Gross Motor Function In Children Research Articles

An Examination of the Effectiveness of Ballet on Gross Motor Function in Children with Intellectual Developmental Disabilities

The purpose of this study was to examine how ballet could be used as a form of therapy to improve gross motor function in children with intellectual developmental disabilities (IDDs). Fourteen participants (ages 4-12, 10 males, 4 females) who were enrolled in Monday and Friday camp days at ABC Educational Services, Inc. Stimulation School Summer Camp were included in the study. Participants completed the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (BOT-2) during the first week of the intervention. For the following six weeks, participants engaged in thirty-minute ballet classes twice a week. During week eight of the intervention participants completed the BOT-2 test a second time. The results indicated that children with a suspected IDD did not consistently score below average on the BOT-2. Additionally, statistically significant correlations between ballet instruction and gross motor proficiency were not found. Further studies should be done to continue to examine the relationship between ballet and gross motor function.

A Cross-Sectional Study Examining the Relationship Between Malnutrition and Gross Motor Function in Cerebral Palsy.

Introduction Cerebral palsy (CP) characterizes a range of permanent, nonprogressive symptoms of postural and motor dysfunction caused by an insult to the developing central nervous system in a fetus or an infant. CP manifests early in life, often within the first two to three years of age. CP is associated with poor growth, that is the deviation from the normal growth parameters. The prevalence of CP ranges from 2.0 to 3.5 per 1000 live births in high-income countries which is comparable to the estimates from low-income countries. Antenatal and perinatal insults are among the most commonly reported causes of CP; however, a large number of cases do not have an identifiable etiology of CP. The current study aims to examine the relationship between malnutrition and gross motor function in children with CP. Materials and Methods This study was conducted at the Department of Pediatrics and Neonatology, Nehru Hospital, Baba Raghav Das (BRD) Medical College, Gorakhpur (UP) over a period of one year (August 2020 to July 2021) after obtaining ethical clearance from the College Research Council. Children of age 1-15 years with CPattending the pediatric outpatient and inpatient departmentswere enrolled as the study participants after obtaining informed consent from a legal guardian. Assessment of motor function was done using the gross motor function classification system (GMFCS). Associations of malnutrition across levels of gross motor function were tested using Chi-square or Fisher's exact test whichever was applicable. Statistical significance was set at p< 0.05 as significant. Data was analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Result We analyzed 110 children with a diagnosis of CP (median age 6.5 years, interquartile range (IQR) 4.4-9.0 years). The majority (65/110; 59%) of the patients were male, and 68 (61.8%) delivered at term gestation. The most common presenting symptom among children with CP was seizures (79/110; 72.3%), the second most common being delayed milestones among 73 (66.8%), followed by difficulty in breathing among 63 (57.5%). The association between the anthropometric index of participants and GMFCS was found to be highly significant. Conclusion Most CP patients were facing gross motor disturbances. Spastic type of CP was most frequent, and more than half of the patients experienced feeding difficulty. A statistically significant association was found between gross motor functioning and the prevalence of malnutrition and stunting.

Limited associations between passive range of motion and gross motor function in ambulant/semi-ambulant children and adolescents with cerebral palsy: A cross-sectional study

Background and aimCerebral palsy (CP) is the most common childhood motor disability, and the Cerebral Palsy Follow-Up Program (CPUP) in Nordic countries uses a traffic light system for passive range of motion (ROM) assessment to aid interpretation and guide decisions regarding interventions. However, the arbitrary chosen ROM threshold values and their potential clinical impact are uncertain. We investigated whether lower extremity ROM values were positively associated with gross motor function and whether gross motor function scores differ between the CPUP ROM thresholds. MethodsThis was a cross-sectional analysis of CPUP data for 841 ambulatory children and adolescents with CP, at a mean (SD) age of 9 (3). Regression analyses were employed to explore the relationship between gross motor capacity and performance (using the Gross Motor Function Measure (GMFM-66) and the Functional Mobility Scale (FMS) 5/50/500 m, respectively) and lower extremity ROM, measured with a goniometer. ROM was assessed both as continuous and categorical variables. ResultsWe found that two out of ten continuous ROM measures were positively associated with gross motor function. Limited differences in gross motor function between the ROM thresholds were seen for seven out of ten ROM measures. The CPUP traffic light thresholds primarily differentiated gross motor function between the red and green categories, predominantly for the subgroup of participants with bilateral spastic CP. ConclusionLimited associations between passive ROM and gross motor function in children and adolescents with CP were observed, indicating that there is more to consider than ROM when identifying whether interventions are needed.

