{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:08:26Z","timestamp":1789391306297,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"},{"id":[{"id":"https:\/\/ror.org\/031d5vw30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Cerebral palsy is associated with complex motor impairments, including spasticity, reduced joint mobility, and functional limitations. Longitudinal data describing changes during sustained rehabilitation remain limited. Objective: We evaluated longitudinal changes in muscle tone, joint mobility, and gross motor function in children with spastic diplegic cerebral palsy participating in a structured 12-month rehabilitation program. Methods: This prospective, uncontrolled observational study included 94 children aged 5\u201310 years, selected from 116 children screened for eligibility. Assessments were performed at baseline (T0), 6 months (T1), and 12 months (T2). Outcomes included muscle tone (Modified Ashworth Scale, MAS), joint mobility (goniometry), and gross motor function (GMFM-88). Longitudinal changes were assessed using the Friedman test, followed by Bonferroni-adjusted post hoc pairwise comparisons between T0\u2013T1, T0\u2013T2, and T1\u2013T2. Associations were assessed using Spearman\u2019s rank correlation coefficient (\u03c1). Results: Significant longitudinal differences were observed across the evaluated outcomes (overall Friedman tests, p &lt; 0.0001). Median MAS scores decreased from 3 at T0 to 2 at T2 across the evaluated muscle groups. Hip abduction increased, knee extension deficit decreased, and ankle dorsiflexion improved over the study period. GMFM-88 scores also increased longitudinally. Moderate-to-strong associations were observed between muscle spasticity and joint mobility parameters (\u03c1 = \u22120.881 to 0.682). Conclusions: Favorable longitudinal changes in muscle tone, joint mobility, and gross motor function were observed during participation in the 12-month rehabilitation program. Given the uncontrolled observational design, these changes cannot be attributed exclusively to the rehabilitation intervention.<\/jats:p>","DOI":"10.3390\/jcm15187092","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:09:51Z","timestamp":1789387791000},"page":"7092","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional Outcomes of a Complex Rehabilitation Program in Children with Spastic Diplegic Cerebral Palsy: A Prospective Observational Study"],"prefix":"10.3390","volume":"15","author":[{"given":"D\u0103nu\u021b Visarion","family":"Caimac","sequence":"first","affiliation":[{"name":"Department of Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Anca Maria","family":"Amzolini","sequence":"additional","affiliation":[{"name":"Department of Medical Semiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Simona","family":"Patru","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Carmen Daniela","family":"Neagoe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Miruna Andreiana","family":"Matei","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Klejda","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Sport University of Tirana, 1001 Tirana, Albania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Adina","family":"Mitrea","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Diana","family":"Clenciu","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Amelia Valentina","family":"Genunche-Dumitrescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Ceal\u00eecu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1789-4277","authenticated-orcid":false,"given":"Paraschiva","family":"Postolache","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Grigore T. Popa University of Medicine and Pharmacy, Iasi, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Ana Maria","family":"Bumbea","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,13]]},"reference":[{"key":"ref_1","first-page":"8","article-title":"A report: The definition and classification of cerebral palsy April 2006","volume":"109","author":"Rosenbaum","year":"2007","journal-title":"Dev. Med. Child Neurol. 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