Catherine Morgan1, Iona Novak2, Russell C Dale3, Andrea Guzzetta4, Nadia Badawi5. 1. Cerebral Palsy Alliance Research Institute, The University of Sydney, PO Box 6427, Frenchs Forest, NSW 2086, Australia. Electronic address: cmorgan@cerebralpalsy.org.au. 2. Cerebral Palsy Alliance Research Institute, The University of Sydney, PO Box 6427, Frenchs Forest, NSW 2086, Australia. Electronic address: inovak@cerebralpalsy.org.au. 3. Department of Neurology, Children's Hospital at Westmead, University of Sydney, Australia, Locked Bag 4001, Westmead, NSW 2145, Australia. Electronic address: russell.dale@health.nsw.gov.au. 4. Stella Maris Infant Lab for Early Intervention, Dept of Developmental Neuroscience, Stella Maris Scientific Institute, University of Pisa, Italy. Electronic address: a.guzzetta@inpe.unipi.it. 5. Cerebral Palsy Alliance Research Institute, The University of Sydney, PO Box 6427, Frenchs Forest, NSW 2086, Australia; Grace Centre for Newborn Care, Children's Hospital at Westmead, University of Sydney, Australia. Electronic address: nadia.badawi@health.nsw.gov.au.
Abstract
BACKGROUND:Cerebral palsy (CP) is caused by a lesion in the developing infant brain. Recent neuroplasticity literature suggests that intensive, task-specific intervention ought to commence early, during the critical period of neural development. AIMS: To determine whether "GAME" (Goals - Activity - Motor Enrichment), a motor learning, environmental enrichment intervention, is effective for improving motor skills in infants at high risk of CP. METHODS AND PROCEDURES: Single blind randomised controlled trial of GAME versus standard care. Primary outcome was motor skills on the Peabody Developmental Motor Scales-2 (PDMS-2). Secondary outcomes included Canadian Occupational Performance Measure (COPM), Bayley Scales of Infant and Toddler Development (BSID-III) and Gross Motor Function Measure-66 (GMFM-66). Outcome assessors were masked to group allocation and data analyzed with multiple regression. OUTCOMES AND RESULTS:All n=30 infants enrolled received the assigned intervention until 16 weeks post enrolment. At 12 months of age, n=26 completed assessments. Significant between group differences were found in raw scores on the PDMS-2 in favour of GAME (B=20.71, 95%CI 1.66-39.76, p=0. 03) and at 12 months on the total motor quotient (B=8.29, 95%CI 0.13-16.45,p =0.05). Significant between group differences favored GAME participants at 12 months on the cognitive scale of the BSID-III and satisfaction scores on the COPM. CONCLUSION:GAME intervention resulted in advanced motor and cognitive outcomes when compared with standard care.
RCT Entities:
BACKGROUND:Cerebral palsy (CP) is caused by a lesion in the developing infant brain. Recent neuroplasticity literature suggests that intensive, task-specific intervention ought to commence early, during the critical period of neural development. AIMS: To determine whether "GAME" (Goals - Activity - Motor Enrichment), a motor learning, environmental enrichment intervention, is effective for improving motor skills in infants at high risk of CP. METHODS AND PROCEDURES: Single blind randomised controlled trial of GAME versus standard care. Primary outcome was motor skills on the Peabody Developmental Motor Scales-2 (PDMS-2). Secondary outcomes included Canadian Occupational Performance Measure (COPM), Bayley Scales of Infant and Toddler Development (BSID-III) and Gross Motor Function Measure-66 (GMFM-66). Outcome assessors were masked to group allocation and data analyzed with multiple regression. OUTCOMES AND RESULTS: All n=30 infants enrolled received the assigned intervention until 16 weeks post enrolment. At 12 months of age, n=26 completed assessments. Significant between group differences were found in raw scores on the PDMS-2 in favour of GAME (B=20.71, 95%CI 1.66-39.76, p=0. 03) and at 12 months on the total motor quotient (B=8.29, 95%CI 0.13-16.45,p =0.05). Significant between group differences favored GAME participants at 12 months on the cognitive scale of the BSID-III and satisfaction scores on the COPM. CONCLUSION: GAME intervention resulted in advanced motor and cognitive outcomes when compared with standard care.
Authors: Rebecca A Dorner; Renee D Boss; Vera Joanna Burton; Katherine Raja; Monica E Lemmon Journal: Dev Med Child Neurol Date: 2020-01-07 Impact factor: 5.449
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