Correlation between clinical measurement scales on gross motor function in children with spastic cerebral palsy

BackgroundChildren with cerebral palsy (CP) may have different gross motor impairments which in sequence affecting their life occupations. The purpose of the study is to investigate the correlation between Gross Motor Function Measurement-66 (GMFM-66), the test of Bruininks-Oseretsky Motor Proficiency (BOTMP), and the Peabody Developmental Motor Scale–Second Edition (PDMS-2) in young children with CP.MethodsA correlational study was applied on 50 children aged from 4 to 6 years (30 girls, 20 boys) with spastic CP.ResultsThe Pearson correlation coefficient between the GMFM scale and PDMS-2 motor quotients, and its subscales (stationary, locomotion, and object control) and also between GMFM and BOTMP gross motor quotients and its subscales (strength, agility, and body coordination) were statistically significant. Spearman’s coefficients between the grade of the Gross Motor Classification System (GMFCS) and the PDMS-2 Gross Motor Composite, BOTS-2, and its subscale results were also statistically significant.ConclusionThe three measurement scales, GMFM- 66, BOTS-2, and PDMS-2, are significantly related. Therefore, GMFCS is useful in predicting movement performance in children with CP and correlated with predictive guidance in treatment development.Trial registrationClinicalTrials.gov Identifier: NCT06124352.

Impact of Equine-Assisted Activities and Therapies on Gross Motor Function in Children with Cerebral Palsy: A Prospective Case Series

Impact of Equine-Assisted Activities and Therapies on Gross Motor Function in Children with Cerebral Palsy: A Prospective Case Series

Multiple Equine Therapies for the Treatment of Gross Motor Function in Children with Cerebral Palsy: A Systematic Review

ABSTRACT Purpose This study aimed to evaluate the impact of three equine therapy approaches on gross motor function in children with cerebral palsy. Methods The studies were retrieved from PubMed, Web of Science, Science Direct, and the Cochrane Library, in accordance with the style commonly found in scientific journal publications:(1) peer-reviewed articles written in English; (2) experimental or quasi-experimental; (3) three Equine Therapy Interventions as experiment’s independent variable; (4) children with cerebral palsy; and (5) measurement of outcomes related to Gross Motor Function. Results The study examined 596 patients with cerebral palsy, whose average age was 8.03 years. The three types of horse therapy interventions had a significant impact on gross motor function in children with cerebral palsy (SMD = 0.19, 95% CI 0.02–0.36, p = 0.031). Additionally, the interventions positively affected dimensions C (SMD = 0.31, 95% CI 0.00–0.62, p = 0.05), D (SMD = 0.30, 95% CI 0.06–0.56, p = 0.017), and B (SMD = 0.72, 95% CI 0.10–1.34, p = 0.023). The Gross Motor Function Measure (GMFM) consists of 88 or 66 items, which are divided into five functional dimensions: GMFM-A (lying down and rolling), GMFM-B (sitting), GMFM-C (crawling and kneeling), GMFM-D (standing), and GMFM-E (walking, running, and jumping). Each subsection of the GMFM can be used separately to evaluate motor changes in a specific dimension of interest. Subgroup analysis revealed that different horse-assisted therapy approaches, types of cerebral palsy, exercise duration, frequency, and intervention periods are important factors influencing treatment outcomes. Conclusion The intervention period ranged from 8 to 12 weeks, with session durations of 30 to 45 minutes, 2 to 3 times per week. Equine-assisted therapy (EAT) demonstrated significant improvements in the overall gross motor function score, Dimension B, Dimension C, and Dimension D among children with cerebral palsy. The most effective treatment is provided by Equine-Assisted Therapy, followed by Horseback Riding Simulator (HRS). Due to its economic practicality, HRS plays an irreplaceable role. Clinical Evidence Equine-Assisted Therapy (EAT) demonstrates the most effective treatment outcomes, suggesting that hospitals and healthcare professionals can form specialized teams to provide rehabilitation guidance. 2. Within equine-assisted therapy, Horseback Riding Simulator (HRS) exhibits treatment efficacy second only to Equine-Assisted Therapy (EAT), making it a cost-effective and practical option worthy of promotion and utilization among healthcare institutions and professionals. 3. In equine-assisted therapy, Therapeutic Horseback Riding (THR) holds certain value in rehabilitation due to its engaging and practical nature.

