Division of Developmental Neurology, Department of Paediatrics, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Dev Med Child Neurol. 2011 Mar;53(3):e8-15. doi: 10.1111/j.1469-8749.2010.03876.x.
The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders on motor outcome, as measured by the Infant Motor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation.
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 1210 g, range 585-4750 g; median gestational age 30 wks, range 25-40 wks) 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.
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).
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.
本研究旨在通过随机对照试验和过程评估相结合的方法，研究针对有发育障碍风险的婴儿进行干预对运动结果的影响，用婴儿运动概况（IMP）进行评估。
在格罗宁根大学医学中心新生儿重症监护病房（中位出生体重 1210g，范围 585-4750g；中位胎龄 30 周，范围 25-40 周），根据明显异常的一般性运动，招募了 46 名（20 名男性，26 名女性）矫正年龄为 3 个月的婴儿。排除标准为严重先天性疾病和对荷兰语理解不足。婴儿被随机分配到以家庭为中心的 COPing with and CAring for Infants with Special Needs（COPCA）干预组（n=21；9 名男性，12 名女性）或传统婴儿物理治疗（TIP）干预组（n=25；11 名男性，14 名女性），干预期为 3 个月。有 3 名被分配到 TIP 组的婴儿（1 名男性，2 名女性）未接受物理治疗。由盲法评估者在 3、4、5、6 和 18 个月时测量 IMP 评分。在每个年龄阶段，婴儿都接受神经学检查。在 4 个月和 6 个月时对物理治疗课程进行录像。在 6 个月和 18 个月时，将量化的物理治疗动作与 IMP 评分相关联。
在干预前、干预中和干预后，COPCA 和 TIP 组的 IMP 评分均无差异。一些物理治疗动作与 IMP 结果相关；对于患有脑瘫的婴儿（n=10）和未患有脑瘫的婴儿（n=33），这些关联有所不同。
在随机对照试验水平上，用 IMP 测量，TIP 和 COPCA 组的评分在运动结果方面均无差异。对物理治疗动作的分析显示，这些动作与 IMP 结果之间存在关联。然而，本研究的样本量较小，无法得出相关结论。
