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早产儿运动模仿疗法(MIT-PB):改善脑瘫高危婴儿神经发育结局的新方法。

Movement Imitation Therapy for Preterm Babies (MIT-PB): a Novel Approach to Improve the Neurodevelopmental Outcome of Infants at High-Risk for Cerebral Palsy.

作者信息

Soloveichick Marina, Marschik Peter B, Gover Ayala, Molad Michal, Kessel Irena, Einspieler Christa

机构信息

Neonatal Intensive Care Unit, Lady Davis Carmel Medical Center, Haifa, Israel.

The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.

出版信息

J Dev Phys Disabil. 2020;32(4):587-598. doi: 10.1007/s10882-019-09707-y. Epub 2019 Nov 18.

Abstract

To improve the neurodevelopmental outcome in infants with high grade intraventricular haemorrhage and cramped-synchronised (CS) general movements (GMs). Four very preterm infants with intraventricular haemorrhage grade III ( = 3) or intraventricular haemorrhage with apparent periventricular haemorrhagic infarction ( = 1) were diagnosed with CS GMs at 33 to 35 weeks postmenstrual age. A few days later MIT-PB [Movement Imitation Therapy for Preterm Babies], an early intervention programme, was commenced: the instant an infant showed CS movements, the therapist intervened by gently guiding the infant's limbs so as to manoeuvre and smoothen the movements, thereby imitating normal GM sequences as closely as possible (at least for 10 min, 5 times a day, with increasing frequency over a period of 10 to 12 weeks). After a period of consistent CS GMs, the movements improved. At 14 weeks postterm age, the age specific GM pattern, fidgety movements, were normal in three infants, one infant had abnormal fidgety movements. At preschool age, all participants had a normal neurodevelopmental outcome. This report on four cases demonstrates that mimicking normal and variable GM sequences might have a positive cascading effect on neurodevelopment. The results need to be interpreted with caution and replication studies on larger samples are warranted. Nonetheless, this innovative approach may represent a first step into a new intervention strategy.

摘要

改善患有重度脑室内出血且具有痉挛同步性(CS)全身运动(GMs)的婴儿的神经发育结局。4例极早产儿,其中3例为Ⅲ级脑室内出血,1例为伴有明显脑室周围出血性梗死的脑室内出血,在孕龄33至35周时被诊断为CS GMs。几天后开始实施早期干预项目MIT-PB[早产儿运动模仿疗法]:当婴儿出现CS运动时,治疗师立即进行干预,轻轻引导婴儿肢体,以使动作灵活并顺畅,从而尽可能紧密地模仿正常GM序列(至少10分钟,每天5次,在10至12周内频率逐渐增加)。经过一段时间持续的CS GMs后,动作得到改善。在足月后14周时,3例婴儿的年龄特异性GM模式、不安运动正常,1例婴儿的不安运动异常。在学龄前,所有参与者的神经发育结局均正常。这份关于4例病例的报告表明,模仿正常且多变的GM序列可能对神经发育产生积极的连锁效应。结果需要谨慎解读,有必要对更大样本进行重复研究。尽管如此,这种创新方法可能代表了新干预策略的第一步。

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