Correlation of Siting and Standing Performance with Gross Motor Functional Classification System in Children with Spastic Cerebral Palsy

Background: Cerebral palsy (CP) is the most common motor disability in childhood, with spasticity as a frequent complication. Understanding the relationship between the Gross Motor Function Classification System (GMFCS) and motor abilities, such as sitting and standing performance, is critical for managing CP. Objective: This study aimed to analyze the correlation between sitting and standing performance with GMFCS in children with spastic cerebral palsy. Methods: A cross-sectional study was conducted with 350 children diagnosed with CP, aged 6-12 years. Data were gathered over six months at a government secondary school for special education. The GMFCS was used to classify motor function, while sitting and standing abilities were assessed using the Sit to Stand Test. Data analysis was performed using SPSS version 25, employing descriptive statistics and Spearman's rank correlation. Results: The study found that children at GMFCS levels I and II could often sit and walk with minimal or no assistance, whereas those at levels IV and V exhibited varied sitting abilities and primarily used technological aids or wheelchairs. A statistically significant association between sitting ability and GMFCS level was identified (Pearson Chi-Square = 29.151, p = 0.023). Children with spastic CP were predominantly classified at GMFCS levels III (49 participants) and V (49 participants), while those with dyskinetic CP were mainly at level II (13 participants). Conclusion: The GMFCS is an effective tool for assessing gross motor function in children with CP, with strong correlations found between GMFCS levels and sitting and standing performance. These findings can inform targeted interventions to improve mobility and quality of life for children with CP.

Relationship between sensory processing patterns and gross motor function of children and adolescents with Down syndrome and typical development: a cross-sectional study.

Children and adolescents with Down syndrome (DS) may experience impairments in sensory and motor skills that can be interrelated. The purposes of this study were (i) to compare the sensory processing patterns and gross motor function between children and adolescents with DS and with typical development (TD) and (ii) to explore associations between these areas in both DS and TD groups. This cross-sectional study involved a sample size of 25 participants with DS (mean age 10.24±2.04years) and 25 participants with TD (mean age 10.04±2.82years). The sensory processing patterns were assessed using the Sensory Profile Second Version questionnaire, and the gross motor function was measured with the Gross Motor Function Measure (GMFM-88) dimensions (D) standing, and (E) walking, running, and jumping. Differences between groups were tested using the Mann-Whitney test, and the relationship between the variables was examined using Spearman's correlation tests, with a significance level set at 5%. Children with DS showed greater difficulties with sensory processing than TD children in Seeker (P<0.001), Avoider (P<0.001), Sensitivity (P<0.001), Registration (P<0.001), Auditory (P<0.001), Touch (P=0.001), Movements (P=0.001), Oral (P=0.028), Conduct (P=0.005), Socioemotional (P<0.001), and Attentional (P<0.001) domains. Additionally, children with DS presented lower gross motor function than TD in GMFM-88, standing (P<0.001) and walking, running, and jumping (P<0.001). Correlations were found between greater difficulties with sensory processing in Touch and lower gross motor function in walking, running, and jumping for the DS group. Our results suggest there are more difficulties in sensory processing patterns and gross motor function in children with DS than in TD. Also, there is a single association between more difficulties in sensory processing and less well-developed motor function in the DS group. Therefore, a comprehensive assessment of all these aspects should be performed in children and adolescents with DS, along with the provision of relevant interventions addressing specific needs.

