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Effectiveness of motor interventions in infants with cerebral palsy: a systematic review
Catherine Morgan1, Johanna Darrah2, Andrew M Gordon3
1Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.
Insights
Early motor interventions show promise for infants with cerebral palsy. Key elements include child-led movement, environmental changes, and specific task training, though more high-quality research is needed.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation
Background:
- Cerebral palsy (CP) affects motor development in infants.
- Early motor interventions aim to improve outcomes for infants with CP or at high risk.
- Evidence on the effectiveness of these interventions requires systematic review.
Purpose of the Study:
- To systematically review the evidence on the effectiveness of motor interventions for infants (birth to 2 years) diagnosed with or at high risk of cerebral palsy.
- To identify key components of effective early motor interventions.
Main Methods:
- Systematic literature search of multiple databases (PubMed, Embase, CINAHL, Cochrane, Web of Knowledge, PEDro).
- Inclusion criteria: infants aged 0-2 years with CP or at high risk, receiving early motor intervention.
- Included 34 studies, 10 of which were randomized controlled trials.
Main Results:
- Studies varied in quality, interventions, and participant criteria.
- Neurodevelopmental therapy was a common intervention.
- Interventions with moderate to large effect sizes (>0.7) emphasized child-initiated movement, environmental modification, and task-specific training.
Conclusions:
- The evidence base is limited by a lack of high-quality trials.
- Early interventions incorporating child-initiated movement, parental education, and environmental modification show positive effects on motor development.
- Further high-quality research is crucial to confirm these findings.
Aim:
To systematically review the evidence on the effectiveness of motor interventions for infants from birth to 2 years with a diagnosis of cerebral palsy or at high risk of it.
Method:
Relevant literature was identified by searching journal article databases (PubMed, Embase, CINAHL, Cochrane, Web of Knowledge, and PEDro). Selection criteria included infants between the ages of birth and 2 years diagnosed with, or at risk of, cerebral palsy who received early motor intervention.
Results:
Thirty-four studies met the inclusion criteria, including 10 randomized controlled trials. Studies varied in quality, interventions, and participant inclusion criteria. Neurodevelopmental therapy was the most common intervention investigated either as the experimental or control assignment. The two interventions that had a moderate to large effect on motor outcomes (Cohen's effect size>0.7) had the common themes of child-initiated movement, environment modification/enrichment, and task-specific training.
Interpretation:
The published evidence for early motor intervention is limited by the lack of high-quality trials. There is some promising evidence that early intervention incorporating child-initiated movement (based on motor-learning principles and task specificity), parental education, and environment modification have a positive effect on motor development. Further research is crucial.
