Transforming Rehabilitation for Children with Cerebral Palsy

For over 30 years, Dr. Katherine Dimitropoulou has worked with children with cerebral palsy, focusing on improving their mobility and quality of life. As an occupational therapist, she noticed a persistent challenge - while therapy helped correct movement patterns, many children struggled to retain progress beyond structured sessions. Rehabilitation often prioritized physical adjustments, but it did not equip children with the understanding necessary to engage with their own mobility in a meaningful way. 

Recognizing this gap, Dr. Dimitropoulou transitioned from clinical practice to rehabilitation research, seeking to develop evidence-based models that integrate movement science, and functional cognition with active patient engagement. 

Through the Irving Institute for Clinical and Translational Research, Columbia University’s CTSA hub, Dr. Dimitropoulou was able to design and implement research-driven interventions that incorporate community engagement and patient education. Now, she is leading initiatives aimed at advancing rehabilitation strategies that improve long-term mobility outcomes and influence policy changes. 

From Pilot Proposal to a Community-Based Model 

In 2018, as a KL2 Mentored Career Development Award Scholar, Dr. Dimitropoulou advanced pilot work into a controlled study that examined the combined impact of functional mobility and cognition on learning and task performance in children and adolescents with cerebral palsy. This was a laboratory behavioral study carried out in a naturalistic environment (i.e., daily reaching activities, activities of daily living). The project created a detailed analysis of strategies and adaptations children utilized to successfully perform tasks and compared these to the strategies used by age matched typically developing peers. This project was pivotal in demonstrating the role of self-directed mobility in functional performance.  Under the mentorship of Dr. Daichi Shimbo, Director of the Irving Institute’s TRANSFORM resource, she gained critical research direction and refined her approach to focus on mechanisms and conditions that support autonomy in movement learning and execution. 

"Mentorship can define a researcher's path, and meeting the right mentor at the right time provides both direction and purpose. Dr. Shimbo was incredibly supportive, helping me refine my ideas into a focused study with real-world impact. His guidance was instrumental in my transition from clinician to researcher."

Findings from the KL2 project assisted Dr. Dimitropoulou to shape her research idea into a successful proposal, leading to receiving the Community-Based Participatory Research (CBPR) Course and pilot award program in 2019. This study engaged community partners that provided physical activity programs for children and adolescents with Cerebral Palsy. The study focused on examining how children with cerebral palsy navigate mobility in real-life settings as they engage in sports and physical activity programs. Using video observations and detailed behavioral coding, she identified a critical gap: while therapy improved movement in clinics, children struggled to apply these skills independently. Furthermore, the study established preliminary outcomes that measured mobility, physiological responses to movement (i.e. heart rate), and behavioral health as factors that impact the use of newly developed motor skills in real world conditions. 

Developing the GAME ON Framework: From Community Engagement to Scalable Impact 

Through the CBPR Program she not only received pilot funding but also the capability to work directly with families, caregivers, and rehabilitation specialists to develop GAME ON, a structured, interactive rehabilitation model that uses sports-based activities to enhance motor skills, fitness, social engagement, and long-term participation. 

Through her partnership with CP Soccer, a program dedicated to building a national soccer league for kids with cerebral palsy, stroke, or traumatic brain injury, she was able to create an adaptive sports program based on the GAME On principles.  Soccer drills were modified to support the mobility needs and personal goals of each of the players. Structured engaging real-world sports could transform to reinforce healthy mobility and social interactions. The collaboration was instrumental in refining the GAME ON framework: 

• Motor learning principles of movement speed, timing, alignment and intensity were utilized to improve movement retention and application  

• Personal goals and needs for mobility and function were embedded into structured play, encouraging self-adjustment of movement patterns and creating new and healthier habits 

• Peers and near-peers are mentors in this process through shared experiences, strategies and emotional support.  

• Community engagement, equipping families, coaches and organizations that provide programming with the skills to support this self-directed mobility engagement and productive peer interactions and relationships.  

To bring GAME ON into practice, Dr. Dimitropoulou led annual GAME ON camps. GAME ON’s findings were presented at major conferences like the American Academy for Cerebral Palsy & Developmental Medicine (2022, 2024, 2025), American Occupational Therapy Association (2021,2024), and Medical Rehabilitation Research Resource Network (MR3) -NIH (2024).

Building on the GAME ON program effectiveness, Dr. Dimitropoulou and her collaborators then secured a $250,000 PCORI Engagement Award to expand the academic community collaborations in New York and Boston metropolitan areas and develop a comprehensive research agenda. Focusing on meaningful patient-oriented outcomes and the necessary collaborations to carry out large scale pragmatic clinical trials, the ultimate goal is to expand this work nationwide and inform health care delivery models, and policy discussions. She is now preparing for the R01 grant to further explore the underlying behavioral and physiological mechanisms of movement learning and application. The work will be pivotal to support future community-based rehabilitation care programs that are informed and directly benefit the functional mobility, cognition and behavioral health of children and adolescents with cerebral palsy. GAME ON is redefining how children with cerebral palsy engage with their mobility through research, community collaboration, and policy integration. 

Dr. Dimitropoulou’s advice to early-career researchers, “step outside traditional silos, engage with communities, and design research that directly influences lives. True innovation happens when science meets the people it aims to serve.” Her work is a testament that therapy should go beyond correcting movement - it should empower children to take control of their mobility and independence. The Irving Institute takes pride in supporting this groundbreaking work, driving meaningful change in mobility science and patient-centered care. 

 
Follow-on 

Building Community Competence/Capacity for Physical Activity in Cerebral Palsy Through CER  

The Effects of an Adapted Community Sports Camp (“GAME ON”) on Functional Mobility, and Fitness in Children and Adolescents With Cerebral Palsy (CP)