Motor development trajectories of children with cerebral palsy in a community-based early intervention program in rural South India

Developmental trajectories are crucial for evidence-based prognostication, planning interventions, and monitoring progress in children with cerebral palsy (CP). To describe gross motor development patterns of children with CP in rural South India for the five Gross Motor Function Classification System (GMFCS) levels. Longitudinal cohort study of 302 children (176 males, 126 females) with CP aged 0 to 10 years, followed by a community-based early intervention program. GMFCS levels were 5.4 % level 1, 16.5 % level II, 22.8 % level III, 26.8 % level IV, and 28.5 % level V. Assessments were undertaken using the Gross Motor Function Measure (GMFM-66) at 6-month intervals between April 2017 and August 2020. Longitudinal analyses were performed using mixed-effects linear regression models. Five distinct motor development curves were created for ages 0 to 10 years by GMFCS levels as a function of age and GMFM-66 with a stable limit model, variation in estimated limits and rates of development. Motor development trajectories for CP in an LMIC differ from those reported in HICs. Consideration of how social determinants of health, environmental and personal factors impact motor development in low-resource contexts is crucial. Further work is needed to describe developmental trajectories of children for CP in LMICs. •Few longitudinal studies of children with cerebral palsy (CP) in LMICs exist.•Gross motor development in children with CP is influenced by contextual factors.•Developmental trajectories differ in an LMIC as compared to high-income countries.•Motor development in CP in LMICs shows a slower rate and lower limit than in HICs.•The Gross Motor Function Classification System for CP may need LMIC adaptation.