A Physical Therapy Intervention to Advance Cognitive and Motor Skills: A Single Subject Study of a Young Child With Cerebral Palsy

Dusing, Stacey C.; Harbourne, Regina T.; Lobo, Michele A.; Westcott-McCoy, Sally; Bovaird, James A.; Kane, Audrey E.; Syed, Gullnar; Marcinowski, Emily C.; Koziol, Natalie A.; Brown, Shaaron E

doi:10.1097/pep.0000000000000635

Cited by 12 publications

(7 citation statements)

References 18 publications

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“…Of particular importance is the need for frequent practice of the activities that lead to skilled movement and functional independence. Intervention environments and professional input are not sufficiently frequent to achieve the goals of early intervention programs …”

Section: Resultsmentioning

confidence: 99%

“…Two systematic reviews and 9 RCTs were identified. Child-initiated movement, targeted motor training activities, and task-specific and context-specific exercises have the potential to maximize functional outcomes .…”

Section: Resultsmentioning

confidence: 99%

“…There were no CP-specific cognitive systematic reviews found for children younger than 2 years. Eleven RCTs measured effects of early intervention strategies. A Cochrane meta-analysis on the effectiveness of early intervention for infants born preterm supported small sustained gains for cognition.…”

Section: Resultsmentioning

confidence: 99%

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Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

et al. 2021

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IMPORTANCECerebral palsy (CP) is the most common childhood physical disability. Early intervention for children younger than 2 years with or at risk of CP is critical. Now that an evidence-based guideline for early accurate diagnosis of CP exists, there is a need to summarize effective, CP-specific early intervention and conduct new trials that harness plasticity to improve function and increase participation. Our recommendations apply primarily to children at high risk of CP or with a diagnosis of CP, aged 0 to 2 years. OBJECTIVE To systematically review the best available evidence about CP-specific early interventions across 9 domains promoting motor function, cognitive skills, communication, eating and drinking, vision, sleep, managing muscle tone, musculoskeletal health, and parental support. EVIDENCE REVIEWThe literature was systematically searched for the best available evidence for intervention for children aged 0 to 2 years at high risk of or with CP. Databases included CINAHL, Cochrane, Embase, MEDLINE, PsycInfo, and Scopus. Systematic reviews and randomized clinical trials (RCTs) were appraised by A Measurement Tool to Assess Systematic Reviews (AMSTAR) or Cochrane Risk of Bias tools. Recommendations were formed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and reported according to the Appraisal of Guidelines, Research, and Evaluation (AGREE) II instrument.FINDINGS Sixteen systematic reviews and 27 RCTs met inclusion criteria. Quality varied. Three best-practice principles were supported for the 9 domains: (1) immediate referral for intervention after a diagnosis of high risk of CP, (2) building parental capacity for attachment, and (3) parental goal-setting at the commencement of intervention. Twenty-eight recommendations (24 for and 4 against) specific to the 9 domains are supported with key evidence: motor function (4 recommendations), cognitive skills (2), communication (7), eating and drinking (2), vision (4), sleep (7), tone (1), musculoskeletal health (2), and parent support (5).CONCLUSIONS AND RELEVANCE When a child meets the criteria of high risk of CP, intervention should start as soon as possible. Parents want an early diagnosis and treatment and support implementation as soon as possible. Early intervention builds on a critical developmental time for plasticity of developing systems. Referrals for intervention across the 9 domains should be specific as per recommendations in this guideline.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

et al. 2021

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“…Conventional physiotherapy approaches are effective for increasing motor development during childhood [ 15 , 41 , 42 , 43 , 44 ]. However, the sensory integration effect on the motor development of infants with CVI and CP has not been investigated.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Sensory Integration Interventions on Motor and Sensory Functions in Infants with Cortical Vision Impairment and Cerebral Palsy: A Single Blind Randomized Controlled Trial

2022

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Cortical vision impairment (CVI) and Cerebral Palsy (CP) lead to decrement in sensory and motor functions of infants. The current study examined the effectiveness of sensory integration interventions on sensory, motor, and oculomotor skills in infants with cortical vision impairment. Thirty-four infants with and CP aged 12–18 months were enrolled to the study. The infants were randomly divided into two groups as the control and intervention groups. The intervention group took sensory integration intervention 2 days a week for 8 weeks in addition to conventional physiotherapy 2 days a week for 8 weeks. The control group only received the conventional physiotherapy program 2 days a week for 8 weeks. The duration of the treatment sessions were 45 min for both interventions. Before and after the intervention, sensory processing functions were evaluated with the Test of Sensory Functions in Infants (TSFI), and motor functions were evaluated with the Alberta Infant Motor Scale (AIMS). There was a statistically significant difference between the pre- and post-test mean TSFI total and AIMS scores in the intervention group and control group (p < 0.001). The intervention group mean TSFI scores were more statistically significant than the those of the control group. Mean post-intervention AIMS scores did not differ between groups. Sensory integration intervention delivered with the conventional physiotherapy program was more effective than the conventional physiotherapy program in increasing sensory processing skills in one measure in infants with CVI and CP.

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“…These infants learned the activation of a toy that contingently responded when the infant lifted their head over a threshold (Tripathi et al, 2019). The second principle of the intervention is to challenge the infant just beyond their current ability, reward success, and gradually increase the challenge, which we refer to as the "just right challenge" (Dusing et al, 2018(Dusing et al, , 2019Harbourne et al, 2018).…”

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confidence: 99%

A Clinical Trial Based on Reward Contingency to Improve Prone Tolerance and Motor Development is Feasible in 3- to 6-Month-Old Infants

Tripathi

Dusing

Pidcoe

et al. 2020

Journal of Motor Learning and Development

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Aims: The American Academy of Pediatrics recommends “parents to incorporate supervised, awake ‘prone play’ in their infant’s routine to support motor development and minimize the risk of plagiocephaly”. The purpose of this feasibility study was to compare usual care to a reward contingency–based intervention, developed to increase prone tolerance and improve motor skills. Methods: Ten full-term infants, 3–6- months old, with poor prone tolerance were randomized to either the Education group or Reward contingency group. Each group participated in three parent education sessions and 15 intervention sessions, over the period of three weeks. Infants in the Reward contingency group used the Prone Play Activity Center, a technology developed to reinforce motor behavior of infants in prone position. Intervention frequency and parent feedback data determined the feasibility of the interventions. Results: Infants in the Reward contingency group practiced a median of 12 of the 15 anticipated intervention sessions in the Prone Play Activity Center. These infants used the device for a mean of 18 minutes per day. Parents of infants in the Education group practiced a median of 10 sessions of the 15 anticipated intervention sessions. Conclusion: The reward contingency–based intervention is feasible for use in a future clinical trial with some modifications.

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A Physical Therapy Intervention to Advance Cognitive and Motor Skills: A Single Subject Study of a Young Child With Cerebral Palsy

Cited by 12 publications

References 18 publications

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy

The Effectiveness of Sensory Integration Interventions on Motor and Sensory Functions in Infants with Cortical Vision Impairment and Cerebral Palsy: A Single Blind Randomized Controlled Trial

A Clinical Trial Based on Reward Contingency to Improve Prone Tolerance and Motor Development is Feasible in 3- to 6-Month-Old Infants

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