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Task-oriented therapy in the motor development of infants at biological risk for neurodevelopmental delay: a randomized controlled clinical trial

Abstract

Human development is a process that starts from intrauterine life, being influenced by both biological and socio-environmental factors. Biological risk factors lead to a greater propensity of unfavorable evolution in infants, who may present delays during motor development or some health conditions, such as cerebral palsy. Moreover, even with biological risk, infants do not always receive physiotherapeutic intervention after hospital discharge. Therefore, strategies for early, effective interventions, based on scientific evidence, with family-centered care, are necessary. OBJECTIVE: To evaluate the effect of a task-oriented home treatment program with environmental enrichment strategies and family-centered care practices on the motor development of infants aged 3 to 6 months at biological risk for neurodevelopmental disorders. METHODS: This is a randomized controlled, double-blind clinical trial in which 54 infants of both sexes, aged between 3 and 6 months, and presenting one of the following criteria: prematurity, low birth weight and asphyxia, will participate in the study. Motor development assessments will take place at the infant's home or at the Laboratory for Research and Analysis of Movement (LaPAM) using the Infant Motor Profile (IMP) and Alberta Infant Motor Scale (AIMS) instruments. In addition, the availability of affordances will also be assessed by the Affordances in the Home Environment for Motor Development - Infant Scale questionnaire. After the initial assessment, the family will carry out the goal setting process, based on the Canadian Occupational Performance Measure (COPM) together with the researcher. All infants, regardless of the group (experimental or control), will be submitted to 5 evaluations, being: evaluation 1 (pre-training), evaluations 2, 3 and 4 at the end of each week of training and evaluation 5, after 7 days from the end of training (retention). The training program of the experimental group will include task-oriented therapy, environmental enrichment and family-centered care, while the control group will receive only environmental enrichment and family-centered care. The intervention will take place in the infants' homes, in a total of 3 weeks, 5 days a week, performed 2 days by the researcher and 3 days by the parents and/or guardians, lasting 1 hour per day. EXPECTED RESULTS: It is expected that the group that received task-oriented therapy associated with environmental enrichment will have an improvement in motor development when compared to the control group. (AU)

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