Very early upper limb interventions for infants with asymmetric brain lesions

Boyd, Roslyn N.; Perez, Micah; Guzzetta, Andrea

doi:10.1016/b978-0-7020-5099-2.00013-3

Cited by 4 publications

(11 citation statements)

References 80 publications

(80 reference statements)

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“…59 Human infants with asymmetric brain lesions are at high risk of congenital hemiplegia by the end of their first year of life. 58,60 These at-risk infants can experience impaired motor function (e.g. in the UL), which can detrimentally impact their ability to acquire manual skills needed to participate in daily activities (e.g.…”

Section: Impact Of Asymmetric Brain Injury On Upper Limb Motor Develomentioning

confidence: 99%

“…58,76 The potential impact of these three interventions remains unclear, however, and requires further investigation. 60 The systematic review 203 (Chapter 2) identified that signature CIMT, mCIMT, hybrid CIMT, FUT and OT supplemented with intramuscular UL injections of BoNT-A are more effective than usual care in improving unimanual and bimanual UL function in school-aged children (including infants) with UCP. 203 There was limited use, however, of valid and reliable outcome measures to quantify meaningful change in response to interventions in infants with or at risk of UCP.…”

Section: There Will Be Limited Evidence Reporting the Efficacy Of Earmentioning

confidence: 99%

“…58,76 The potential impact of these interventions on the development of corticospinal tracts following a brain lesion and development of early UL motor function remain unclear, however, and require further investigation. 60 The systematic review 203 in Chapter 2 identified only one published RCT with a study sample of participants with UCP who were all younger than three years. 5 The RCT reported that an ecological approach of CIMT (eco-CIMT) was more effective than usual care when eco-CIMT was delivered by parents and preschool teachers (who were supervised by an occupational therapist).…”

Section: Evidence Supporting the Efficacy Of Early Upper Limb Motor Imentioning

confidence: 99%

“…62 Asymmetries in hand prehension skills (unimanual capacity, reaching and grasping) may be evident in infants with asymmetric brain lesions by six to twelve months corrected age (C.A.). 58,60 Congenital hemiplegia refers to unilateral motor impairment as a result of presumed prenatal, perinatal or postnatal brain injury. 63,64 Infants born prematurely may also sustain asymBI, which in and of itself, exposes the immature brain to the risk of haemorrhage, or to transient or genetic coagulation.…”

Section: Pvl)mentioning

confidence: 99%

“…174 Earlier detection of UCP is needed to enable timely referral to infant-friendly interventions within the critical period of brain development. 58,60,175 Early detection of UCP involves identification of asymmetries in UL reaching (both spontaneous and purposeful), grasp ability and grasp strength. 109 To date, UCP has been identified in infants with perinatal or neonatal stroke using: (i) asymmetries of wrist movements during the fidgety period (nine to 20 weeks post-term) of General Movements (GMs) 176 ; (ii) measurement of bimanual midline toy manipulation 177 ; and (iii) measurement of reaching trajectories.…”

Section: Introductionmentioning

confidence: 99%

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Early reach to grasp development of infants with asymmetric brain injury on the Grasp and Reach Assessment of Brisbane (GRAB)

Perez¹

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Section: Impact Of Asymmetric Brain Injury On Upper Limb Motor Develomentioning

confidence: 99%

Section: There Will Be Limited Evidence Reporting the Efficacy Of Earmentioning

confidence: 99%

Section: Evidence Supporting the Efficacy Of Early Upper Limb Motor Imentioning

confidence: 99%

Section: Pvl)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early reach to grasp development of infants with asymmetric brain injury on the Grasp and Reach Assessment of Brisbane (GRAB)

Perez¹

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Development, and construct validity and internal consistency of the Grasp and Reach Assessment of Brisbane (GRAB) for infants with asymmetric brain injury

Perez

Ziviani

Guzzetta

et al. 2016

Infant Behavior and Development

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UP-BEAT (Upper Limb Baby Early Action–observation Training): protocol of two parallel randomised controlled trials of action–observation training for typically developing infants and infants with asymmetric brain lesions

et al. 2013

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IntroductionInfants with asymmetric brain lesions are at high risk of developing congenital hemiplegia. Action–observation training (AOT) has been shown to effectively improve upper limb motor function in adults with chronic stroke. AOT is based on action observation, whereby new motor skills can be learnt by observing motor actions. This process is facilitated by the Mirror Neuron System, which matches observed and performed motor actions. This study aims to determine the efficacy of AOT in: (1) influencing the early development of reaching and grasping of typically developing infants and (2) improving the upper limb activity of infants with asymmetric brain lesions.Methods and analysisThis study design comprises two parallel randomised sham-controlled trials (RCTs) in: (1) typically developing infants (cohort I) and (2) infants with asymmetric brain lesions (eg, arterial stroke, venous infarction, intraventricular haemorrhage or periventricular leukomalacia; cohort II). Cohort II will be identified through a neonatal ultrasound or neonatal MRI. A sham control will be used for both RCTs, taking into consideration that it would be unethical to give no intervention to an at-risk population. Based on a two-tailed t test of two independent means, with a significance (α) level of 0.05, 80% power, predicted effect size of 0.8 and a 90% retention rate, we require 20 participants in each group (total sample of 40) for cohort I. The sample size for cohort II was based on the assumption that the effect size of the proposed training would be similar to that found by Heathcock et al in preterm born infants (n=26) with a mean effect size of 2.4. Given the high effect size, the calculation returned a sample of only four participants per group, on a two-tailed t test, with a significance (α) level of 0.05 and 80% power. As cohort II will consist of two subgroups of lesion type (ie, arterial stroke and venous infarction), we have quadrupled the sample to include 16 participants in each group (total sample of 32). Infants will be randomised to receive either AOT or standard Toy Observation Training (TOT). Both interventions will be of 4 weeks’ duration, from the infant's 9th–13th post-term week of age. Three sessions of 5 min each will be performed each day for 6 days/week (total of 6 h over 28 days). Parents of the AOT group will repeatedly show the infant a grasping action on a set of three toys, presented in random order. Parents of the TOT group will show the infant the same set of three toys, in random order, without demonstrating the grasping action. At 14, 16 and 18 weeks, the quantity and quality of reaching and grasping will be measured using the Grasping and Reaching Assessment of Brisbane; symmetry of reaching and grasping will be measured using the Hand Assessment of Infants (HAI) and pressure of grasping for each hand with a customised pressure sensor. At 6 months’ corrected age, the primary outcome measures will be the HAI and Bayley Scales of Infant and Toddler Development (third edition; BSID III), to measure cog...

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Very early upper limb interventions for infants with asymmetric brain lesions

Cited by 4 publications

References 80 publications

Early reach to grasp development of infants with asymmetric brain injury on the Grasp and Reach Assessment of Brisbane (GRAB)

Early reach to grasp development of infants with asymmetric brain injury on the Grasp and Reach Assessment of Brisbane (GRAB)

Development, and construct validity and internal consistency of the Grasp and Reach Assessment of Brisbane (GRAB) for infants with asymmetric brain injury

UP-BEAT (Upper Limb Baby Early Action–observation Training): protocol of two parallel randomised controlled trials of action–observation training for typically developing infants and infants with asymmetric brain lesions

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