Effect of VOJTA Therapy on Gross Motor Function in Children with Cerebral Palsy

Effect of VOJTA Therapy on Gross Motor Function in Children with Cerebral Palsy

The effects of COVID-19 restrictions on gross motor function of children with cerebral palsy

Purpose. COVID-19 is an extremely infectious, life-threatening viral illness that has constituted a global public health emergency. Rehabilitation programs of children with cerebral palsy were interrupted during the COVID-19 pandemic. The aim of the study was to assess the effects of COVID-19 restrictions on gross motor function of children with cerebral palsy.&#x0D; Material and Methods. In this study, a survey of fifty eight cerebral palsied children of both genders who received physical therapy recruited from three hospitals in Cairo, Egypt (October 6 university hospital -6th of October general hospital- El Hosary hospital- Zaid general hospital- Zaid specialled hospital- Private physical therapy centers). It was done through paediatrics Quality of life inventory (cerebral therapy module) to compare between the level of the children’s quality of life before and after frequent stopping of physical therapy sessions due to covid-19 pandemic.&#x0D; Results. The result of this study shows that there was a significant difference in movement and balance before and after the lockdown (p &lt;0.001). The mean value was decreased from 54.1% to 33.3%. Also, there was a significant decrease in Pain and hurt (p&lt;0.001) from 68.2% to 37.1% and in fatigue (p&lt;0.001) from 58.8% to 37.8%. Regarding age there was a significant difference between different age groups regarding daily activities (p&lt;0.001), pain (p&lt;0.010) and fatigue (p&lt;0.030), while after lockdown, there was a significant difference between different age groups regarding daily activities (p&lt;0.001) and fatigue (p&lt;0.001).&#x0D; Conclusion. Children with cerebral palsy were protected from COVID-19 exposure by staying at home, but their rehabilitation activities were disrupted. Therefore, during pandemics, caregivers must develop effective homecare therapy procedures, and healthcare professionals must routinely reassess the state of the child and caregiver. Additionally, caregivers of children with CP should experience less stress and anxiety. Children with CP can get multidisciplinary support, effective communication, and contact between medical professionals and families.

AN ICF CORE SET BASED INVESTIGATION OF THE EFFECTS OF GROSS MOTOR FUNCTIONS ON HEALTH IN CHILDREN WITH CEREBRAL PALSY

Purpose: The Gross Motor Function Measure (GMFM) is commonly used to assess gross motor functions in children with cerebral palsy (CP). Our aim was to investigate the relationship between gross motor function and health status in children with CP based on clinical types and functional levels. Methods: This cross-sectional study included 75 children with CP (mean age ± SD 7.59 ±3.86 years). The 66-item Gross Motor Function Measure (GMFM-66) was used to measure the gross motor functions of children. The International Classification of Functioning, Disability and Health (ICF) CP Core Set was used to assess the general health status of children including body functions and structures, activity and participation, and environmental factors for obtaining a holistic framework. Results: Of the children, 61 (81.3%) were spastic and 14 (18.7%) were dyskinetic. Children were divided into 3 groups based on the Gross Motor Function Classification System (GMFCS) level as mild (levels 1-2, n=28), moderate (level 3, n=16), and severe (levels 4-5, n=31). The GMFM-66 had moderate to strong correlations with body functions and structures (r=-0.811, p

Effects of Lower Extremity Functional Training (LIFT) on Gross Motor Function and Gait in Children with Spastic Cerebral Palsy

