Effect of early intervention in infants at very high risk of cerebral palsy: A systematic review

Mijna Hadders-Algra*, Anke G. Boxum, Tjitske Hielkema, Elisa G. Hamer

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

72 Citations (Scopus)

Abstract

AIM First, to systematically review the evidence on the effect of intervention applied during the first postnatal year in infants with or at very high risk of cerebral palsy (CP) on child and family outcome. Second, to assess whether type and dosing of intervention modify the effect of intervention.

METHOD Relevant literature was identified by searching the PubMed, Embase, and CINAHL databases. Selection criteria included infants younger than 12 months corrected age with or at very high risk of CP. Methodological quality including risk of bias was scrutinized.

RESULTS Thirteen papers met the inclusion criteria. Seven studies with moderate to high methodological quality were analysed in detail; they evaluated neurodevelopmental treatment only (n=2), multisensory stimulation (n=1), developmental stimulation (n=2), and multifaceted interventions consisting of a mix of developmental stimulation, support of parent- infant interaction, and neurodevelopmental treatment (n=2). The heterogeneity precluded conclusions. Yet, two suggestions emerged: (1) dosing may be critical for effectiveness; (2) multifaceted intervention may offer best opportunities for child and family.

INTERPRETATION The literature on early intervention in very high-risk infants with sufficient methodological quality is limited, heterogeneous, and provides weak evidence on the effect. More studies are urgently needed. Suggestions for future research are provided.

Original languageEnglish
Pages (from-to)246-258
Number of pages13
JournalDevelopmental Medicine and Child Neurology
Volume59
Issue number3
Early online date7-Dec-2016
DOIs
Publication statusPublished - Mar-2017

Keywords

  • RANDOMIZED CONTROLLED-TRIAL
  • MINOR NEUROLOGICAL DYSFUNCTION
  • ABNORMAL GENERAL MOVEMENTS
  • CENTRAL-NERVOUS-SYSTEM
  • INTENSIVE-CARE-UNIT
  • PRETERM INFANTS
  • PHYSICAL-THERAPY
  • BRAIN-INJURY
  • NEURODEVELOPMENTAL TREATMENT
  • EARLY IDENTIFICATION

Cite this