for assessing motor functions, whereas cognitive functions were measured using the Stroop Test and Auditory Verbal Learning Test (AVLT). Results: The analysis revealed statistically significant enhancements in various parameters for both groups, including OGS, GMFM-66 total score, total goal achievement, and scores in the C, D, and E dimensions. Notably, the study group exhibited significantly greater improvements in OGS, GAS, and GMFM-66 total score, total goal achievement, and D, E dimensions' scores compared to the control group by the fourth week of intervention. Furthermore, significant improvements were observed in Stroop test S5T and S5C scores, and AVLT scores across all parameters in the study group. Conclusion: The results of this study showed that intensive rehabilitation practices had positive effects on motor and cognitive functions in children with CP who underwent multi-level BoNT-Aapplication to spastic muscles.

Keywords

• Cerebral palsy
• intensive rehabilitation
• cognitive function
• botulinum toxin.

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