Reabilitação precoce na paralisia cerebral: importância e impactos nos desfechos motores - uma revisão integrativa

Abstract

to analyze the importance and effectiveness of early rehabilitation compared to late rehabilitation in cerebral palsy and its impact on motor outcomes in children, as well as to discuss factors influencing the timely initiation of intervention through an integrative literature review. Methods: studies published from 2016 onward were included from PubMed, MEDLINE, and SciELO databases up to March 2026. Study selection and data extraction were performed independently by two researchers. The analysis was descriptive and comparative of the selected literature. Results: among the 33 studies analyzed, 17 (51.52%) showed a significant positive impact of early rehabilitation on motor outcomes in children with cerebral palsy, while 1 (3.03%) found no significant differences. The main interventions identified were bimanual training (17.9%), CIMT (14.9%), motor learning and neuroplasticity-based approaches (11.9%), task-oriented training (10.4%), home-based programs (10.4%), and family-centered interventions (9.0%). Less frequently reported were the Vojta method (3.0%), vibration therapy (3.0%), Bobath concept (3.0%), GAME (3.0%), baby-BIM (1.5%), baby-CIMT (1.5%), and other associated therapeutic resources (1.5%), as identified in the included studies. Conclusions: early rehabilitation has a significant positive impact on motor outcomes, especially when initiated within the first months of life. Evidence shows improvements in gross and fine motor function, postural control, mobility, coordination, and functional independence. Active, intensive, and goal-directed therapies demonstrated better outcomes. However, resource limitations, shortage of professionals, lack of standardized protocols, and diagnostic delays still hinder its implementation in current clinical practice.