| Autor: |
Elvrum AG; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Clinic of Rehabilitation, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway., Kårstad SB; Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Child and Adolescent Mental Health Services, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway., Hansen G; Children and Youth Clinic, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway., Bjørkøy IR; Children and Youth Clinic, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway., Lydersen S; Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway., Grunewaldt KH; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Children and Youth Clinic, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway., Eliasson AC; Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, 17671 Stockholm, Sweden.; Neuropediatric Research Unit, Astrid Lindgren Children's Hospital, 17176 Stockholm, Sweden. |
| Abstrakt: |
Background/Objectives : Early interventions for infants at high risk of cerebral palsy (CP) are recommended, but limited evidence exists. Our objective was, therefore, to evaluate the effects of the family-centered and interprofessional Small Step early intervention program on motor development in infants at high risk of CP (ClinicalTrials.gov: NCT03264339). Methods : A single-subject research design was employed to investigate participant characteristics (motor dysfunction severity measured using the Hammersmith Infant Neurological Examination (HINE) and Alberta Infant Motor Scale (AIMS) at three months of corrected age (3mCA) related to intervention response. The repeated measures Peabody Developmental Motor Scales-2 fine and gross motor composite (PDMS2-FMC and -GMC) and Hand Assessment for Infants (HAI) were analyzed visually by cumulative line graphs, while the Gross Motor Function Measure-66 (GMFM-66) was plotted against reference percentiles for various Gross Motor Function Classification System (GMFCS) levels. Results : All infants ( n = 12) received the Small Step program, and eight completed all five training steps. At two years of corrected age (2yCA), nine children were diagnosed with CP. The children with the lowest HINE < 25 and/or AIMS ≤ 6 at 3mCA ( n = 4) showed minor improvements during the program and were classified at GMFCS V 2yCA. Children with HINE = 25-40 ( n = 5) improved their fine motor skills during the program, and four children had larger GMFM-66 improvements than expected according to the reference curves but that did not always happen during the mobility training steps. Three children with HINE = 41-50 and AIMS > 7 showed the largest improvements and were not diagnosed with CP 2yCA. Conclusions : Our results indicate that the Small Step program contributed to the children's motor development, with better results for those with an initial higher HINE (>25). The specificity of training could not be confirmed. |
