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      LEARN 2 MOVE 0-2 years: effects of a new intervention program in infants at very high risk for cerebral palsy; a randomized controlled trial

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          Abstract

          Background

          It is widely accepted that infants at risk for cerebral palsy need paediatric physiotherapy. However, there is little evidence for the efficacy of physiotherapeutic intervention. Recently, a new intervention program, COPCA (Coping with and Caring for infants with special needs - a family centered program), was developed. COPCA has educational and motor goals. A previous study indicated that the COPCA-approach is associated with better developmental outcomes for infants at high risk for developmental disorders. LEARN 2 MOVE 0-2 years evaluates the efficacy and the working mechanisms of the COPCA program in infants at very high risk for cerebral palsy in comparison to the efficacy of traditional infant physiotherapy in a randomized controlled trial. The objective is to evaluate the effects of both intervention programs on motor, cognitive and daily functioning of the child and the family and to get insight in the working elements of early intervention methods.

          Methods/design

          Infants are included at the corrected age of 1 to 9 months and randomized into a group receiving COPCA and a group receiving traditional infant physiotherapy. Both interventions are given once a week during one year. Measurements are performed at baseline, during and after the intervention period and at the corrected age of 21 months. Primary outcome of the study is the Infant Motor Profile, a qualitative evaluation instrument of motor behaviour in infancy. Secondary measurements focus on activities and participation, body functions and structures, family functioning, quality of life and working mechanisms. To cope with the heterogeneity in physiotherapy, physiotherapeutic sessions are video-recorded three times (baseline, after 6 months and at the end of the intervention period). Physiotherapeutic actions will be quantified and related to outcome.

          Discussion

          LEARN 2 MOVE 0-2 years evaluates and explores the effects of COPCA and TIP. Whatever the outcome of the project, it will improve our understanding of early intervention in children with cerebral palsy. Such knowledge is a prerequisite for tailor-made guidance of children with CP and their families.

          Trial registration

          The trial is registered under NTR1428.

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          Most cited references32

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          Proposed definition and classification of cerebral palsy, April 2005

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            Measuring empowerment in families whose children have emotional disabilities: A brief questionnaire.

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              A systematic review of the effects of early intervention on motor development.

              We present a systematic review on the effect of early intervention, starting between birth and a corrected age of 18 months, on motor development in infants at high risk for, or with, developmental motor disorders. Thirty-four studies fulfilled the selection criteria. Seventeen studies were performed within the neonatal intensive care unit (NICU) environment. Eight studies had a high methodological quality. They evaluated various forms of intervention. Results indicated that the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) intervention might have a temporary positive effect on motor development. Twelve of the 17 post-NICU studies had a high methodological quality. They addressed the effect of neurodevelopmental treatment (NDT) and specific or general developmental programmes. The results showed that intervention in accordance with the principles of NDT does not have a beneficial effect on motor development. They also indicated that specific or general developmental programmes can have a positive effect on motor outcome. We concluded that the type of intervention that might be beneficial for infants at preterm age differs from the type that is effective in infants who have reached at least term age. Preterm infants seem to benefit most from intervention that aims at mimicking the intrauterine environment, such as NIDCAP intervention. After term age, intervention by means of specific or general developmental programmes has a positive effect on motor development.
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                Author and article information

                Journal
                BMC Pediatr
                BMC Pediatrics
                BioMed Central
                1471-2431
                2010
                2 November 2010
                : 10
                : 76
                Affiliations
                [1 ]Beatrix Children's Hospital - Division of Developmental Neurology, University Medical Center Groningen, Groningen, The Netherlands
                [2 ]Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
                [3 ]Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands
                [4 ]Beatrix Children's Hospital - Division of Neonatology, University Medical Center Groningen, Groningen, The Netherlands
                [5 ]BOSK, Association of physically disabled persons and their parents, Utrecht, The Netherlands
                [6 ]Department of Behavioural and Social Sciences, Rijksuniversiteit Groningen, Groningen, The Netherlands
                [7 ]Rudolf Magnus Institute of Neuroscience and Centre of Excellence for Rehabilitation medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands
                Article
                1471-2431-10-76
                10.1186/1471-2431-10-76
                2991293
                21044299
                7f087e4c-3c87-4a0d-9185-3cfb0f104bb8
                Copyright ©2010 Hielkema et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 3 June 2010
                : 2 November 2010
                Categories
                Study Protocol

                Pediatrics
                Pediatrics

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