Faccioli Silvia, Sassi Silvia, Pagliano Emanuela, Maghini Cristina, Perazza Silvia, Siani Maria Francesca, Sgherri Giada, Farella Giuseppina Mariagrazia, Foscan Maria, Viganò Marta, Sghedoni Silvia, Bai Arianna Valeria, Borelli Giulia, Ferrari Adriano
Paediatric Rehabilitation Unit, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy.
Children (Basel). 2024 Jul 13;11(7):852. doi: 10.3390/children11070852.
In 2020, a multiprofessional panel was set up in collaboration with the Italian FightTheStroke Foundation family association to produce evidence-based recommendations for the management and neuromotor rehabilitation of persons with cerebral palsy aged 2-18 years to implement in clinical practice in Italy.
The recommendations of these care pathways were developed according to the American Academy for Cerebral Palsy and Developmental Medicine guidelines for Care Pathways Development and the Grading of Recommendations Assessment Development and Evaluation working group for adoption, adaptation, or de novo development of recommendations from high-quality guidelines (GRADE-ADOLOPMENT).
Four strong positive recommendations were developed regarding comprehensive management, and twenty-four addressed neuromotor treatment.
A holistic, individualized approach was affirmed in terms of both multidimensional patient profile and interdisciplinary management in a network with the school where children and adolescents are integrated. It was defined that all motor rehabilitation approaches must be individually tailored considering age and developmentally appropriate activities as interventions and goals, in light of the reference curves addressing prognosis for Gross Motor Function and Manual Ability Classification Systems. Intervention must be structured with adaptations of the task and/or of the context (objects and environment) based on the analysis of the child's skills to support motivation and avoid frustration.
2020年，与意大利抗击中风基金会家庭协会合作成立了一个多专业小组，以制定基于证据的建议，用于2至18岁脑瘫患者的管理和神经运动康复，以便在意大利的临床实践中实施。
这些护理路径的建议是根据美国脑瘫与发育医学学会护理路径开发指南以及推荐评估发展与评价工作组（GRADE-ADOLOPMENT）的建议制定的，用于从高质量指南中采用、改编或重新制定建议。
就综合管理制定了四项强有力的积极建议，就神经运动治疗制定了二十四项建议。
在多维患者概况和与儿童和青少年融入其中的学校建立的网络中的跨学科管理方面，都肯定了一种整体、个性化的方法。明确指出，所有运动康复方法都必须根据年龄和适合发育阶段的活动作为干预措施和目标进行个性化定制，同时参考粗大运动功能和手动能力分类系统预后的参考曲线。必须根据对儿童技能的分析对任务和/或环境（物体和环境）进行调整，以构建干预措施，从而激发动力并避免挫折感。
