Holmström Linda, Eliasson Ann-Christin, Almeida Rita, Furmark Catarina, Weiland Ann-Louise, Tedroff Kristina, Löwing Kristina
Paediatric Neurology, Department of Women's and Children's Health, Karolinska Institutet, SE 171 77 Stockholm, Sweden.
Stockholm University Brain Imaging Centre (SUBIC), Stockholm University, SE 106 91 Stockholm, Sweden.
J Clin Med. 2019 Jul 11;8(7):1016. doi: 10.3390/jcm8071016.
The objective was to evaluate the effects of the Small Step Program on general development in children at risk of cerebral palsy (CP) or other neurodevelopmental disorders. A randomized controlled trial compared Small Step with Standard Care in infants recruited at 4-9 months of corrected age (CA). The 35-week intervention targeted mobility, hand use, and communication during distinct periods. The Peabody Developmental Motor Scales (PDMS-2) was the primary outcome measure. For statistical analysis, a general linear model used PDMS-2 as the main outcome variable, together with a set of independent variables. Thirty-nine infants were randomized to Small Step ( = 19, age 6.3 months CA (1.62 SD)) or Standard Care ( = 20, age 6.7 months CA (1.96 SD)). Administering PDMS-2 at end of treatment identified no group effect, but an interaction between group and PDMS-2 at baseline was found ( < 0.02). Development was associated with baseline assessments in the Standard Care group, while infants in the Small Step group developed independent of the baseline level, implying that Small Step helped the most affected children to catch up by the end of treatment. This result was sustained at 2 years of age for PDMS-2 and the PEDI mobility scale.
目的是评估小步计划对有脑瘫(CP)或其他神经发育障碍风险儿童的总体发育的影响。一项随机对照试验将小步计划与标准护理对矫正年龄(CA)为4 - 9个月的婴儿进行了比较。为期35周的干预针对不同时期的运动能力、手部使用和沟通能力。皮博迪发育运动量表(PDMS - 2)是主要的结局指标。在统计分析中,一个通用线性模型将PDMS - 2作为主要结局变量,并结合一组自变量。39名婴儿被随机分为小步计划组(n = 19,CA年龄6.3个月(标准差1.62))或标准护理组(n = 20,CA年龄6.7个月(标准差1.96))。在治疗结束时进行PDMS - 2评估未发现组间效应,但发现组与基线时的PDMS - 2之间存在交互作用(P < 0.02)。标准护理组的发育与基线评估相关,而小步计划组的婴儿发育与基线水平无关,这意味着小步计划帮助受影响最严重的儿童在治疗结束时实现了追赶。对于PDMS - 2和PEDI运动量表,这一结果在2岁时仍然成立。