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功效

基本信息

批准号：
10744698
负责人：
Stacey Chapman Dusing
金额：
$ 20.02万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-11-21 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10744698
关键词：
3-Dimensional Address Age Age Months Animals Ataxia Attentional deficit Award Awareness Basic Science Behavior Behavioral Caring Categories 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 Impairment Infant Intervention Intervention Studies Learning Learning Disabilities Life Measures Mediating Mental Health Modeling 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 Problem Solving Randomized Readiness Reading Recommendation Rehabilitation therapy Reporting Research Risk Sampling Services Severities Special Education Therapeutic Intervention Time Toddler Treatment Efficacy United States National Institutes of Health accurate diagnosis cognitive skill community intervention comparative efficacy comparison control disability efficacy evaluation empowerment environmental enrichment for laboratory animals evidence base extreme prematurity federal policy follow-up group intervention high risk improved improved outcome infant outcome innovation motor learning physical therapist preventive intervention randomized, clinical trials rehabilitation service service intervention skills social systematic review therapy development treatment as usual visual motor

项目摘要

PROJECT SUMMARY (PARENT AWARD) 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.

项目摘要（父母奖）出生的婴儿非常早产（≤28周的妊娠）患有发育障碍的高风险包括脑瘫，协调障碍，注意力不足和学习障碍。损害包括减少姿势控制，运动变异性，视觉运动技能和运动学习是常见的在生命的头几个月中，与后来的发育障碍有关。但是，婴儿出生在基本的头几个月中，很少早产很少接受基于证据的治疗干预措施科学和动物干预研究表明效率最高。入学服务延迟的障碍服务和交付模型的发作很少支持针对性的预防干预或增强在从新生儿重症监护病房（NICU）过渡到家中的父母参与。 NICU中支持姿势控制和运动学习的有针对性的干预措施已导致短暂术语运动收益。增强父母阅读婴儿线索并提供的干预措施参与机会改善了孕产妇的心理健康以及婴儿的社会和认知结果短期。这项随机临床试验的目的是评估干预措施的效率结合基于证据的运动干预和父母的参与，以增强父母的能力提供日常运动和认知机会，从而改善运动和认知结果。支持游戏探索和发展干预（Speedi）使用指导参与赋予父母阅读婴儿的行为提示，确定互动的理想时期并丰富环境和学习机会。父母在3周内参加5个会议，同时学习原理参与，准备互动以及提供早期运动和认知学习机会。父母每天提供20分钟的电动机和基于认知游戏的富集，每两周提供12周物理治疗师的支持。父母有权确定婴儿的当前能力并提高在整个12周内，“正当挑战”的活动可能会在干预后继续进行。 Speedi的效率将在3个目标中进行评估：将Speedi的效率与通常的护理进行比较 2）在2个时间点交付期间；从NICU到家的过渡（在婴儿的到期日左右）和从调整年龄的3-4个月开始（婴儿到期日之后）3）婴儿后来被诊断出患有脑瘫和未被诊断为脑瘫的患者。九十个婴儿将被随机分配给通常的护理组，speedi_early或speedi_late组。小组差异将在婴儿和幼儿的贝利量表的电机和认知量表上的发展结果开发，早期解决问题指标以及每个末尾的总体运动功能度量干预期，12岁和24个月大。此外，我们将探索可能的行动机制，父母的参与度以及这种干预对以后康复服务的需求的影响。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Effect of Contingency Paradigm-Based Interventions on Developmental Outcomes in Young Infants: A Systematic Review.

基于应急范式的干预措施对幼儿发育结果的影响：系统评价。

DOI：
10.1097/pep.0000000000000873
发表时间：
2022
期刊：
Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association
影响因子：
0
作者：
Inamdar,Ketaki;Khurana,Sonia;Dusing,StaceyC
通讯作者：
Dusing,StaceyC

Parent Experiences in the NICU and Transition to Home.

DOI：
10.3390/ijerph20116050
发表时间：
2023-06-04
期刊：
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
影响因子：
0
作者：
Spence, Christine M;Stuyvenberg, Corri L;Kane, Audrey E;Burnsed, Jennifer;Dusing, Stacey C
通讯作者：
Dusing, Stacey C

Factors Influencing Receipt and Type of Therapy Services in the NICU.

DOI：
10.3390/bs13060481
发表时间：
2023-06-07
期刊：
BEHAVIORAL SCIENCES
影响因子：
2.6
作者：
Butera, Christiana D.;Brown, Shaaron E.;Burnsed, Jennifer;Darring, Jodi;Harper, Amy D.;Hendricks-Munoz, Karen D.;Hyde, Megan;Kane, Audrey E.;Miller, Meagan R.;Stevenson, Richard D.;Spence, Christine M.;Thacker, Leroy R.;Dusing, Stacey C.
通讯作者：
Dusing, Stacey C.

Effect of neonatal therapy on the motor, cognitive, and behavioral development of infants born preterm: a systematic review.