Multi-Component Upper-Extremity Intervention
Multi-Component Upper-Extremity Intervention
Evidence reviewed as of before 01-01-2021
Author(s): Hanson, J (BSc); Ogourtsova, T. (PhD OT)
Introduction
The intervention involves therapist-coached and parent-administered activities over a four-week period. Key components included wearing a soft-constraint mitt-harness on the less-affected UE, targeted reach practice with the more-affected hand, motor-sensory training for increased sensory feedback, bimanual play, and structured guidance for parent engagement. Notably, the intervention was designed to fit seamlessly into daily routines and playtimes, respecting the attention span and endurance of infants. With therapist coaching and parent administration, this approach provides a feasible and effective means of enhancing motor and sensory development in infants with CP. Importantly, the intervention can be integrated into family routines, with tools and activities readily accessible.
Resources
Parent & Family Information
Yes, there are various approaches to multi-component UE interventions to address different motor challenges in children. It is possible to tailor the intervention to meet the specific needs of the child with CP.
The multi-component UE intervention has shown promising results in improving reaching ability, fine motor skills, and sensory processing in infants aged 6 to 24 months with asymmetric CP. Many parents have reported positive changes in their child’s motor skills and sensory function with consistent participation in the intervention.
Multi-component UE intervention is typically provided by certified occupational therapists or physical therapists with specialized training and experience in working with infants with CP. These professionals are skilled in assessing your child’s needs and designing customized intervention plans to address their specific motor and sensory difficulties.
The treatment period for multi-component UE intervention can vary depending on your child’s individual needs and response to therapy. Typically, sessions are conducted several times a week, with each session lasting around 20-30 minutes. The duration of intervention may range from a few weeks to several months, depending on the goals set for your child and their progress over time.
Multi-component UE intervention is generally considered safe and well-tolerated for infants with asymmetric CP. However, like any therapy, there may be minor discomfort or fatigue associated with engaging in new activities or exercises. It’s essential to communicate openly with your child’s therapist and monitor their progress closely to address any concerns that may arise during intervention.
Whether multi-component UE intervention is the right fit for your child depends on various factors, including their specific motor and sensory challenges, goals for therapy, and individual preferences. Consulting with healthcare professionals and discussing your child’s needs and concerns can help determine if multi-component UE intervention aligns with their unique circumstances and can contribute positively to their motor and sensory development.
One high-quality RCT (Maitre et al., 2020) investigated the effects of multi-component UE intervention on reach smoothness in infants with unilateral or quadriplegic CP. This high-quality RCT randomized infants to receive a multi-component UE intervention vs. bimanual play therapy. Reach smoothness (affected, less affected arm) was assessed using a kinematic measure of reach movement units at post-treatment (4 weeks). Significant between-group differences were found for both the affected and the less affected arm, favoring the multi-component UE intervention vs. bimanual therapy.
Conclusion: There is moderate evidence (Level 1b) from one high-quality RCT that a multi-component UE intervention is more effective than bimanual therapy in improving the affected and the less affected arm reach smoothness in infants with unilateral or quadriplegic CP.
One high-quality RCT (Maitre et al., 2020) investigated the effects of multi-component UE intervention on unimanual fine motor capacity in infants with unilateral or quadriplegic CP. This high-quality RCT randomized infants to receive a neuroscience-based multi-component UE intervention vs. the waitlisted group who received bimanual play therapy. Fine motor capacity was assessed using Bayley unimanual fine motor raw scores at post-treatment (4 weeks). Significant between-group differences were found for both the affected and the less affected arm, favouring the multi-component UE intervention vs. bimanual therapy.
Conclusion: There is moderate evidence (Level 1b) from one high-quality RCT that a multi-component UE intervention is more effective than a bimanual therapy in improving unimanual fine motor capacity in infants with unilateral or quadriplegic CP.
One high-quality RCT (Maitre et al., 2020) investigated the effects of multi-component UE intervention on somatosensory processing in infants with unilateral or quadriplegic CP. This high-quality RCT randomized infants to receive a neuroscience-based multi-component UE intervention vs. the waitlisted group who received bimanual play therapy. Somatosensory processing was assessed using a measure of tactile perception at the contralateral electrode cluster (P200) at post-treatment (4 weeks). No significant between-group differences were found.
Conclusion: There is moderate evidence (Level 1b) from one high-quality RCT that a multi-component UE intervention is as effective as bimanual therapy in improving somatosensory processing infants with unilateral or quadriplegic CP.
References
Maitre NL, Jeanvoine A, Yoder PJ, Key AP, Slaughter JC, Carey H, Needham A, Murray MM, Heathcock J; BBOP group. Kinematic and Somatosensory Gains in Infants with Cerebral Palsy After a Multi-Component Upper-Extremity Intervention: A Randomized Controlled Trial. Brain Topogr. 2020 Nov;33(6):751-766. doi: 10.1007/s10548-020-00790-5. Epub 2020 Aug 3. PMID: 32748303.
Definitions
A group of lifelong disorders affecting a person’s movement, coordination, and muscle tone and which are the result of damage to the brain before, during, or shortly after birth.
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