Department of Pediatric Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands.
Research Institute for Health Sciences, IQ healthcare, Radboud university medical center, Nijmegen, Netherlands.
Occup Ther Int. 2023 Jan 6;2023:8128407. doi: 10.1155/2023/8128407. eCollection 2023.
To explore the effect of an Early Intensive-Upper Limb intervention (EI-UL) compared to EI-UL with integrated Multisensory Stimulation And Priming (MuSSAP) training on improving manual ability in infants with a unilateral brain lesion.
A pilot randomised clinical trial with pre- and postintervention and follow-up measurements (T0, T1, and T2) was conducted. Sixteen infants with a unilateral brain lesion (corrected age is 4-10 months) received home-based intervention with video coaching. Eight infants received EI-UL and eight infants received EI-UL with integrated MuSSAP training. Primary outcome was the Hand Assessment for Infants (HAI) score. Additionally, effects were explored on initiation of goal-directed movements in both groups and on attention in the EI-UL with integrated MuSSAP training group.
No significant group differences in HAI scores were found. Overall, HAI 'Affected hand score' increased between T0 and T1 ( = 0.001, Cohen's d = 1.04) and between T0 and T2 ( < 0.001, Cohen's d = 1.28); and the HAI 'Both Hands Measure' increased between T0 and T1 ( < 0.001, Cohen's d = 1.72) and between T0 and T2 ( < 0.001, Cohen's d = 1.81). At the start of the intervention, six infants (three in both groups) did not demonstrate initiation of goal-directed contralesional upper limb movements. During the intervention one infant receiving EI-UL and all three infants receiving EI-UL with integrated MuSSAP training started to initiate goal-directed movements.
The results suggest manual ability of infants with unilateral brain lesion improved with both interventions. We hypothesize that the integrated MuSSAP training may facilitate attention and initiation of contralesional upper limb goal-directed movements. This trial is registered with NCT05533476).
探索早期强化上肢干预（EI-UL）与整合多感觉刺激和启动（MuSSAP）训练对改善单侧脑损伤婴儿手部能力的效果。
采用预干预、后干预和随访测量（T0、T1 和 T2）的前瞻性随机临床试验。16 名单侧脑损伤婴儿（矫正年龄 4-10 个月）接受家庭为基础的视频指导干预。8 名婴儿接受 EI-UL，8 名婴儿接受整合 MuSSAP 训练的 EI-UL。主要结局指标是婴儿手评估（HAI）评分。此外，还探讨了两组中目标导向运动的启动和 EI-UL 中整合 MuSSAP 训练组注意力的效果。
HAI 评分在两组间无显著差异。总体而言，HAI“受影响手评分”在 T0 到 T1 之间增加（ = 0.001，Cohen's d = 1.04），在 T0 到 T2 之间增加（ < 0.001，Cohen's d = 1.28）；HAI“双手测量”在 T0 到 T1 之间增加（ < 0.001，Cohen's d = 1.72），在 T0 到 T2 之间增加（ < 0.001，Cohen's d = 1.81）。在干预开始时，6 名婴儿（两组各 3 名）未表现出对侧上肢目标导向运动的启动。在干预过程中，1 名接受 EI-UL 的婴儿和 3 名接受 EI-UL 整合 MuSSAP 训练的婴儿开始启动目标导向运动。
结果表明，单侧脑损伤婴儿的手部能力通过两种干预措施都有所提高。我们假设整合 MuSSAP 训练可能促进注意力和对侧上肢目标导向运动的启动。本试验在 NCT05533476 注册。
