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A new study published in Disability and Rehabilitation reports that a multimodal approach to interventions is beneficial to the babies with the greatest risk of developing cerebral palsy. Risk factors for cerebral palsy are wide-ranging, including premature delivery, low-birth weight, maternal infections, and others.
Early interventions are important to either preventing cerebral palsy or minimizing the disabilities it causes. Multimodal care could help many more babies and their families. Cerebral palsy can cause a wide range of disabilities, but it is largely associated with motor development, muscles, and movements. Intervention strategies can minimize the disabilities and improve motor function.
The study, called LEARN2MOVE 0-2 took place in the Netherlands at the Beatrix Children’s Hospital. A randomized controlled study, it aimed to test the impact of early interventions—through a family-centered program—on infants with a very high risk of being diagnosed with cerebral palsy.
One group of families received the usual intervention for high-risk cerebral palsy infants. They went through a physical therapy program to work on muscles and joints. The other group of families received the COPCA intervention.
COPCA is a newer style of intervention for cerebral palsy, also known as “Coping with and Caring for Infants with Special Needs.” COPCA involves two components. One involves the family in working with a physical therapist. The therapist helps the family learn how to work with the infant and make smart decisions.
The second part is neurodevelopmental. Based on an idea called Neuronal Group Selection Theory, this is an approach to intervention that allows the infant to develop motor skills with less input from caregivers.
The researchers were hoping to answer several questions with this study. They wanted to know if high-risk infants receiving these two different interventions would fare the same or see different levels of improvement. They also hoped to find out if specific types of physical therapy helped most and if the type of risk factor an infant has makes a difference in choosing intervention type.
The study investigators looked at several factors when evaluating the results of the interventions. They measured neuromotor development, behaviors, cognition, function in daily activities, participation in activities, and family empowerment and coping ability. The researchers measured these factors at the beginning of the study, at three, six, and twelve months, and at two years.
What the study reports is that both types of interventions helped the children to a similar degree. The researchers concluded that the best approach to intervention with high-risk infants is multimodal. Using both the COPCA and traditional physical therapy should provide the best overall results.
This study should help inform pediatricians and specialists working with infants at risk for cerebral palsy. By understanding that multiple approaches work best, these medical caregivers will be able to develop the best programs for intervention with individual patients and their families.