Background: Children with spastic cerebral palsy face challenges in mobility due to impairments in gross motor function and gait. Lower Extremity Functional Training (LIFT) is posited as a potential intervention to ameliorate these difficulties. Objective: This study aimed to evaluate the effectiveness of LIFT on enhancing gross motor function and gait in children with spastic cerebral palsy. Methods: Employing a Randomized Controlled Trial design, the study recruited 22 participants and allocated them into intervention and control groups. Over six weeks, the intervention group received LIFT along with baseline treatment, while the control group received only baseline treatment. Outcomes were measured using the 2-minute Walk Test, Single Leg Stance Test, and Gross Motor Function Measure (GMFM). Results: Post-intervention, the intervention group exhibited a statistically significant improvement in the Single Leg Stance Test (p=0.032). However, no significant differences were observed in the 2 Minute Walk Test (p=0.448) and GMFM (p=0.289) between the intervention and control groups. Within-group comparisons showed significant improvements from pre- to post-intervention in both the Single Leg Stance Test (p=0.006) and the 2 Minute Walk Test (p=0.012) for the intervention group, and in the 2 Minute Walk Test (p=0.003) and GMFM (p=0.004) for the control group. Conclusion: While LIFT resulted in significant within-group improvements in single-leg balance, it did not demonstrate a significant advantage over baseline treatment alone in improving overall gait and gross motor function in children with spastic cerebral palsy. Further research with larger sample sizes and longer intervention durations may be necessary to ascertain the full impact of LIFT in this population.

Engaging the Lower Extremity via Active Therapy Early (ELEVATE) Is Feasible and May Improve Gross Motor Function in Children with Spastic Bilateral Cerebral Palsy: A Case Series.

The feasibility of ELEVATE with respect to adherence and preliminary efficacy was determined for children with spastic bilateral cerebral palsy (CP) from encephalopathy of prematurity. A case series was used. Participants were randomized to receive ELEVATE immediately or delay the intervention by 3 months before receiving the intervention. The outcomes included feasibility measures of (1) number of children recruited, (2) percentage of sessions attended, (3) stride counts during the intervention, and preliminary efficacy measures of change over the intervention period in (4) Gross Motor Function Measure-66 (GMFM-66), and (5) kinematics and weight-bearing during treadmill walking. Four boys under 3 years of age participated. All participants tolerated 60-minute intervention sessions four times/week for 12 weeks, and attended 75%-94% (min-max) of the targeted sessions. The median step count per session ranged from 833 to 2484 steps (min-max) during the final week of training. Participants showed an increase in GMFM-66 score of 2.4-7.5 points (min-max) over the 3-month intervention phase, as compared to a decrease of 1.7 for one participant and an increase of 1.3 for another over the delay period. Three participants demonstrated small improvements in their gait with the intervention. Engaging young children with bilateral CP in intensive rehabilitation targeting gross motor function was feasible and demonstrated preliminary efficacy. The results have guided the design of a larger clinical trial to assess efficacy of early, active interventions for children with spastic bilateral CP.

Using artificial intelligence-based technologies to detect clinically relevant changes of gross motor function in children with cerebral palsy.

To compare the 66-item Gross Motor Function Measure (GMFM-66) with the reduced version of the GMFM-66 (rGMFM-66) with respect to the detection of clinically relevant changes in gross motor function in children with cerebral palsy (CP). The study was a retrospective single centre analysis of children with CP who participated in a rehabilitation programme. Overall, 1352 pairs of GMFM-66 and rGMFM66 measurements with a time interval of 5 to 7 months were available. To measure clinically relevant changes in gross motor function, the individual effect size (iES) was calculated. The study population consisted of 1352 children (539 females), mean age 6 years 4 months (SD 2 years 4 months). The iES based on the GMFM-66 and the rGMFM-66 showed a significant correlation (r = 0.84, p < 0.001). The analysis of the area under the receiver operating characteristic curve showed an excellent agreement for clinically relevant gross motor improvement (Cohen's d ≥ 0.5; area under the curve = 0.90 [95% confidence interval 0.88-0.92]) or deterioration (Cohen's d ≤ -0.5; area under the curve = 0.95 [95% confidence interval 0.92-0.97]). Performing the rGMFM-66 saves time compared to the full GMFM-66. The rGMFM-66 showed good agreement with the GMFM-66 with respect to the detection of clinically relevant changes in gross motor function in children with CP, so its use in everyday clinical practice seems justifiable. The reduced version of the 66-item Gross Motor Function Measure (rGMFM-66) detects clinically relevant changes in gross motor function in children with cerebral palsy. The rGMFM-66 correlates highly with the full GMFM-66. The rGMFM-66 can be used in clinical practice when the time schedule is limited.

