TY - JOUR T1 - Effect of Intensive Rehabilitation Programs on Motor and Cognitive Functions in Children with Cerebral Palsy TT - Effect of Intensive Rehabilitation Programs on Motor and Cognitive Functions in Children with Cerebral Palsy AU - Çapa Tayyare, Begüm AU - Gözpınar, Güler AU - Gokbel, Tugba AU - Akarsu, Melike AU - Dursun, Nigar PY - 2025 DA - March Y2 - 2025 DO - 10.30934/kusbed.1532081 JF - Kocaeli Üniversitesi Sağlık Bilimleri Dergisi JO - KOU Sag Bil Derg PB - Kocaeli Üniversitesi WT - DergiPark SN - 2149-8571 SP - 10 EP - 17 VL - 11 IS - 1 LA - en AB - 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. KW - Cerebral palsy KW - intensive rehabilitation KW - cognitive function KW - botulinum toxin. N2 - 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. CR - Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109(suppl 109):8-14. CR - Shevell M, Dagenais L, Oskoui M. The epidemiology of cerebral palsy: new perspectives from a Canadian registry. Semin Pediatr Neurol. 2013;20(2):60-64. CR - Shevell MI. Current understandings and challenges in the management of cerebral palsy. Minerva Pediatr. 2009;61(4):399-413. CR - Pruitt DW, Tsai T. Common medical comorbidities associated with cerebral palsy. Phys Med Rehabil Clin N Am. 2009;20(3):453-467. CR - Rosenbaum P. Stewart D. The World Health Organization International Classification of Functioning, Disability, and Health: a model to guide clinical thinking, practice and research in the field of cerebral palsy. Semin Pediatr Neurol. 2004;11(1):5-10. CR - Song, CS. Relationships between physical and cognitive functioning and activities of daily living in children with cerebral palsy. J Phys Ther Sci. 2013;25(5):619-622. CR - Cornec G, Brochard S, Drewnowski G, Desguerre I, Toullet P, Fontaine A, et al. The use and outcomes of motor rehabilitation services among people with cerebral palsy change across the lifespan. Front Neurol. 2022;12:e771348. CR - Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr. 2020;9(Suppl 1), S125-S135. CR - Mc Mahon M, Adams J. Cerebral Palsy. In: Alexander M, ed. Pediatric Rehabilitation Principles and Practice. 4th ed. Bang Printing; 2010:165–98. CR - Tur B. (2014). Özürlü Çocuklar. Delisa’nın Fiziksel Tıp ve Rehabilitasyon İlkeler ve Uygulamalar. Ankara: Güneş Tıp Kitabevi. 2014:1475–1502. CR - Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Phys Ther. 2006;86(11):1534-1540. CR - Dursun N, Akyuz M, Gokbel T, Akarsu M, Yilmaz E, Karacan C, et al. GMFCS level improvement in children with cerebral palsy treated with repeat botulinum toxin injections and intensive rehabilitation: A retrospective study. J Pediatr Rehabil Med. 2022;15(1):107-112. CR - Rahlin M, Duncan B, Howe CL, 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. 2020;10(7): e036630. CR - Arpino C, Vescio MF, De Luca A, Curatolo P. Efficacy of intensive versus nonintensive physiotherapy in children with cerebral palsy: a meta-analysis. Int J Rehabil Res. 2010;33(2):165-171. CR - Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, 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. 2020;20(2):3. CR - Carvalho I, Pinto SM, das Virgens Chagas D, Dos Santos JLP, de Sousa Oliveira T, Batista LA. Robotic gait training for individuals with cerebral palsy: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2017;98(11):2332-2344. CR - Størvold GV, Jahnsen RB, Evensen KAI, Romild UK, Bratberg GH. Factors associated with enhanced gross motor progress in children with cerebral palsy: a register-based study. Phys Occup Ther Pediatr. 2018;38(5):548-561. CR - Novak I, Mcintyre S, Morgan C, Campbell L, Dark L, Morton N, et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013;55(10):885-910. CR - Löwing K, Bexelius A, Carlberg EB. Goal-directed functional therapy: a longitudinal study on gross motor function in children with cerebral palsy. Disabil Rehabil. 2010;32(11):908-916. UR - https://doi.org/10.30934/kusbed.1532081 L1 - https://dergipark.org.tr/tr/download/article-file/4139857 ER -