The rehabilitation program "Auf die Beine" was developed based on scientific insights into the functional musculoskeletal unit and current physiotherapeutic evidence for treating children and adolescents with mobility impairments. Its goal is to restore early impairments through targeted interventions, prevent secondary complications, and enable age-appropriate participation. Since 2006, "Auf die Beine" has been part of clinical care in Germany and remains unique in its concept. It involves short inpatient stays (2-3 weeks) at the Pediatric Rehabilitation Center (UniReha GmbH, University Hospital Cologne) combined with longer home-based, vibration-supported training (4-6 months) by caregivers. The intensive physiotherapy focuses on goal-oriented development, motivation, repetition, and training to the point of fatigue. The program can be repeated up to four times, with six months of home training in the first year and four months in subsequent years. Follow-up assessments occur 6-8 months post-intervention to evaluate sustainability. Over 8,000 patients with conditions such as cerebral palsy, spinal muscular atrophy, and spina bifida have been treated.

A recent scientific evaluation examined the effectiveness of "Auf die Beine" on gross motor function across all participants, regardless of underlying diagnosis, over four therapy years. Motor function was assessed using the widely used Gross Motor Function Measure-66 (GMFM-66), along with the 1-minute walk test (1MWT) and the 6-minute walk test (6MWT), both with and without assistive devices. The study design included three measurement points: baseline, post-intervention, and follow-up, allowing comparison of changes during therapy and recovery. A control group receiving only standard outpatient therapy was established for comparison.

The study population included 3,059 children in the intervention group versus 2,226 in the control group for GMFM-66; other measures involved smaller cohorts. The groups were comparable in age, gender, height, BMI, and diagnoses. Most comparisons showed significantly better improvements in gross motor function in the intervention group (p<0.001), with effect sizes (Cohen's d) mostly above 0.5, indicating clinically relevant changes. These motor improvements were observed consistently across all four therapy years. 

In conclusion, data from the past 18 years suggest that "Auf die Beine" produces significant and clinically meaningful improvements in gross motor function in children and adolescents with mobility impairments. This comprehensive evaluation represents the largest cohort studied in Germany to date and provides a foundation for developing future treatment strategies tailored to lifestyle and healthcare structures.