Physical Therapy Publications

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Developmental Medicine and Child Neurology

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AIM: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).

METHOD: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal graphs for each GMFCS level, depicting change across time using centiles. Using multinomial models, we analyzed the relationship between therapies (amount, focus, family-centeredness, and the extent therapies met children's needs) and whether change in balance, walking endurance, and participation was 'more than' and 'less than' the reference of 'as expected'.

RESULTS: Children were more likely to progress 'more than expected' when participating in recreation when therapies were family-centered, met children's needs, and focused on structured play/recreation. A focus on health and well-being was positively associated with participation and self-care. The amount of therapy did not predict outcomes.

INTERPRETATION: Therapy services that are family-centered, consider the needs of the child, and focus on structured play/recreational activities and health/well-being may enhance the development of children with CP.


"This is the peer reviewed version of the following article: Westcott McCoy S, Palisano RJ, Avery L, Jeffries L, LaForme Fiss A, Chiarello L, Hanna S (forthcoming). Physical, occupational, and speech therapy for children with cerebral palsy. Developmental Medicine and Child Neurology [vol, issue, pages], which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."

This article is emerged from research conducted by the On Track Study Team, which includes Dr. Doreen Bartlett, Faculty of Health Sciences, Western University.

The On Track Study was funded by: The Canadian Institutes of Health Research, MOP-119276 and The Patient-Centered Outcomes Research Institute, CE-12-11-5321.