Leussen, T. van (2012) Houdingsregulatie bij zuigelingen met een hoog risico op neurologische ontwikkelingsstoornissen. De behandeling: traditionele babyfysiotherapie of COPCA. thesis, Medicine.
Full text available on request.Abstract
Introduction: Knowledge on the development of postural control in infants at high risk for developmental disorders is limited. In the neural control of posture two levels can be distinguished. The first level consists of direction-specific postural activity. This means that the dorsal muscles are primary activated when the body sways forward and the ventral muscles are primary activated when the body sways backward. The second level is the fine-tuning, for example the adaptation of the number of direction-specific muscles used and the order of muscle activation. The early intervention project (Dutch: Vroegtijdige Interventie Project, VIP) investigates the development of infants at high risk for developmental disorders and studies differences between infants who are treated with Traditional Infant Physical Therapy (TIP) and infants treated with the new ‘COPing with and Caring for Infants with Special Needs’ (COPCA) program. Method: Forty six infants participated in the VIP-project. They had been admitted to the neonatal intensive care unit of the University Medical Centre Groningen (UMCG) and had definitely abnormal general movements at 3 months corrected age. They were randomized in two intervention groups (TIP n = 25; COPCA n = 21). At the corrected ages of 4, 6 and 18 months, video and EMG-registration of the postural muscles were made while the children were reaching. The reaches were elicited by presenting a toy in the infant’s midline. The analyses focused on the number of direction-specific trials; the number of direction-specific muscles that were used and the order of activation of the direction-specific muscles. Results: The development of postural control was characterized by variation. The VIP-group showed at 18 months less direction-specific trials than the control group (median resp. 63% vs. 88%, p = 0,002). The complete pattern was the most frequently use strategy in control and VIP-group (median 58%-75%). The recruitment order of the postural muscles was characterized by variation in both groups. The preference for a top-down recruitment order in the control group decreased with increasing age (100% - 16,7%, p = 0,033), while the preference for a bottom-up recruitment order increased (0% - 66,7%, p = 0,031). Similar changes were absent in the VIP-group. The TIP- and the COPCA-group showed no differences in the development of postural control. Conclusion: In typically developing infants and in infants at high risk for developmental disorder development of postural control is characterized by variation. Nevertheless, the current study showed that infants at high risk for developmental disorders, show a slower and different development of the postural control than typically developing in infants. The effect of both interventions on the development of postural control was similar.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | 1e Facultaire begeleider: and Hadders-Algra, prof. dr. M. and 2e Facultaire begeleider: and Balen, L.C. van MSc and Ontwikkelingsneurologie UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/794 |
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