Goal-directed functional therapy: a longitudinal study on gross motor function in children with cerebral palsy

Disabil Rehabil. 2010;32(11):908-16. doi: 10.3109/09638280903353422.


Purpose: To investigate gross motor function and goal attainment in children with cerebral palsy before, during and after goal-directed functional therapy (GDT), to evaluate body functions, and explore relationships.

Method: Prospective longitudinal intervention study. Twenty-two children, uni- or bilateral CP, 1-6 years (mean: 46 months SD: 16 months), classified in GMFCS and MACS level I-IV participated. Outcome measures were Gross Motor Function Measure (GMFM-66), performed at seven occasions, Goal Attainment Scale, assessments of passive range of motion, spasticity and selective motor control (SMC). Baseline, the GDT-intervention and the follow-up period were 12 weeks each.

Results: Improvements were demonstrated in GMFM-66 during the intervention (mean difference: 5.07, CI: 3.8-6.4, p < 0.001). The baseline and follow-up assessments were stable. Evaluations of ankle dorsiflexion displayed small improvement (mean difference: 9 degrees , CI: 5-13, p < 0.001). Estimations of spasticity and SMC did not demonstrate significant changes. Goal attainment to the expected level or higher was achieved in 93/110 goals and further improved at the long-term follow-up (103/110).

Conclusion: Gross motor function improved during GDT, and was maintained 12 weeks later. The goals were reached to a high extent, and the children gradually progressed towards their goals after the end of the intervention. The therapy did not induce any deterioration of body functions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / rehabilitation
  • Cerebral Palsy / therapy*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Goals*
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Motor Activity / physiology*
  • Muscle Spasticity / physiopathology
  • Outcome and Process Assessment, Health Care
  • Prospective Studies