Effect of selective dorsal rhizotomy on muscle morphology, spasticity, gait and gross motor function in children with spastic cerebral palsy

Effect of selective dorsal rhizotomy on muscle morphology, spasticity, gait and gross motor function in children with spastic cerebral palsy

Effectiveness of Neurodevelopmental Treatment and Sensory Integration Therapy on Gross Motor Function, Balance and Gait Parameters in Children With Spastic Diplegia.

Background Spastic diplegic cerebral palsy is the type that is most frequently seen in clinical settings. Spastic diplegic children have trouble maintaining their balance, gait, and gross motor function.This study investigated the effects of the Neurodevelopmental Technique (NDT) and Sensory Integration Technique (SIT) on balance, gross motor function, and gait characteristics in children with spastic diplegia. Method The study's participants were 8 to 12 years old, with spastic diplegia, categorized into stages I to III of the Gross Motor Function Classification System. While individuals in group B underwent sensory integration therapy, group A's subjects received NDT for 45 minutes. Both groups received traditional physiotherapy for 15 minutes. The protocol was given for five days a week, continuously for four weeks. All 40 subjects underwent pre- and post-treatment assessments using the Gross Motor Function Measure-88 (GMFM-88), Paediatric Balance Scale, Gait Parameters, and Gross Motor Function Classification System. Results The trial involved 40 children, divided into two groups of 20 each. Statistical analysis demonstrated a substantial improvement in group B post-intervention (P>0.0001).The study's findings were drawn using the Chi-Square test, paired and unpaired t-tests, and SPSS Statistics for Windows, version 27.0 (IBM Corp., Armonk, USA).A p<0.05 and theGraphPad Prism version 7.0 (GraphPad Software, Boston, USA)were used. A total of 40 children completed the entire duration of treatment for a month. 20 subjects participated in group A (age range 8-12 years; mean age 10.3 years) and 20 subjects in group B (age range 8-12 years; mean age 10.25 years). The GMFM-88, which assesses motor function, reveals that the between-group comparison indicates a substantial difference of 7.95 (6.04-9.86) in favor of Group B, with a p-value of 0.0001, signifying statistical significance.Similarly, the Pediatric Balance Scale (PBS) outcomes significantly enhanced in both groups post-intervention.The comparison between groups yields a difference of 1.85 (1.11-2.59) in favor of Group B,with a p-value of 0.0001. Conclusion The study concluded that SIT has a positive impact on gait metrics, balance, and gross motor function in children with spastic diplegia.

The Effectiveness of Neuro Developmental Therapy with Myofascial Release on Gross Motorfunction of Children with Spastic Cerebral Palsy

The Effectiveness of Neuro Developmental Therapy with Myofascial Release on Gross Motorfunction of Children with Spastic Cerebral Palsy

Validity of the Gross Motor Function Measurement in a sample of Turkish Children with Neurofibromatosis Type 1

