Department of Pediatrics-Developmental Neurology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands.
Phys Ther. 2011 Sep;91(9):1303-22. doi: 10.2522/ptj.20100207. Epub 2011 Jun 30.
Evidence for effectiveness of pediatric physical therapy in infants at high risk for developmental motor disorders is limited. Therefore, "Coping With and Caring for Infants With Special Needs" (COPCA), a family-centered, early intervention program, was developed. The COPCA program is based on 2 components: (1) family involvement and educational parenting and (2) the neuromotor principles of the neuronal group selection theory. The COPCA coach uses principles of coaching to encourage the family's own capacities for solving problems of daily care and incorporating variation, along with trial and error in daily activities.
The purpose of this study was to evaluate whether the content of sessions of the home-based, early intervention COPCA program differs from that of traditional infant physical therapy (TIP) sessions, which in the Netherlands are largely based on neurodevelopmental treatment.
The study was conducted at the University Medical Center Groningen in the Netherlands.
A quantitative video analysis of therapy sessions was conducted with infants participating in a 2-arm randomized trial.
Forty-six infants at high risk for developmental motor disorders were randomly assigned to receive COPCA (n=21) or TIP (n=25) between 3 and 6 months corrected age. Intervention sessions were videotaped at 4 and 6 months corrected age and analyzed with a standardized observation protocol for the classification of physical therapy actions. Outcome parameters were relative amounts of time spent on specific physical therapy actions.
The content of COPCA and TIP differed substantially. For instance, in TIP sessions, more time was spent on facilitation techniques, including handling, than in COPCA sessions (29% versus 3%, respectively). During COPCA, more time was spent on family coaching and education than during TIP (16% versus 4%, respectively).
The major limitation of the study was its restriction to the Netherlands, implying that findings cannot be generalized automatically to other countries.
The COPCA program differs broadly from TIP as applied in the Netherlands. Studies on the effectiveness of this family-centered program are needed.
针对发育性运动障碍高危婴儿的儿科物理治疗效果的证据有限。因此，开发了以家庭为中心的早期干预项目“应对和照顾有特殊需要的婴儿”（COPCA）。COPCA 计划基于两个组成部分：（1）家庭参与和教育性育儿，以及（2）神经元选择理论的神经运动原理。COPCA 教练使用指导原则来鼓励家庭自身解决日常护理问题的能力，并在日常活动中融入变化、尝试和犯错。
本研究旨在评估基于家庭的早期干预 COPCA 计划的内容是否与荷兰传统婴儿物理治疗（TIP）课程不同，后者主要基于神经发育治疗。
该研究在荷兰格罗宁根大学医学中心进行。
对参加双臂随机试验的婴儿进行基于治疗的视频分析。
46 名发育性运动障碍高危婴儿在 3 至 6 个月校正年龄时被随机分配接受 COPCA（n=21）或 TIP（n=25）。干预课程在 4 个月和 6 个月校正年龄时被录像，并使用标准化观察协议进行物理治疗动作分类分析。结果参数为特定物理治疗动作的相对时间量。
COPCA 和 TIP 的内容有很大差异。例如，在 TIP 课程中，促进技术（包括处理）的时间比 COPCA 课程多（分别为 29%和 3%）。在 COPCA 期间，家庭指导和教育的时间比 TIP 多（分别为 16%和 4%）。
该研究的主要限制是仅限于荷兰，这意味着研究结果不能自动推广到其他国家。
COPCA 计划与荷兰应用的 TIP 有很大不同。需要对这个以家庭为中心的计划的有效性进行研究。
