Functional severity and rehabilitation demand in pediatric cerebral palsy: a cross sectional study

Arsovski, Denis and Chichevska-Jovanova, Natasha and Jankulovska, Angelka and Stojchevska-Prodanovska, Viktorija and Kostovski, Nikolina (2026) Functional severity and rehabilitation demand in pediatric cerebral palsy: a cross sectional study. Hrvatska revija za rehabilitacijska istraživanja, 62 (1). pp. 58-68. ISSN 1848-7734

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Abstract

Background and aim: Cerebral palsy present heterogeneous motor impairments that complicate the planning of rehabilitation in pediatric populations. Although the Gross Motor Function Classification System (GMFCS) is used to describe functional severity, its translation into actual rehabilitation demand in practice remains insufficiently explored. The aim of this research paper is to examine if functional severity serves as a variable related to rehabilitation demand in children with cerebral palsy. Participants and methods: A cross-sectional observational research were conducted with 30 children and adolescents with cerebral palsy, recruited from rehabilitation and disability centers in North Macedonia. Data were collected with structured caregiver interviews conducted in the home environment. Motor severity was classified with GMFCS (from I to V level). Rehabilitation demand was assessed with structured questionnaire that obtained the type, intensity, and frequency of rehabilitation interventions. Descriptive statistical analyses were performed, followed by Spearman’s rank correlation to examine the association between GMFCS level and the need for rehabilitation. Group differences were analyzed with independent samples t-tests, and effect sizes were calculated. Associations between categorical variables were examined with Fisher’s exact test. Results: No significant association was found between GMFCS level and rehabilitation demand (rs = 0.017, p = 0.928), indicating variability in rehabilitation needs in functional severity levels. In contrast, age showed as a significant association, with children classified as having high rehabilitation demand being older than those with low to moderate levels of demand (t(28) = 2.31, p = 0.028) in combination with a large effect size (Cohen’s d = 0.86). Conclusions and implications: These results show that rehabilitation demand in children with cerebral palsy cannot be predicted by motor severity alone. Age and developmental factors appear to be important, supporting the need for personalized, developmentally informed planning of the rehabilitation beyond functional classification systems.

Item Type:	Article
Subjects:	Scientific Fields (Frascati) > Social Sciences > Educational sciences Scientific Fields (Frascati) > Medical and Health Sciences > Health sciences Scientific Fields (Frascati) > Medical and Health Sciences > Other medical sciences Scientific Fields (Frascati) > Social Sciences > Other social sciences
Divisions:	Higher Medical School
Depositing User:	MSc Denis Arsovski
Date Deposited:	01 Jul 2026 08:27
Last Modified:	01 Jul 2026 08:27
URI:	https://eprints.uklo.edu.mk/id/eprint/11658

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