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Background <p>Rehabilitation in cerebral palsy (CP) is determined by neurodevelopmental timing, motor impairment severity, comorbidities, environmental factors, and the dose, intensity, and content of therapeutic interventions. Understanding how these determinants influence outcomes across developmental stages is essential for optimizing motor function and participation.</p> Methods <p>A narrative review of PubMed/MEDLINE and Web of Science (2010–2025), supplemented by seminal earlier literature and international guidelines, synthesized evidence from systematic reviews, randomized controlled trials, cohort and registry studies, and expert consensus. Evidence was organized by functional domains and stratified by clinical relevance.</p> Results <p>There is strong evidence for early, active, task-specific, and goal-directed interventions, including gait-oriented programs and high-intensity upper-limb therapies. Higher therapy intensity generally yields superior functional outcomes, though optimal dosing remains undefined. Age, GMFCS level, comorbidities, and contextual factors substantially moderate treatment response. Technology-supported modalities—robotic-assisted gait training, virtual reality, and neuromuscular electrical stimulation—enhance practice volume and engagement but cannot substitute for active motor learning. Evidence for adolescents and adults is limited, with rehabilitation focusing primarily on maintenance and revealing significant gaps during transition to adult care.</p> Conclusion <p>Effective CP rehabilitation requires individualized, developmentally responsive, and family-centred planning within the ICF framework. Early intervention, sufficient therapy intensity, and selective integration of technology-supported practice provide the most consistent benefits. Future research should clarify dosing parameters, evaluate long-term outcomes, and strengthen continuity of evidence-based care across health-care systems.</p>

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Evidence and Practice in the Rehabilitation of Patients with Cerebral Palsy: A Structured Narrative Review Informed by a Systematic Literature Search

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月6日

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  • Stanislava Klobucká,
  • Katarína Chamutyová,
  • Robert Klobucký,
  • Pavel Šiarnik,
  • Ľudmila Podracká,
  • Branislav Kollár

摘要

Background

Rehabilitation in cerebral palsy (CP) is determined by neurodevelopmental timing, motor impairment severity, comorbidities, environmental factors, and the dose, intensity, and content of therapeutic interventions. Understanding how these determinants influence outcomes across developmental stages is essential for optimizing motor function and participation.

Methods

A narrative review of PubMed/MEDLINE and Web of Science (2010–2025), supplemented by seminal earlier literature and international guidelines, synthesized evidence from systematic reviews, randomized controlled trials, cohort and registry studies, and expert consensus. Evidence was organized by functional domains and stratified by clinical relevance.

Results

There is strong evidence for early, active, task-specific, and goal-directed interventions, including gait-oriented programs and high-intensity upper-limb therapies. Higher therapy intensity generally yields superior functional outcomes, though optimal dosing remains undefined. Age, GMFCS level, comorbidities, and contextual factors substantially moderate treatment response. Technology-supported modalities—robotic-assisted gait training, virtual reality, and neuromuscular electrical stimulation—enhance practice volume and engagement but cannot substitute for active motor learning. Evidence for adolescents and adults is limited, with rehabilitation focusing primarily on maintenance and revealing significant gaps during transition to adult care.

Conclusion

Effective CP rehabilitation requires individualized, developmentally responsive, and family-centred planning within the ICF framework. Early intervention, sufficient therapy intensity, and selective integration of technology-supported practice provide the most consistent benefits. Future research should clarify dosing parameters, evaluate long-term outcomes, and strengthen continuity of evidence-based care across health-care systems.