{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:17:29Z","timestamp":1787818649281,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n The ability to predict functional outcomes in children with cerebral palsy (\n CP<\/jats:styled-content>\n ) after surgical procedures and a subsequent inpatient rehabilitation unit\u00a0(\n IRU<\/jats:styled-content>\n ) stay is limited based on current literature.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To determine if length of stay (\n LOS<\/jats:styled-content>\n ) and functional outcomes could be predicted in children with\n CP<\/jats:styled-content>\n following a surgical procedure and\n IRU<\/jats:styled-content>\n stay based on the surgical procedure performed, pattern of involvement, etiology, and Gross Motor Function Classification System level.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary care pediatrics.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n \n Pediatric patients with\n CP<\/jats:styled-content>\n (\n N<\/jats:italic>\n \u2009=\u2009139) who underwent one of three surgical procedures followed by an\n IRU<\/jats:styled-content>\n stay.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Selective dorsal rhizotomy, single\u2010event multilevel orthopedic surgery, or intrathecal baclofen pump implantation and subsequent IRU stay.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n IRU LOS, Functional Independence Measure for Children (WeeFIM) total score, subscores (mobility, self\u2010care, and cognition), efficiency, and change score.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Surgical procedure and\n WeeFIM<\/jats:styled-content>\n mobility subscore at admission were significantly predictive of\n LOS<\/jats:styled-content>\n (\n p<\/jats:italic>\n \u2009<\u2009.001). Type\/pattern of limb involvement, age, etiology, Gross Motor Function Classification System, and admission\n WeeFIM<\/jats:styled-content>\n total were significantly predictive of total\n WeeFIM<\/jats:styled-content>\n score at discharge (\n p<\/jats:italic>\n \u2009<\u2009.001) and explained 86% of the variance. All\n WeeFIM<\/jats:styled-content>\n subscores at admission were significant predictors of subscores at discharge (\n p<\/jats:italic>\n \u2009<\u2009.001). Type\/pattern of limb involvement, as an individual predictor, was most associated with\n WeeFIM<\/jats:styled-content>\n efficiency (\n r<\/jats:italic>\n \u2009=\u2009.398) and\n WeeFIM<\/jats:styled-content>\n change (\n r<\/jats:italic>\n \u2009=\u2009.445,\n p<\/jats:italic>\n \u2009<\u2009.001). Cognition was found to be a significant mediator of the relationship between both admission mobility and self\u2010care and the gains attained during an\n IRU<\/jats:styled-content>\n stay (\n p<\/jats:italic>\n \u2009\u2264\u2009.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n LOS<\/jats:styled-content>\n and functional outcomes could be predicted with a minimal set of factors accounting for 86% of the variance. Cognition at\n IRU<\/jats:styled-content>\n admission has an important influence on functional outcomes during the postoperative rehabilitation period.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.70199","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:23:51Z","timestamp":1787815431000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting functional outcomes following surgical intervention and inpatient rehabilitation stay in children with cerebral palsy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2042-2035","authenticated-orcid":false,"given":"Amy","family":"Barbuto","sequence":"first","affiliation":[{"name":"Texas Children's Hospital \u2013 The Woodlands Department of Physical and Occupational Therapy The Woodlands Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2527-4028","authenticated-orcid":false,"given":"Michelle L.","family":"Seymour","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Department of Physical Medicine & Rehabilitation, Texas Children's Hospital, Division of Pediatric Rehabilitation Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5259-4136","authenticated-orcid":false,"given":"Sruthi P.