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Randomized Controlled Trial
. 2021 Apr;110(4):1189-1200.
doi: 10.1111/apa.15619. Epub 2020 Oct 24.

The Coping with and Caring for Infants with Special Needs intervention was associated with improved motor development in preterm infants

Schirin Akhbari Ziegler  1 , Michael von Rhein  2   3 , André Meichtry  1 , Markus Wirz  1 , Tjitske Hielkema  4 , Mijna Hadders-Algra  5 ; Swiss Neonatal Network & Follow-Up Group
Affiliations
Randomized Controlled Trial

The Coping with and Caring for Infants with Special Needs intervention was associated with improved motor development in preterm infants

Schirin Akhbari Ziegler et al. Acta Paediatr. 2021 Apr.

Abstract

Aim: We compared the impact of standard infant physiotherapy and the family-centred programme, Coping with and Caring for Infants with Special Needs (COPCA), in infants born before 32 weeks without significant brain lesions.

Methods: This randomised controlled trial was carried out in patients' homes and outpatient settings in Switzerland between January 2016 and October 2019. We used data from the national SwissNeoNet register and an assessment battery that included infant and family outcomes and video analyses of therapy sessions. The Infant Motor Profile was the primary outcome instrument.

Results: The COPCA group comprised six boys and two girls with a median gestational age of 27 weeks (range 25-30), and the standard care group comprised seven boys and one girl with a median gestational age of 29.5 weeks (range 26-31). COPCA participants improved significantly more between baseline and 18 months in the IMP variation (9.0 percentage points, 95% confidence interval: 0.3-17.5) and performance (12.0 percentage points, 95% confidence interval: 4.1-20.6) domains than standard care participants. COPCA coaching was positively associated with IMP scores at 18 months, but some standard care actions were negatively associated.

Conclusion: COPCA was associated with better motor outcome in infants born before 32 weeks than standard infant physiotherapy.

Keywords: early physiotherapy; family outcomes; family-centred practice; motor outcome; preterm infants.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of participants and enrolment. BSID‐III: Bayley Scales of Infant and Toddler Development, Third Edition; COPCA, Coping with and Caring for Infants with Special Needs; DPC, Developmental Pediatric Center; FES, Family Empowerment Scale; IMP, Infant Motor Profile; MPOC, Measure of Processes of Care; NE, neurological examination; PEDI, Pediatric Evaluation of Disability Inventory; PPT, Pediatric Physiotherapy; SC, standard care
Figure 2
Figure 2
Characteristics of the COPCA intervention and standard care infant physiotherapy intervention. A, COPCA intervention. The mother (left) is playing with the infant. She challenges the infant to self‐produced motor behaviour while receiving hints from the COPCA coach. B, Standard care. The mother (left) is applying hands‐on facilitation techniques to promote the infant's normal sensorimotor experiences while receiving strict instructions from the therapist
Figure 3
Figure 3
Developmental changes in IMP scores in of both groups. (A) developmental changes in the variation domain. (B) developmental changes in the performance domain. The lines indicate the group mean values, and the error bars indicate one standard error. Group: ‐‐‐‐‐‐‐‐‐, COPCA; ———, Standard care
See this image and copyright information in PMC

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