Background

Recent systematic reviews have already provided an overview of the impact of early interventions on developmental outcomes in infants at risk for cerebral palsy. However, none has thus far focused specifically on how early interventions might improve motor outcome in infants diagnosed with unilateral cerebral palsy (uCP). Hence, the aim of this systematic review was to provide an overview of early intervention programs used in infants with uCP to improve motor outcome.

Methods

A systematic literature search was performed in PubMed, Embase, Cochrane Central Register of Controlled trials, CINAHL and Web of Science following the PRISMA-statement guidelines. Risk of bias was assessed using the Cochrane risk-of-bias 2 tool.

Results

Three single-blinded randomized controlled trials (RCTs) were identified, including 88 infants with uCP. These RCTs suggest that modified constraint-induced movement therapy (mCIMT) is effective and safe for improving upper limb function in infants with uCP. Bimanual training compared to mCIMT was found to be equally effective in one study. No clinical or neurological predictors of treatment response could be identified yet.

Conclusion

Although more high-quality RCTs are urgently needed, early interventions seem effective, safe and feasible to apply in infants with uCP for improving upper limb motor function. This underlines the importance of prompt referral to diagnostic-specific centres to start up such early interventions.

中文翻译：

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单侧脑瘫婴儿的早期干预：系统评价和叙述综合

背景

最近的系统评价已经概述了早期干预对有脑瘫风险的婴儿发育结果的影响。然而，迄今为止，还没有人专门关注早期干预如何改善诊断为单侧脑瘫 (uCP) 的婴儿的运动结果。因此，本系统评价的目的是概述用于 uCP 婴儿以改善运动结果的早期干预计划。

方法

根据 PRISMA 声明指南，在 PubMed、Embase、Cochrane Central Register of Controlled trial、CINAHL 和 Web of Science 中进行了系统的文献检索。使用 Cochrane 偏倚风险 2 工具评估偏倚风险。

结果

确定了三项单盲随机对照试验 (RCT)，其中包括 88 名患有 uCP 的婴儿。这些 RCT 表明，改良的约束诱导运动疗法 (mCIMT) 可有效且安全地改善 uCP 婴儿的上肢功能。在一项研究中发现双手训练与 mCIMT 相比同样有效。尚未确定治疗反应的临床或神经学预测因素。

结论

尽管迫切需要更多高质量的 RCT，但早期干预措施似乎是有效、安全和可行的，适用于 uCP 婴儿以改善上肢运动功能。这强调了迅速转诊至特定诊断中心以启动此类早期干预措施的重要性。