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Department of Neurosurgery, Texas Children's Hospital, Division of Pediatric Rehabilitation Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5182-5406","authenticated-orcid":false,"given":"Katy","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Texas Woman's Univeristy \u2013 Houston Department of Physical Therapy Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0512-1322","authenticated-orcid":false,"given":"Christian M.","family":"Niedzwecki","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Department of Physical Medicine & Rehabilitation, Texas Children's Hospital, Division of Pediatric Rehabilitation Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"8","article-title":"A report: the definition and classification of cerebral palsy April 2006","volume":"109","author":"Rosenbaum P","year":"2007","journal-title":"Dev Med Child Neurol Suppl"},{"issue":"109","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1469-8749.2007.tb12626.x","article-title":"Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy","volume":"49","author":"Cans C","year":"2007","journal-title":"Dev Med Child Neurol"},{"issue":"1","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.spen.2004.01.002","article-title":"The World Health Organization international classification of functioning, disability, and health: a model to guide clinical thinking, practice and research in the field of cerebral palsy","volume":"11","author":"Rosenbaum P","year":"2004","journal-title":"Semin Pediatr Neurol"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/ptj\/82.3.237","article-title":"Physical therapists' perceptions of factors influencing the acquisition of motor abilities of children with cerebral palsy: implications for clinical reasoning","volume":"82","author":"Bartlett DJ","year":"2002","journal-title":"Phys Ther"},{"issue":"2","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s11910-020-1022-z","article-title":"State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy","volume":"20","author":"Novak I","year":"2020","journal-title":"Curr Neurol Neurosci Rep"},{"issue":"7","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.3109\/09638280903180171","article-title":"Evaluation of single event multilevel surgery and rehabilitation in children and youth with cerebral palsy\u2013a 2\u2010year follow\u2010up study","volume":"32","author":"Akerstedt A","year":"2010","journal-title":"Disabil Rehabil"},{"issue":"10","key":"e_1_2_9_8_1","first-page":"1","article-title":"Lumbosacral dorsal Rhizotomy for spastic cerebral palsy: a health technology assessment","volume":"17","author":"O HQ","year":"2017","journal-title":"Ont Health Technol Assess Ser"},{"issue":"1","key":"e_1_2_9_9_1","first-page":"9","article-title":"Selective dorsal rhizotomy in cerebral palsy: selection criteria and postoperative physical therapy protocols","volume":"36","author":"Nicolini\u2010Panisson RD","year":"2018","journal-title":"Rev Paul Pediatr"},{"issue":"3","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.gaitpost.2013.01.014","article-title":"Explaining the variability improvements in gait quality as a result of single event multi\u2010level surgery in cerebral palsy","volume":"38","author":"Rutz E","year":"2013","journal-title":"Gait Posture"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ridd.2014.11.012","article-title":"Predictors for the benefit of selective dorsal rhizotomy","volume":"37","author":"Funk JF","year":"2015","journal-title":"Res Dev Disabil"},{"issue":"2","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1302\/0301-620X.98B2.35959","article-title":"Predictors of outcome after single\u2010event multilevel surgery in children with cerebral palsy: a retrospective ten\u2010year follow\u2010up study","volume":"98","author":"Svehlik M","year":"2016","journal-title":"Bone Joint J"},{"issue":"12","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/dmcn.13981","article-title":"Predictors affecting outcome after single\u2010event multilevel surgery in children with cerebral palsy: a systematic review","volume":"60","author":"Edwards TA","year":"2018","journal-title":"Dev Med Child Neurol"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.gaitpost.2020.05.033","article-title":"Factors affecting GDI improvement after single event multilevel surgery in patients with cerebral palsy","volume":"80","author":"Min JJ","year":"2020","journal-title":"Gait Posture"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.gaitpost.2021.03.032","article-title":"Factors related to better outcomes after single\u2010event multilevel surgery (SEMLS) in patients with cerebral palsy","volume":"86","author":"Freitas Guardini KM","year":"2021","journal-title":"Gait Posture"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.13075"},{"issue":"6","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.2106\/JBJS.N.00676","article-title":"Long\u2010term results and outcome predictors in one\u2010stage hip reconstruction in children with cerebral palsy","volume":"97","author":"Rutz E","year":"2015","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_9_18_1","unstructured":"Pediatric Inpatient Rehab: WeeFIM