Iterative Motor Phenotyping in Cerebral Palsy: A Conceptual Review

Cerebral palsy (CP) is a non-progressive neurodevelopmental disorder in which motor features and their functional impact may change across development. Although longitudinal surveillance and multidisciplinary management are established components of CP care, motor phenotype is often treated as static. This narrative review proposes iterative motor phenotyping as a conceptual framework for repeatedly characterizing spasticity, dystonia, ataxia, hypotonia, and mixed motor features in relation to function, participation, comfort, safety, and child- and family-centered goals. Reassessment may be scheduled during follow-up or triggered by developmental transitions, functional changes, by pain, or by limited or unexpected treatment response. Updated characterization can inform individualized management and may prompt targeted diagnostic evaluation when emerging or atypical features raise concern for an alternative diagnosis. Iterative motor phenotyping is intended to complement, rather than replace longitudinal surveillance, rehabilitation, multidisciplinary care, and diagnostic evaluation. Prospective studies are needed to determine whether this framework improves treatment selection or functional outcomes.