One of the most relevant and challenging problems in modern pediatric physiology and rehabilitation is delayed motor development (DMD), caused by perinatal damage to the central nervous system and associated with an increased risk of subsequent development of cerebral palsy.
A significant number of newborns, with preterm infants constituting a particularly vulnerable group, require professional rehabilitation interventions. Infancy is characterized by exceptionally high neural plasticity, which creates a unique “window of opportunity” for correcting and improving motor activity. Therefore, timely and adequate intervention during this period is crucial for the formation of normal motor patterns and for minimizing long-term disabling consequences. It has been proven that early rehabilitation significantly reduces the need for costly and prolonged corrective measures in the future, while also decreasing the social and financial burden on families and the public healthcare system.
The scientific novelty and theoretical significance of this study lie in the fact that, for the first time, a clear relationship has been established in infants with delayed motor development between the baseline serum concentration of brain-derived neurotrophic factor (BDNF) and their functional recovery potential. The possibility of using BDNF indicators as an objective neurobiological biomarker for early prediction of therapy effectiveness has been demonstrated, opening the way to full individualization of the rehabilitation process. The study provides a comprehensive explanation of the physiological mechanism underlying the complex early intervention program, confirming that its implementation leads to a statistically significant increase in BDNF concentration. In turn, this factor acts as a stimulator of enhanced neuroplasticity and accelerates morphofunctional maturation of neurons in particular and of the central nervous system as a whole. The research expands current understanding of the role of BDNF as a criterion for assessing the biological response to physical activity, thereby substantiating differentiated approaches in physical therapy depending on the child’s biological profile.
The practical significance of the study lies in incorporating BDNF level assessment into the algorithm of early diagnosis and prognosis. This approach enables objective evaluation of neuroplastic potential, identification of children at high risk, and optimization of the intensity, frequency, and duration of physical interventions. Dynamic monitoring of the BDNF biomarker may serve as a criterion for timely adjustment of rehabilitation programs. The study results provide a basis for updating clinical protocols and educational materials for specialists.
To test the proposed hypothesis, a study was conducted at a specialized rehabilitation center involving 56 children aged 7–8 months with delayed motor development. Baseline measurements demonstrated that children with developmental delay, especially those born prematurely, showed a significant lag in motor skill formation against the background of reduced BDNF levels. At the same time, implementation of the developed early intervention program over one month resulted in statistically significant improvement in motor functions and an increase in neurotrophic factor levels. Although the indicators in preterm infants remained lower than those of full-term peers, the identified relationship confirmed the value of BDNF as a promising monitoring tool.
At the next stage, 20 children were selected for a long-term six-month follow-up, during which self-care skills, mobility, and social functioning were assessed. Notably, analysis using specialized questionnaires and the SF-36 family quality of life scale also demonstrated high effectiveness of family-oriented telerehabilitation. Thus, integration of telemedicine technologies contributed to optimization of home-based interventions and improvement in parental quality of life, highlighting the feasibility of implementing such methods within the overall rehabilitation service system.
In conclusion, the obtained data indicate that rehabilitation effectiveness is determined by systemic neurophysiological, musculoskeletal, and sensory adaptations, which substantiates the need for multicomponent, biologically verified, and personalized approaches to early intervention.
