{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:05Z","timestamp":1790575025318,"version":"4.1.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 2006 international consensus defines cerebral palsy as a permanent disorder of movement and posture caused by non-progressive brain injury in the developing fetus or infant, yet it sets no upper age limit for the injury; in practice, countries adopt arbitrary chronological-age cut-offs, most commonly 24 months, without any neurobiological basis, and the 2025\u20132026 updated descriptions, although shifting toward a broader \u201cdescription,\u201d retain the same temporal framework and provide no operational diagnostic boundary.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Core hypothesis<\/jats:title>\n                    <jats:p>The diagnostic essence of cerebral palsy lies not in the chronological age at injury but in whether the injury occurs before the functional maturation threshold of corticospinal motor-control integration in the corresponding functional domain, producing a persistent deviation of that domain's motor developmental trajectory; the gross-motor domain is marked by stable independent walking and the fine-motor domain by accurate pincer grasp as an exploratory extension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Theoretical framework<\/jats:title>\n                    <jats:p>Stable independent walking is the behavioural read-out of the first functional integration of spinal central pattern generators, brainstem postural control, vestibulo-cerebellar integration, and cortical descending modulation, with the corticospinal system as the final common pathway, so the framework applies to all motor subtypes; a four-criterion scheme justifies marker selection, and a complete operational definition is provided with velocity- and pattern-deviation domains, domain-specific criteria, and a stepwise diagnostic algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Testable inferences<\/jats:title>\n                    <jats:p>Stratification by integrative-maturation status is predicted to outperform chronological-age stratification in forecasting motor outcomes, with explicit falsification criteria and a multicentre prospective validation roadmap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Replacing the chronological-age criterion with the integrative-maturation status of each functional domain resolves the longstanding diagnostic ambiguity between cerebral palsy and other static motor impairments; all quantitative thresholds are theoretical working benchmarks pending calibration by multicentre prospective cohort studies.<\/jats:p>\n                  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