Community-Based Physiotherapy Models and Neurological Trajectories in Infants at High Risk of Cerebral Palsy in Rural Tanzania: A Retrospective Routine-Care Study.

Authors

Fernanda Cordeiro da Silva, Giovanna Dantas de Araujo, Natany Carla Lima da Silva, Giane Amorim Ribeiro-Samora, Carolina Daniel de Lima-Alvarez, Silvana Alves Pereira

Published in

Child: care, health and development. Volume 52. Issue 6.

Abstract

Cerebral palsy (CP) refers to a group of motor impairments resulting from nonprogressive brain malformations or injuries that occur early in development. Limited access to rehabilitation services in low- and middle-income countries poses substantial challenges.
This study aimed to describe the clinical and sociodemographic characteristics of children treated at a rural rehabilitation centre in Tanzania and to evaluate their neurological trajectories across three physiotherapy models. A retrospective longitudinal review (April to September 2025) analysed 126 medical records of children aged 3-24 months who underwent the Hammersmith Infant Neurological Examination (HINE) at the beginning of the intervention and after approximately 3 months of care. Participants were categorized into the hope intensive programme (HPP; 40 h/month), early intervention programme (EIP; 16 h/4 months) or conventional physiotherapy programme (CPP; 16 h/4 months).
Neurological function improved across all groups, with substantial raw neurological development gains reflected in the mean HINE scores, which increased from 41.6 to 55.3. Postintervention, the odds of infants remaining in the lowest HINE score range decreased significantly (OR: 0.07). The HPP group showed the fastest developmental progression. The study also supports the feasibility of using the Kiswahili-translated HINE as an excellent low-cost, responsive and context-appropriate tool for longitudinal tracking and clinical monitoring.
Structured neurorehabilitation, particularly intensive intervention, was associated with significant raw neurological progression in this low-resource setting, highlighting the utility of the HINE for objective longitudinal surveillance.

PMID:
43000677
Bibliographic data and abstract were imported from PubMed on 09 Nov 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.