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Efficacy of Motor and Cognitive Intervention for Infants Born Very Preterm

运动和认知干预对极早产婴儿的疗效

基本信息

批准号：
9977258
负责人：
Stacey Chapman Dusing
金额：
$ 45.26万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9977258
关键词：
3-Dimensional Address Age Age-Months Animals Ataxia Attentional deficit Awareness Basic Science Behavior Behavioral Caring Cerebral Palsy Child Clinical Cognitive Coin Control Groups Cues Development Developmental Delay Disorders Developmental Disabilities Diagnosis Disabled Persons Early Diagnosis Early Intervention Education Enrollment Environment Feasibility Studies Future Guidelines Home environment Impairment Infant Intervention Intervention Studies Learning Learning Disabilities Life Logistics Measures Mediating Mental Health Motor Motor Skills Movement Musculoskeletal Equilibrium Neonatal Brain Injury Neonatal Intensive Care Units Neuronal Plasticity Outcome Parent-Child Relations Parents Participant Physicians Play Policy Maker Pregnancy Preventive Intervention Problem Solving Randomized Randomized Clinical Trials Readiness Reading Recommendation Rehabilitation therapy Reporting Research Risk Sampling Service delivery model Services Severities Special Education Therapeutic Intervention Time Toddler Treatment Efficacy United States National Institutes of Health accurate diagnosis base cognitive skill community intervention comparative efficacy disability empowered environmental enrichment for laboratory animals evidence base federal policy follow-up group intervention high risk improved improved outcome infant outcome innovation motor learning physical therapist rehabilitation service service intervention skills social systematic review therapy development treatment as usual visual motor

项目摘要

Infants born very preterm (≤28 weeks of gestation) are at high risk of having developmental disabilities including cerebral palsy, coordination impairments, attention deficit and learning disabilities. Impairment including reduced postural control, movement variability, visual motor skills, and motor learning are common during the first months of life and are associated with later developmental disabilities. However, infant born very preterm rarely receive evidence based therapeutic intervention in the first months of life when basic science and animal intervention studies suggest the greatest efficacy. Barriers to enrollment in services delay the onset of services and delivery models rarely support targeted preventative intervention or enhanced parent engagement during in the transition from the neonatal intensive care unit (NICU) to home. Targeted intervention supporting postural control and motor learning in the NICU have resulted in short term motor gains. Interventions that enhance parent's ability to read their infant's cues and provide engagement opportunities improve maternal mental health and infant social and cognitive outcomes in the short-term. The purpose of this randomized clinical trial is to evaluate the efficacy of an intervention that combines evidence based motor intervention and parent engagement to enhance the parent's ability to provide daily motor and cognitive opportunities resulting in improved motor and cognitive outcomes. Supporting Play Exploration and Development Intervention (SPEEDI) uses guided participation to empower parents in reading infant's behavioral cues, identifying ideal times for interaction, and enriching the environment and learning opportunities. Parents participate in 5 session in 3 weeks while learning principles of engagement, readiness for interaction, and to provide early motor and cognitive learning opportunities. Parents provide 20 minutes of motor and cognitive play based enrichment daily for 12 weeks with bi-weekly physical therapist support. The parent is empowered to determine the infant's current abilities and advance the activities to the “Just Right Challenge” throughout the 12 weeks, likely continuing after the intervention. The efficacy of SPEEDI will be assessed in 3 aims: To compare the efficacy of SPEEDI 1) to usual care 2) during delivery at 2 time point; the transition from the NICU to home (around the infant's due date) and beginning at 3-4 months of adjusted age (after the infants due date) 3) for infant who are later diagnosed with Cerebral Palsy and those not Diagnosed with Cerebral Palsy. Ninety infants will be randomly assigned to a Usual Care group, SPEEDI_Early, or SPEEDI_Late group. Group differences will be assessed in developmental outcomes on the motor and cognitive scales of the Bayley Scales for Infant and Toddler Development, Early Problem Solving Indicator, and Gross Motor Function Measure at the end of each intervention period, 12 and 24 months of age. In addition, we will explore a possible mechanism of action, parent's engagement, and the impact of this intervention on the need for later rehabilitation services.

非常早产（≤28周妊娠）的婴儿患发育障碍的风险很高