Pietruszewski Lindsay, Burkhardt Stephanie, Yoder Paul J, Heathcock Jill, Lewandowski Dennis J, Maitre Nathalie L
Center for Perinatal Research at the Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Special Education, Peabody College of Education, Vanderbilt University, Nashville, TN, USA.
Child Neurol Open. 2020 Sep 23;7:2329048X20946214. doi: 10.1177/2329048X20946214. eCollection 2020 Jan-Dec.
Past work showed that an , therapist-guided, parent-implemented multicomponent intervention increased the motor functioning of the more affected upper extremity (UE) in infants with asymmetric cerebral palsy. The authors document treatment fidelity and provide initial testing of intervention delivery in a new subject sample.
The authors adapted the intervention manual used in the previous trial for telehealth. Infants (6-24 months) were randomly assigned to intervention (n = 7) or waitlist (n = 6). The intervention prescribed soft-constraint wear on the less affected UE for 6 hours, 5 d/wk, and exercises. After an initial in-person training session, three 15- to 45-minute telehealth sessions were performed.
Median weekly constraint wear was 21 hours (interquartile range = 10.3-29.7); average parent-treatment fidelity was 95.7% (SD 11.2). A significant large (Cohen = 0.92) between-group differences occurred on fine motor functioning of more affected UEs.
The telehealth intervention was feasible and potentially effective, but a larger trial is needed to evaluate efficacy.
过去的研究表明，在治疗师指导下由家长实施的多成分干预可提高不对称性脑瘫婴儿中受影响更严重的上肢（UE）的运动功能。作者记录了治疗的保真度，并在一个新的受试者样本中对干预实施情况进行了初步测试。
作者将先前试验中使用的干预手册改编用于远程医疗。将婴儿（6 - 24个月）随机分为干预组（n = 7）或等待名单组（n = 6）。干预措施规定在受影响较小的上肢佩戴软约束装置6小时，每周5天，并进行锻炼。在最初的一次面对面培训课程后，进行了三次15至45分钟的远程医疗课程。
每周约束佩戴时间的中位数为21小时（四分位间距 = 10.3 - 29.7）；家长治疗保真度的平均水平为95.7%（标准差11.2）。在受影响更严重的上肢的精细运动功能方面，组间出现了显著的大效应量差异（科恩d = 0.92）。
远程医疗干预是可行的且可能有效，但需要更大规模的试验来评估其疗效。
