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Background: Paediatric physiotherapy (PPT) in high-risk infants comprises family involvement, but it is unclear whether parents mediate the intervention effect. We demonstrated in a randomized controlled trial in high-risk infants comparing the family centred programme Coping and Caring for infants with special needs (COPCA) and Traditional Infant Physiotherapy (TIP) that process evaluation revealed associations between COPCA-characteristics and outcome., Aims: To assess whether PPT affects how parents position their infant during bathing and whether this is associated with child outcome., Methods and Procedures: 21 infants received COPCA and 25 TIP between 3 and 6 months corrected age. Bathing sessions were videotaped at 3, 6 and 18 months. Time spent with specific infant positions was correlated with quantified PPT-actions and functional mobility at 18 months measured with the Paediatric Evaluation of Disability Inventory (PEDI)., Outcomes and Results: At 3 and 18 months bathing position was similar in both groups, but differed at 6 months (time spent on sitting: COPCA 77.7%, TIP 39.2%; median difference 32.0% (95% CI: 10.6-50.5%). Sitting-time at 6 months was associated with higher PEDI functional mobility scores., Conclusions and Implications: Early PPT may affect parental behaviour, such as infant positioning during bathing, which, in turn, may affect child development., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

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. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders on motor outcome, as measured by the Infant Motor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation. At a corrected age of 3 months, 46 infants (20 males, 26 females) recruited from the neonatal intensive care unit at the University Medical Centre Groningen (median birthweight 1210g, range 585-4750g; median gestational age 30wks, range 25-40wks) were included on the basis of definitely abnormal general movements. Exclusion criteria were severe congenital disorders and insufficient understanding of the Dutch language. The infants were assigned to either the family-centred COPing with and CAring for Infants with Special Needs (COPCA) intervention group ( n=21; 9 males, 12 females) or the traditional infant physiotherapy (TIP) intervention group ( n=25; 11 males, 14 females) for a period of 3 months. Three infants assigned to the TIP group (one male, two females) did not receive physiotherapy. IMP scores were measured by blinded assessors at 3, 4, 5, 6, and 18 months. At each age, the infants were neurologically examined. Physiotherapeutic sessions at 4 and 6 months were videotaped. Quantified physiotherapeutic actions were correlated with IMP scores at 6 and 18 months. The IMP scores of both the COPCA and TIP groups before, during, and after the intervention did not differ. Some physiotherapeutic actions were associated with IMP outcomes; the associations differed for infants who developed cerebral palsy ( n=10) and those who did not ( n=33). At randomized controlled trial level, the scores of both the TIP and COPCA groups did not differ in effect on motor outcome, as measured with the IMP. The analysis of physiotherapeutic actions revealed associations between these actions and IMP outcomes. However, the small sample size of this study precludes pertinent conclusions. [ABSTRACT FROM AUTHOR]