Predictors of the Effectiveness of Medical Rehabilitation of Patients with Cerebral Palsy

INTRODUCTION: Cerebral palsy (CP) is one of the most common causes of disability in children. The use of clinical tools that will allow the prediction of results is necessary for the medical rehabilitation of children with CP. Although clinical and socio-economic factors that determine the prognosis of rehabilitation and further social adaptation of patients with CP are being actively investigated, predictors that help predict the effectiveness of medical rehabilitation measures are not yet identified.

AIM: To determine the predictors of the effectiveness of medical rehabilitation in children with CP using anamnesis, scales, and questionnaire data.

MATERIALS AND METHODS: The study involved 29 children (average age, 5.4 ± 1.1 years) with various forms of CP who underwent medical rehabilitation in inpatient and outpatient conditions within 12 months. Before and after rehabilitation courses, all patients, apart from general somatic-clinical and neurological examinations, underwent tests that use specialized questionnaires and scales and evaluation using the International Classification of Functioning, Disability and Health (ICF) Core Sets for children and adolescence with cerebral palsy. The patients were arranged into groups depending on the presence of improvement determined using the author-developed criterion: reduction of the determinant level relative to “function” and “activity and participation” components of ICF by a minimum of at least one point in three domains. Various uni- and multivariate logistic regression models were used to evaluate the prognostic significance of history, scales, and questionnaire data. Receiver operating characteristic curves were constructed to determine the threshold values of quantitative parameters optimal for predicting a certain treatment outcome.

RESULTS: The Gross Motor Function Measure 88 score of >82.1% before the rehabilitation measures indicated a positive rehabilitation prognosis. ICF domains b760 “control of voluntary movement functions”, d415 “maintaining a body position”, and d710 “basic interpersonal relations” are predictors of the effectiveness of rehabilitation in patients with a CP with determinant level ≤ 1.

CONCLUSION: The results demonstrated that higher parameters of motor and coordination functions and higher levels of interpersonal interactions of children with ICP are significant predictors of the effectiveness of rehabilitation.