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

Abstract

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

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

“…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).…”

The Coping with and Caring for Infants with Special Needs intervention was associated with improved motor development in preterm infants

“…The authors reported that 22 infants (51%) were later diagnosed with cerebral palsy. 10,11 Again, the groups did not differ in developmental outcomes and the content of the physiotherapy was not associated with developmental outcomes. However, a difference in family function emerged and that was that the family's quality of life improved over time in the COPCA group, whereas it remained similar in the standard care group.…”

“…Both studies evaluated COPCA in infants at very high risk of cerebral palsy and used a double approach, by combining a randomised controlled trial (RCT) with process evaluation. The latter 8 included video recordings of the intervention sessions, in which distinguishable intervention elements were defined, quantified and analysed with respect to their association with developmental outcomes 6,9‐11 . The first study 6 comprised 46 term and preterm infants who had definitely abnormal general movements at 10 weeks of corrected age.…”

“…The latter 8 included video recordings of the intervention sessions, in which distinguishable intervention elements were defined, quantified and analysed with respect to their association with developmental outcomes. 6,[9][10][11] The first study 6 comprised 46 term and preterm infants who had definitely abnormal general movements at 10 weeks of corrected age. Of these, 10 (22%) were later diagnosed with cerebral palsy.…”

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

“…In this article, we report the infant's neuromotor, cognitive, and behavioral outcome. In our accompanying article [11], we address family outcome and the child's activities and participation.…”