Centre For Developmental Disabilities, Leuven, Belgium; KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.
KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; University Hospitals Leuven, Clinical Motion Analysis Laboratory, Leuven, Belgium.
Res Dev Disabil. 2021 Oct;117:104058. doi: 10.1016/j.ridd.2021.104058. Epub 2021 Aug 17.
Recent systematic reviews have already provided an overview of the impact of early interventions on developmental outcomes in infants at risk for cerebral palsy. However, none has thus far focused specifically on how early interventions might improve motor outcome in infants diagnosed with unilateral cerebral palsy (uCP). Hence, the aim of this systematic review was to provide an overview of early intervention programs used in infants with uCP to improve motor outcome.
A systematic literature search was performed in PubMed, Embase, Cochrane Central Register of Controlled trials, CINAHL and Web of Science following the PRISMA-statement guidelines. Risk of bias was assessed using the Cochrane risk-of-bias 2 tool.
Three single-blinded randomized controlled trials (RCTs) were identified, including 88 infants with uCP. These RCTs suggest that modified constraint-induced movement therapy (mCIMT) is effective and safe for improving upper limb function in infants with uCP. Bimanual training compared to mCIMT was found to be equally effective in one study. No clinical or neurological predictors of treatment response could be identified yet.
Although more high-quality RCTs are urgently needed, early interventions seem effective, safe and feasible to apply in infants with uCP for improving upper limb motor function. This underlines the importance of prompt referral to diagnostic-specific centres to start up such early interventions.
最近的系统评价已经概述了早期干预对脑瘫高危婴儿发育结果的影响。然而，迄今为止，尚无专门针对早期干预如何改善单侧脑瘫（uCP）婴儿运动结局的研究。因此，本系统评价旨在概述用于改善 uCP 婴儿运动结局的早期干预方案。
按照 PRISMA 声明指南，在 PubMed、Embase、Cochrane 对照试验中心注册库、CINAHL 和 Web of Science 中进行系统文献检索。使用 Cochrane 偏倚风险 2 工具评估偏倚风险。
确定了 3 项单盲随机对照试验（RCT），共纳入 88 例 uCP 婴儿。这些 RCT 表明，改良强制性运动疗法（mCIMT）对改善 uCP 婴儿上肢功能有效且安全。一项研究发现，双手训练与 mCIMT 同样有效。但目前尚未确定治疗反应的临床或神经预测因素。
尽管迫切需要更多高质量 RCT，但早期干预似乎对改善 uCP 婴儿上肢运动功能有效、安全且可行。这强调了及时转至专门的诊断中心开始此类早期干预的重要性。
