Parent-reported engagement in a home-based, parent-delivered early intervention for infants with unilateral cerebral
Kimberley S Scott1, Leanne Sakzewski2, Jenny Ziviani3
1Department of Physical Therapy, Creighton University, Omaha, NE, USA.
Insights
Parent engagement in infant rehabilitation was high and consistent over time for both constraint-induced movement therapy and bimanual therapy. Some parents need support integrating therapy into family life.
Area of Science:
- Pediatric rehabilitation
- Clinical trials
- Child development
Background:
- Infant-friendly constraint-induced movement therapy (Baby-CIMT) and bimanual therapy (Baby-BIM) are interventions for infants with unilateral cerebral palsy (UCP).
- Parental engagement is crucial for the success of pediatric rehabilitation interventions.
- The Rehabilitation Early for Congenital Hemiplegia (REACH) trial evaluated these therapies.
Purpose of the Study:
- To quantify parent self-reported engagement over time in the REACH trial for infants with UCP.
- To identify factors influencing parent engagement during pediatric rehabilitation.
Main Methods:
- Secondary analysis of the REACH trial data.
- Included 90 infants with or at risk for UCP, randomized to Baby-CIMT or Baby-BIM.
- Parental engagement measured using the Pediatric Rehabilitation Intervention Measure of Engagement-General (PRIME-G) at baseline, midpoint, and end of intervention.
Main Results:
- Parent engagement scores were high at intervention start and remained stable over time, with no significant differences between Baby-CIMT and Baby-BIM groups.
- Some parents reported lower scores related to integrating the intervention into family life.
- No infant, parent, or therapist factors significantly predicted changes in engagement scores.
Conclusions:
- Parental engagement was high and sustained in both Baby-CIMT and Baby-BIM interventions.
- Parents may require additional support to seamlessly integrate rehabilitation activities into their daily family routines.
- The REACH trial interventions successfully empowered parents in delivering therapy to their infants.
Purpose:
Quantify parent self-reported engagement over time in a randomized comparison trial (Rehabilitation EArly for Congenital Hemiplegia, REACH) for infants with UCP and discover factors impacting engagement.
Materials And Methods:
This secondary analysis from the REACH clinical trial included N = 90 infants with or at risk for UCP, randomized to infant-friendly constraint-induced movement therapy (Baby-CIMT) or bimanual therapy (Baby-BIM). Pediatric Rehabilitation Intervention Measure of Engagement-General (PRIME-G) was administered at the start, midpoint, and end of intervention.
Results:
Parent-reported engagement was near the maximum possible PRIME-G score at intervention start, with no significant difference in score distribution over time. No between-group differences in parent engagement were found. PRIME-G items scored lower over time by some parents related to fitting intervention within family life. No infant-, parent-, or therapist-related variables significantly predicted changes in PRIME-G scores.
Conclusions:
REACH interventions were designed to empower parents to provide intervention activities with their infant. Parent engagement was high for Baby-CIMT and Baby-BIM. Some parents may need support to integrate intervention within family life and sustain engagement over time.