Scores.2022https:\/\/my.clevelandclinic.org\/pediatrics\/outcomes\/1043-pediatric-inpatient-rehab-weefim-scores"},{"issue":"12","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/j.1469-8749.2008.03150.x","article-title":"Outcome tools used for ambulatory children with cerebral palsy: responsiveness and minimum clinically important differences","volume":"50","author":"Oeffinger D","year":"2008","journal-title":"Dev Med Child Neurol"},{"issue":"3","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.ridd.2012.11.006","article-title":"Validity, responsiveness, minimal detectable change, and minimal clinically important change of pediatric balance scale in children with cerebral palsy","volume":"34","author":"Chen C\u2010l","year":"2013","journal-title":"Res Dev Disabil"},{"issue":"3","key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/dmcn.12226","article-title":"A systematic review of activities of daily living measures for children and adolescents with cerebral palsy","volume":"56","author":"James S","year":"2014","journal-title":"Dev Med Child Neurol"},{"key":"e_1_2_9_22_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression\u2010Based Approach","author":"Hayes AF","year":"2022"},{"issue":"10","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1093\/ptj\/80.10.974","article-title":"Validation of a model of gross motor function for children with cerebral palsy","volume":"80","author":"Palisano RJ","year":"2000","journal-title":"Phys Ther"},{"issue":"11","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1001\/jama.288.11.1357","article-title":"Prognosis for gross motor function in cerebral palsy: creation of motor development curves","volume":"288","author":"Rosenbaum PL","year":"2002","journal-title":"JAMA"},{"issue":"4","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1469-8749.2008.03196.x","article-title":"Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21\u2009years","volume":"51","author":"Hanna SE","year":"2009","journal-title":"Dev Med Child Neurol"},{"issue":"2","key":"e_1_2_9_26_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/j.1469-8749.2011.04143.x","article-title":"Single\u2010event multilevel surgery for children with cerebral palsy: a systematic review","volume":"54","author":"McGinley JL","year":"2012","journal-title":"Dev Med Child Neurol"},{"issue":"10","key":"e_1_2_9_27_1","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1589\/jpts.29.1732","article-title":"Relationship between gross motor function and the function, activity and participation components of the international classification of functioning in children with spastic cerebral palsy","volume":"29","author":"Lee BH","year":"2017","journal-title":"J Phys Ther Sci"},{"issue":"5","key":"e_1_2_9_28_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/dmcn.13683","article-title":"Evolution of self\u2010care and functional mobility after single\u2010event multilevel surgery in children and adolescents with spastic diplegic cerebral palsy","volume":"60","author":"Dequeker G","year":"2018","journal-title":"Dev Med Child Neurol"},{"issue":"1","key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/dmcn.12932","article-title":"\u201cParticipation\u201d: a systematic review of language, definitions, and constructs used in intervention research with children with disabilities","volume":"58","author":"Imms C","year":"2016","journal-title":"Dev Med Child Neurol"},{"key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ridd.2017.07.006","article-title":"Understanding participation of children with cerebral palsy in family and recreational activities","volume":"69","author":"Alghamdi MS","year":"2017","journal-title":"Res Dev Disabil"},{"issue":"4","key":"e_1_2_9_31_1","first-page":"442","article-title":"Factors affecting participation of children with cerebral palsy in meaningful activities. Systematic review","volume":"35","author":"Pashmdarfard M","year":"2021","journal-title":"Occup Ther Health Care"},{"issue":"5","key":"e_1_2_9_32_1","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1302\/1863-2548.12.180123","article-title":"Selective dorsal rhizotomy in ambulant children with cerebral palsy","volume":"12","author":"Wang KK","year":"2018","journal-title":"J Child Orthop"}],"container-title":["PM&R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.70199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.70199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:23:55Z","timestamp":1787815435000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.70199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":31,"alternative-id":["10.1002\/pmrj.70199"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.70199","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"assertion":[{"value":"2025-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pmrj.70199"}}