Background: Gross motor development curves for children with Cerebral Palsy (CP), grouped by Gross Motor Function Classification System (GMFCS) levels, help health care professionals and parents to understand children's motor function prognosis. Although these curves are widely used in Brazil to guide clinical decision-making, they were developed with Canadian children with CP. Little is known about how these patterns evolve in children and adolescents with CP in low-income countries like Brazil. The PARTICIPA BRAZIL aims to: (i) to identify and draw a profile of functioning and disability of Brazilian children and adolescents with CP by classifying them, for descriptive purposes, with all five valid and reliable functional classifications systems (gross motor function, manual ability, communication function, visual and eating and drinking abilities); (ii) to create longitudinal trajectories capturing the mobility capacity of Brazilian children and adolescents with CP for each level of the GMFCS; (iii) to document longitudinal trajectories in the performance of activities and participation of Brazilian children and adolescents with CP across two functional classification systems: GMFCS and MACS (Manual Abilities Classification System); (iv) to document longitudinal trajectories of neuromusculoskeletal and movement-related functions and exercise tolerance functions of Brazilian children and adolescents with CP for each level of the GMFCS; and (v) to explore interrelationships among all ICF framework components and the five functional classification systems in Brazilian children and adolescents with CP. Methods: We propose a multi-center, longitudinal, prospective cohort study with 750 Brazilian children and adolescents with CP from across the country. Participants will be classified according to five functional classification systems. Contextual factors, activity and participation, and body functions will be evaluated longitudinally and prospectively for four years. Nonlinear mixed-effects models for each of the five GMFCS and MACS levels will be created using test scores over time to create prognosis curves. To explore the interrelationships among ICF components, a multiple linear regression will be performed.

How could I apply this information?"The Gross Motor Function Measure (GMFM) is the most frequently used instrument to evaluate gross motor function in children and adolescents with cerebral palsy. As clinicians and researchers, we are constantly searching the literature for the expansion of its use across the world and across different cultures. It is important this instrument is translated, adapted, and psychometrically tested for the care of children with special needs. The GMFM-SP, as a valid and reliable measure, will help build more evidence-based care and goals in clinical practice and research settings across Spain. "What should I be mindful about when applying this information?"The GMFM-SP now needs to be tested across different clinical settings and research fields in Spain. The authors reported that 6 hours of training on the tool before applying the instrument may be enough for its use and that there is a difference across Gross Motor Function Classification System (GMFCS) levels and the GMFM score. In addition, some evaluators had no previous experience with the GMFM, but they had excellent inter-and intraexaminer reliability after 6 hours of training. This is important information both for the dissemination of the tool and for encouraging its use and ensuring therapeutic goals are correctly established according to each level of the GMFCS. It is possible to obtain a criterion test at the CanChild Web site to test your reliability to apply the GMFM (https://www.canchild.ca/en/shop/47gmfm-criterion-test). The GMFM is a measure that is constantly changing and adapting itself to the needs of children.