Does physiotherapeutic intervention affect motor outcome in high-risk infants? An approach combining a randomized controlled trial and process evaluation

Tjitske Hielkema, Cornill H. Blauw-Hospers, Tineke Dirks, Marieke Drijver-Messelink, Arend F. Bos, Mijna Hadders-Algra*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

53 Citations (Scopus)

Abstract

AIM The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders onmotor outcome, as measured by the InfantMotor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation.

METHOD At a corrected age of 3 months, 46 infants (20 males, 26 females) recruited from the neonatal intensive care unit at the University Medical Centre Groningen (median birthweight 1210g, range 585-4750g; median gestational age 30wks, range 25-40wks) were included on the basis of definitely abnormal general movements. Exclusion criteria were severe congenital disorders and insufficient understanding of the Dutch language. The infants were assigned to either the family-centred COPing with and CAring for Infants with Special Needs (COPCA) intervention group (n=21; 9 males, 12 females) or the traditional infant physiotherapy (TIP) intervention group (n=25; 11 males, 14 females) for a period of 3 months. Three infants assigned to the TIP group (one male, two females) did not receive physiotherapy. IMP scores were measured by blinded assessors at 3, 4, 5, 6, and 18 months. At each age, the infants were neurologically examined. Physiotherapeutic sessions at 4 and 6 months were videotaped. Quantified physiotherapeutic actions were correlated with IMP scores at 6 and 18 months. RESULTS The IMP scores of both the COPCA and TIP groups before, during, and after the intervention did not differ. Some physiotherapeutic actions were associated with IMP outcomes; the associations differed for infants who developed cerebral palsy (n=10) and those who did not (n=33).

INTERPRETATION At randomized controlled trial level, the scores of both the TIP and COPCA groups did not differ in effect on motor outcome, as measured with the IMP. The analysis of physiotherapeutic actions revealed associations between these actions and IMP outcomes. However, the small sample size of this study precludes pertinent conclusions.

Original languageEnglish
Pages (from-to)E8-E15
Number of pages8
JournalDevelopmental Medicine and Child Neurology
Volume53
Issue number3
DOIs
Publication statusPublished - Mar-2011

Keywords

  • GROUP SELECTION THEORY
  • PHYSICAL-THERAPY
  • CEREBRAL-PALSY
  • DISORDERS
  • BEHAVIOR
  • CHILDREN
  • PROFILE

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