Spider Cage Therapy's Impact on GMFM-88 in Iraqi Infants with Cerebral Palsy in Two Rehabilitation Centers

Document Type : Original Article

Authors

1 Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq

2 Rheumatologist & Physiatrist, Al-Hassan Al-Mujtaba Teaching Hospital, Karbala, Iraq

3 Neurosurgeon specialist, Alhindiyah Teaching Hospital, Karbala, Iraq

4 Community Medicine Specialist, Karbala Health Directorate, Karbala, Iraq

10.22038/ijn.2025.80381.2549

Abstract

Background: This study aimed to evaluate the efficacy of incorporating spider cage therapy into the rehabilitation regimen of infants and children with cerebral palsy (CP) by assessing improvements in Gross Motor Function Measure (GMFM-88) scores. Rehabilitation of CP infants typically involves various therapies to improve motor function and overall development.
Methods: This interventional study involved 40 infants and children with CP who had undergone traditional rehabilitation prior to the implementation of spider cage therapy. The intervention consisted of structured sessions within the spider cage aimed at improving motor function. Data analysis was conducted using SPSS (Version 26.0). Continuous data were presented as mean ± SD, while categorical data were expressed as numbers and percentages. A paired t-test was used to compare the results before and after therapy, and an independent t-test and one-way ANOVA were employed to compare parameters, with significance set at P ≤ 0.05. The calculated effect size (Cohen's d) is approximately 0.58, indicating a medium effect size. Additionally, a 95% confidence interval was used to detect a significant effect at a 5% significance level.
Results: The mean chronological age of the participants was 2 years (±1.6 SD), and the mean developmental age was 0.6 years (±0.2 SE) with a male-to-female ratio of 1.5:1. Most were hospital-delivered (92.5%), with 55% born via Caesarian section and 55% having NICU admission (median: 13 days ±5 SE). Medication usage varied, with 65% not taking any medication or only tonics, 25% on antispasticity drugs, and 10% on anti-epileptics. Additionally, 37.5% were premature, and 42.5% were low birth weight. Significant improvement in GMFM-88 scores was observed post-therapy (mean increase from 37.33 to 51.55, p < 0.05). GMFCS scores also improved (mean decrease from 3.73 to 3.00, p < 0.05). Improvements were more pronounced in those with a chronological age <3 years (not statistically significant) and a developmental age ≥1 year (statistically significant).
Conclusion: Spider cage therapy is a beneficial addition to traditional rehabilitation methods for managing cerebral palsy (CP). Early intervention, especially for younger infants, along with the use of accurate assessment tools such as GMFM-88, is vital for achieving the best possible results in this group.
 

Keywords

References

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Iranian Journal of Neonatology
Volume 16, Issue 3
July 2025
Pages 1-13

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