Effects of an Intensive Gait Training Rehabilitation Protocol After Single Event Multilevel Surgery in Cerebral Palsy: Activ’Marche

Objective: Functional gait parameters of children with cerebral palsy (CP) are not systematically improved after conventional rehabilitation post-single-event multilevel surgery (SEMLS). To enhance functional outcomes in patients one year post-surgery, a new intensive rehabilitation phase called “Activ’Marche” was added to the usual protocol. This late intensive phase was expected to improve gait function and motor performance. Methods: Design: Quasi-experimental pre–post intervention study with 3-month follow-up. Setting: In-care rehabilitation center followed by home-based telerehabilitation. Participants: 23 adolescents with CP (age 12–19 years), classified as Gross Motor Function Classification System (GMFCS) levels I-II, one year after SEMLS. Intervention: 6-week intensive rehabilitation program consisting of 4 weeks of full-time in-care rehabilitation followed by 2 weeks of home-based telerehabilitation. The program combined high-intensity interval training, muscle strengthening, and functional gait training. Main measures: Activity capacity was assessed by 6-Minute Walk test (6MWT), 10-Meter Walk test (10MWT) and Gait Deviation Index (GDI) computation using clinical gait analysis; activity performance was measured by Gross Motor Function Measure (GMFM) D/E score, and one week of actimetric recording, which also partially reflects participation. Quality of life was assessed by the Pediatric Quality of Life Inventory (PedsQL). Results: Significant improvements were observed in the 6MWT (+13%, p = 0.008), GMFM-66 dimensions D (+6.7%, p = 0.007) and E (+8.5%, p < 0.001), and 10MWT (+14,2%, p = 0.002), with gains maintained or enhanced at follow-up. Conclusions: This new intensive rehabilitation protocol significantly improves overall motor function and walking performance in adolescents with CP following SEMLS without affecting gait quality or quality of life.