LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: neuromotor, cognitive, and behavioral outcome

Hielkema, Tjitske; Hamer, Elisa G.; Boxum, Anke G; Gemert, Sacha la Bastide‐van; Dirks, Tineke; Reinders-Messelink, Heleen A.; Maathuis, Carel G. B.; Verheijden, Johannes; Geertzen, Joannes; Hadders‐Algra, Mijna

doi:10.1080/09638288.2019.1610508

Cited by 35 publications

(57 citation statements)

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“…The randomized controlled trial indicated that family outcome and the infant's functional outcome (activities and participation) in the COPCA and typical infant physiotherapy groups were similar. However, a too small sample size resulted in underpowering of our study, so it is not possible to draw clear conclusions [21]. After analysing contents of intervention, family empowerment was positively associated with COPCA-related interventional elements.…”

Section: Discussionmentioning

confidence: 85%

“…Typical infant physiotherapy was originally based on NeuroDevelopmental Treatment principles, but nowadays a more functional approach and more involvement of the family has been implemented [13,18,20]. In our accompanying paper, we reported that infant neuromotor, cognitive, and behavioral function was similar in the two intervention groups [21].…”

Section: Introductionmentioning

confidence: 93%

“…Primary outcome of the LEARN2MOVE 0-2 study is the Infant Motor Profile [25], and power calculation was also based on the Infant Motor Profile, described in our accompanying paper [21]. The current paper addresses family and infant outcomes measured by questionnaires and structured interviews.…”

Section: Measurementsmentioning

confidence: 99%

“…(1) NeuroDevelopmental Treatment versus COPCA-factor, a dimension reflecting the diametrically opposed core elements of NeuroDevelopmental Treatment (hands-on techniques and training) and COPCA (coaching and challenging self-produced motor activities); (2) non-directive communication and self-produced motor behavior; and (3) directive communication and training. Details of the process and factor analysis are described in our accompanying paper [21].…”

Section: Process Analysis Of Physical Therapy Intervention Sessionsmentioning

confidence: 99%

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LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: family outcome and infant’s functional outcome

Hielkema

Boxum

Hamer

et al. 2019

Disability and Rehabilitation

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f BOSK, Association of persons with a physical disability, Utrecht, The Netherlands ABSTRACT Purpose: To compare family and functional outcome in infants at very high risk of cerebral palsy, after receiving the family centred programme "Coping with and Caring for infants with special needs (COPCA)" or typical infant physiotherapy. Materials and methods: Forty-three infants at very high risk were included before 9 months corrected age and randomly assigned to one year COPCA (n ¼ 23) or typical infant physiotherapy (n ¼ 20). Family and infant outcome were assessed before and during the intervention. Physiotherapy intervention sessions were analysed quantitatively for process analysis. Outcome was evaluated with non-parametric tests and linear mixed-effect models. Results: Between-group comparisons revealed no differences in family and infant outcomes. Within-group analysis showed that family's quality of life improved over time in the COPCA-group. Family empowerment was positively associated with intervention elements, including "caregiver coaching." Conclusions: One year of COPCA or typical infant physiotherapy resulted in similar family and functional outcomes. Yet, specific intervention elements, e.g., coaching, may increase empowerment of families of very high risk infants and may influence quality of life, which emphasizes the importance of family centred services. ä IMPLICATIONS FOR REHABILITATIONOne year of the family centred programme "Coping with and a Caring for infants with special needs" compared with typical infant physiotherapy resulted in similar family outcome and similar functional outcome for the infants at very high risk for cerebral palsy. Specific contents of intervention, such as caregiver coaching, are associated with more family empowerment and increased quality of life. Emphasis on family needs is important in early intervention for infants at very high risk for cerebral palsy. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 93%

Section: Measurementsmentioning

confidence: 99%

Section: Process Analysis Of Physical Therapy Intervention Sessionsmentioning

confidence: 99%

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LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: family outcome and infant’s functional outcome

Hielkema

Boxum

Hamer

et al. 2019

Disability and Rehabilitation

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“…In contrast, the feasibility and preliminary efficacy trials of a novel parent coaching-based approach (COPCA) disappointingly did not confer any gains over and above passive neurodevelopmental therapy within traditional physiotherapy (yellow light, weak positive) [87][88][89][90]. Likewise, conductive education [91] and Vojta therapy [79,80] for infants with cerebral palsy also appear ineffective for improving movement skills (yellow light, weak negative).…”

Section: Early Interventionsmentioning

confidence: 98%

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

Novak

Morgan

Fahey

et al. 2020

Curr Neurol Neurosci Rep

532

554

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Purpose of Review Cerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012-2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019. Recent Findings Effective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy. Summary We have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.

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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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LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: neuromotor, cognitive, and behavioral outcome

Abstract: Hadders-Algra & L2M 0-2 Study Group (2019): LEARN2MOVE 0-2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: neuromotor, cognitive, and behavioral outcome, Disability and Rehabilitation,

Cited by 35 publications

References 22 publications

LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: family outcome and infant’s functional outcome

LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: family outcome and infant’s functional outcome

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

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

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