Assessment of Gross Motor Function in Pediatric Patients Aged 5–12 Years with Hemiplegia Before Treatment and Two Years After Medical Rehabilitation

Background: Pediatric hemiplegia is a spastic form of cerebral palsy characterized by paralysis of one side of the body, most often resulting from impaired cerebral circulation.It affects the contralateral brain hemisphere, typically causing more damage to the face and upper limb than the lower limb.Evaluating gross motor function in these patients using the Gross Motor Function Measure (GMFM) is essential for assessing the effectiveness of rehabilitation.Objectives: The study aimed to implement rehabilitation treatment in patients with pediatric hemiplegia and improve the corresponding motor functions.This is a highly relevant and necessary area of research, particularly considering Georgia's specific context.Methods: A total of 36 pediatric patients with hemiplegia were included and divided into four age groups: 5-6 years (n=10), 7-8 years (n=8), 9-10 years (n=9), and 11-12 years (n=9).Gross motor function was assessed using the GMFM-88 scale, which includes six functional domains: (i) lying and rolling, (ii) sitting, (iii) crawling and kneeling, (iv) standing, (v) walking, and (vi) total gross motor score.Each item was scored on a 0-3 scale.Patients underwent 40 rehabilitation courses (384 procedures) over two years, with individualized treatment plans developed by an interdisciplinary team.The severity of pediatric hemiplegia was evaluated by determining the child's ability to move independently.Based on these functions, five levels of disease severity were defined.Statistical analysis was conducted using the Mann-Whitney U test with significance at P < 0.05.Results: All age groups showed statistically significant improvement in GMFM scores after two years of treatment, as indicated by the Mann-Whitney U test (P<0.05).The most notable improvements were observed in the 5-6-year age group, followed by 7-8, 9-10, and 11-12-year age groups.Younger patients demonstrated greater percentage increases in motor function scores, indicating a stronger response to rehabilitation when started earlier.Conclusions: Medical rehabilitation significantly improves gross motor function in children with hemiplegia across all age groups -early treatment initiation results in better outcomes.As determined through interdisciplinary evaluation, rehabilitation should be tailored individually based on age, disease severity, and each patient's specific functional deficits.