Cerebral palsy is a life-long condition that causes heterogeneous motor disorders. Motor rehabilitation interventions must be adapted to the topography of the symptoms, ambulatory capacity, and age of the individual. Current guidelines do not differentiate between the different profiles of individuals with cerebral palsy, which limits their implementation.

To develop evidence-based, implementable guidelines for motor rehabilitation interventions for individuals with cerebral palsy according to the age, topography of the cerebral palsy, and ambulatory capacity of the individual and to determine a level of priority for each intervention.

We used a mixed methods design that combined a systematic review of the literature on available motor rehabilitation interventions with expert opinions. Based on the French National Authority for Health methodology, recommendations were graded as strong, conditional, or weak. Interventions were then prioritized by the experts according to both the evidence and their own opinions on relevance and implementability to provide a guide for clinicians. All recommendations were approved by experts who were independent from the working group.

Strong recommendations as first-line treatments were made for gait training, physical activities, and hand-arm bimanual intensive therapy for all children and adolescents with cerebral palsy. Moderate recommendations were made against passive joint mobilizations, muscle stretching, prolonged stretching with the limb fixed, and neurodevelopmental therapies for all children and adolescents with cerebral palsy. Strong recommendations as first-line treatments were made for gait training for all adults with cerebral palsy and moderate recommendations as moderate importance interventions for strengthening exercises and ankle-foot orthoses for motor impairment of the feet and the ankles.

These guidelines, which combine research evidence and expert opinions, could help individuals with cerebral palsy and their families to codetermine rehabilitation goals with health professionals, according to their preferences.

脑瘫是一种终生疾病，会导致异质性运动障碍。运动康复干预措施必须适应个体的症状、行走能力和年龄。目前的指南没有区分脑瘫患者的不同特征，这限制了它们的实施。

根据年龄、脑瘫的地形和个人的行走能力，为脑瘫患者制定基于证据的、可实施的运动康复干预指南，并确定每项干预的优先级。

我们采用混合方法设计，将现有运动康复干预文献的系统回顾与专家意见相结合。根据法国国家卫生局的方法，建议分为强、有条件或弱。然后，专家根据证据和他们对相关性和可实施性的意见对干预措施进行优先排序，为临床医生提供指导。所有建议均由独立于工作组的专家批准。

对所有脑瘫儿童和青少年的步态训练、体育活动和手部双手强化治疗作为一线治疗提出了强烈建议。对所有患有脑瘫的儿童和青少年的被动关节活动、肌肉拉伸、长时间固定肢体拉伸和神经发育疗法提出了中度建议。对所有脑瘫成人的步态训练作为一线治疗提出了强烈建议，对加强锻炼和踝足矫形器作为中等重要性的干预措施提出了中度建议，以治疗足部和脚踝的运动障碍。

这些指南结合了研究证据和专家意见，可以帮助脑瘫患者及其家人根据自己的喜好与卫生专业人员共同确定康复目标。