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Res Dev Disabil. 2016 Aug;55:256-67. doi: 10.1016/j.ridd.2016.04.005. Epub 2016 May 7.

Single blind randomised controlled trial of GAME (Goals - Activity - Motor Enrichment) in infants at high risk of cerebral palsy.

Author information

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.

KEYWORDS:

Cerebral palsy; Early intervention; Environmental enrichment; Motor learning

PMID:
27164480
DOI:
10.1016/j.ridd.2016.04.005
[Indexed for MEDLINE]

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