Krabben, I.H.M. (2012) Bestaat er een verschil in de houdingsregulatie na vroegtijdige interventie met verschillende therapieën bij zuigelingen met een hoog risico op ontwikkelingsstoornissen? thesis, Medicine.
Full text available on request.Abstract
Background: Postural control is important for balance in daily life; it accompanies goal direct activity. Two functional levels in postural control may be distinguished. The first level is direction specificity, which prevents balance disturbances. At the second level of postural control fine-tuning of posture is regulated; it develops through experience. To compare the effect of COPCA (COPing with and CAring for infants with special needs a family centered program), a new intervention method, with that of TIP (Traditional Infant Physical Therapy), the VIP (early intervention project) was set up. In the current sub-project, differences in postural control during reaching between healthy infants and infants with a high risk of CP is examined and the effect of TIP and COPCA is compared. Methods/design: In 46 infants at high risk for CP (25 TIP, 21 COPCA) reaching in sitting position was recorded on video at 4, 6 and 18 months. Meanwhile EMG activity of arm and postural was recorded. The infants had been admitted to the University Medical Center Groningen (UMCG) and showed definitely abnormal general movements at 3 months. Results: Large variation was seen in muscle activity during reaching at different ages in infancy. Children at high risk for CP showed less direction specificity at trunk level at 18 months than the reference group (63% vs. 88%; p=0,002). At the second level of control we found significantly more top down activation in the reference group than in the VIP-group (100% vs. 14%; p=0,015), but this difference was absent at older ages. Small difference in postural development between the two intervention groups emerged. The TIP group showed at the first assessment at 4 months a higher rate of direction-specificity in the neck than the COPCA-group (53% vs. 10%, p=0,029). This difference disappeared at older ages. The children in the TIP-group more often showed contraction of all three recorded trunk muscles at [the age of] 6 months than the COPCA-group (75% vs. 41%; p=0,001). Conclusion: Infants at high risk for CP showed a delay in the development of direction-specificity at trunk level at 18 months compared to typically developing children. The high risk infants also showed a different development of the recruitment pattern. Small differences in postural development emerged to the advantage of COPCA compared to TIP. Future research should address additional ways of fine regulation and re-examine the children at older age. Evaluation of COPCA and TIP intervention over a longer period is recommended.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | 1e Facultair begeleider: and Hadders-Algra, Prof. Dr. M. Hoogleraar ontwikkelingsneurolog and 2e Facultair begeleider: and Balen, L.C. van arts |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:07 |
| Last Modified: | 25 Jun 2020 11:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2673 |
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