Purpose: Muscle weakness and delays in motor development are more common problems in children with neurofibromatosis type 1. Gross Motor Function Measurement-88 is widely used tool to evaluate motor functions in children with developmental disabilities. We aimed to investigate validity of the Gross Motor Function Measurement-88 in a sample of Turkish children with neurofibromatosis type 1. Methods: Aged between 5 to 17 years 40 children (20 male/20 female) with neurofibromatosis type 1 participated in this study. To asses validity of Gross Motor Function Measurement 88, Manual Muscle Test was done seven muscle groups in upper and lower limbs bilaterally by a physical therapist. Results: The mean age was 9.7±3.81 years. A positive moderate to strong correlation was found between Manual Muscle Test and Gross Motor Function Measurement-88 subdomains (r=0.317-0.668; p &amp;lt;0.05). Conclusion: Gross Motor Function Measurement-88 is a valid measurement for evaluating gross motor functions in children with neurofibromatosis type 1. Identifying motor developmental delays in children with neurofibromatosis type 1 will be a guide for establishing early intervention programs and determining symptom-specific rehabilitation goals. We recommend the use of Gross Motor Function Measurement-88 in children with neurofibromatosis type 1 for evaluating gross motor function.

Effects of hippotherapy on gross motor function in children and adolescents with cerebral palsy – a scoping review

Introduction: Cerebral palsy is one of the most commonly diagnosed neurological syndromes in children today. The most prevalent abnormalities in the development of patients with cerebral palsy are related to general motor skills, body posture and muscle tension. The sum of these disorders affects, inter alia, gross motor skills, which are movements involving either the entire body or a significant part of it. These include, for example, walking, running, jumping, swimming, and cycling. Nowadays, medicine offers many types of therapy to patients with cerebral palsy. Properly adjusted, they provide a chance to maintain appropriate levels of activity and physical fitness, and prevent the patient’s clinical condition from worsening. One of the supportive forms of therapy for people suffering from cerebral palsy is hippotherapy, which, thanks to its universal status, is an important complement to the rehabilitation process. The aim of the study was to assess the effects of hippotherapy on gross motor skills in children with cerebral palsy based on a literature review. Materials and methods: The MEDLINE PubMed medical database was reviewed as recommended by PRISMA, using the following keywords: “cerebral palsy” in combination with “hippotherapy” and “gross motor function.” The review included clinical trials examining the effects of hippotherapy on gross motor skills in children with cerebral palsy. Results: A total of 25 articles published between 1998 and 2021 were identified. The effects of hippotherapy on changes in gross motor activity were assessed using the Gross Motor Function Measure (GMFM), Functional Status Scale, Pediatric Balance Scale, Bruininks–Oseretsky Test of Motor Proficiency. Second Edition (BOT-2) scales, Gross Motor Function Classification System (GMFCS), and changes in selected gait determinants including walking speed and stride length. Conclusions: Hippotherapy improves gross motor skills in children and adolescents with cerebral palsy aged 3–19, classified as GMFCS levels I–V. However, more research is needed to establish the long-term effects of hippotherapy.

Predicting Gross Motor Function in Children and Adolescents with Cerebral Palsy Applying Artificial Intelligence Using Data on Assistive Devices

Data obtained from routine clinical care find increasing use in a scientific context. Many routine databases, e.g., from health insurance providers, include records of medical devices and therapies, but not on motor function, such as the frequently used Gross Motor Function Measure-66 (GMFM-66) score for children and adolescents with cerebral palsy (CP). However, motor function is the most common outcome of therapeutic efforts. In order to increase the usability of available records, the aim of this study was to predict the GMFM-66 score from the medical devices used by a patient with CP. For this purpose, we developed the Medical Device Score Calculator (MDSC) based on the analysis of a population of 1581 children and adolescents with CP. Several machine learning algorithms were compared for predicting the GMFM-66 score. The random forest algorithm proved to be the most accurate with a concordance correlation coefficient (Lin) of 0.75 (0.71; 0.78) with a mean absolute error of 7.74 (7.15; 8.33) and a root mean square error of 10.1 (9.51; 10.8). Our findings suggest that the MDSC is appropriate for estimating the GMFM-66 score in sufficiently large patient groups for scientific purposes, such as comparison or efficacy of different therapies. The MDSC is not suitable for the individual assessment of a child or adolescent with CP.