Differences Between the Family-Centered "COPCA" Program and Traditional Infant Physical Therapy Based on Neurodevelopmental Treatment Principles
Differences Between the Family-Centered "COPCA" Program and Traditional Infant Physical Therapy Based on Neurodevelopmental Treatment Principles
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DOI：
10.2522/ptj.20100207
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发表时间：
2011-09-01
期刊：
影响因子：
3.2
通讯作者：
Hadders-Algra, Mijna
中科院分区：
文献类型：
--
作者：
Dirks, Tineke;Blauw-Hospers, Cornill H.;Hadders-Algra, Mijna
背景资料。儿科理疗对患有发育性运动障碍的高危婴儿有效的证据有限。因此，一个以家庭为中心的早期干预计划--“应对和照顾有特殊需要的婴儿”(COPCA)应运而生。COPCA计划基于两个组成部分：(1)家庭参与和教育育儿；(2)神经元群选择理论的神经运动原理。科普卡教练使用教练的原则来鼓励家庭自己解决日常护理问题的能力，并在日常活动中进行尝试和错误。这项研究的目的是评估以家庭为基础的早期干预COPCA计划的课程内容是否与传统的婴儿物理治疗(TIP)课程不同，在荷兰，TIP课程主要基于神经发育治疗。这项研究是在荷兰格罗宁根大学医学中心进行的。对参加双臂随机试验的婴儿进行了治疗过程的定量视频分析。患者和干预。46名发育运动障碍高危婴儿随机分为COPCA组(n=21)和TIP组(n=25)，年龄在3~6个月矫正年龄之间。干预过程在校正的4个月和6个月时被录像，并用标准化的观察方案进行分析，以便对物理治疗行为进行分类。结果参数是花费在特定物理治疗行动上的相对时间量。COPCA和TIP的含量有很大不同。例如，在TIP会议上，包括处理在内的促进技术上花费的时间比在COPCA会议上花的时间更多(分别为29%和3%)。在Copca期间，花在家庭辅导和教育上的时间比在TIP期间花的时间更多(分别为16%和4%)。这项研究的主要局限性是其限于荷兰，这意味着研究结果不能自动推广到其他国家。COPCA方案与荷兰适用的TIP方案有很大的不同。需要对这一以家庭为中心的计划的有效性进行研究。
Background. Evidence for effectiveness of pediatric physical therapy in infants at high risk for developmental motor disorders is limited. Therefore, "Coping With and Caring for Infants With Special Needs" (COPCA), a family-centered, early intervention program, was developed. The COPCA program is based on 2 components: (1) family involvement and educational parenting and (2) the neuromotor principles of the neuronal group selection theory. The COPCA coach uses principles of coaching to encourage the family's own capacities for solving problems of daily care and incorporating variation, along with trial and error in daily activities.Objective. The purpose of this study was to evaluate whether the content of sessions of the home-based, early intervention COPCA program differs from that of traditional infant physical therapy (TIP) sessions, which in the Netherlands are largely based on neurodevelopmental treatment.Setting. The study was conducted at the University Medical Center Groningen in the Netherlands.Design. A quantitative video analysis of therapy sessions was conducted with infants participating in a 2-arm randomized trial.Patients and Intervention. Forty-six infants at high risk for developmental motor disorders were randomly assigned to receive COPCA (n = 21) or TIP (n = 25) between 3 and 6 months corrected age. Intervention sessions were videotaped at 4 and 6 months corrected age and analyzed with a standardized observation protocol for the classification of physical therapy actions. Outcome parameters were relative amounts of time spent on specific physical therapy actions.Results. The content of COPCA and TIP differed substantially. For instance, in TIP sessions, more time was spent on facilitation techniques, including handling, than in COPCA sessions (29% versus 3%, respectively). During COPCA, more time was spent on family coaching and education than during TIP (16% versus 4%, respectively).Limitations. The major limitation of the study was its restriction to the Netherlands, implying that findings cannot be generalized automatically to other countries.Conclusion. The COPCA program differs broadly from TIP as applied in the Netherlands. Studies on the effectiveness of this family-centered program are needed.