The Effectiveness of Sensory Integration Interventions on Motor and Sensory Functions in Infants with Cortical Vision Impairment and Cerebral Palsy: A Single Blind Randomized Controlled Trial

Mustafa Cemali, Serkan Pekçetin, Esra Akı, Mustafa Cemali, Serkan Pekçetin, Esra Akı

Abstract

Cortical vision impairment (CVI) and Cerebral Palsy (CP) lead to decrement in sensory and motor functions of infants. The current study examined the effectiveness of sensory integration interventions on sensory, motor, and oculomotor skills in infants with cortical vision impairment. Thirty-four infants with and CP aged 12−18 months were enrolled to the study. The infants were randomly divided into two groups as the control and intervention groups. The intervention group took sensory integration intervention 2 days a week for 8 weeks in addition to conventional physiotherapy 2 days a week for 8 weeks. The control group only received the conventional physiotherapy program 2 days a week for 8 weeks. The duration of the treatment sessions were 45 min for both interventions. Before and after the intervention, sensory processing functions were evaluated with the Test of Sensory Functions in Infants (TSFI), and motor functions were evaluated with the Alberta Infant Motor Scale (AIMS). There was a statistically significant difference between the pre- and post-test mean TSFI total and AIMS scores in the intervention group and control group (p < 0.001). The intervention group mean TSFI scores were more statistically significant than the those of the control group. Mean post-intervention AIMS scores did not differ between groups. Sensory integration intervention delivered with the conventional physiotherapy program was more effective than the conventional physiotherapy program in increasing sensory processing skills in one measure in infants with CVI and CP.

Keywords: cerebral palsy; cortical visual impairment; early intervention; motor function; sensory integration.

Conflict of interest statement

Authors confirm that there is no known conflict of interest associated with this publication.

Figures

Figure 1
Figure 1
Flow diagram: the flow of during each trial phase.

References

    1. Blackstone S.W., Luo F., Canchola J., Wilkinson K.M., Roman-Lantzy C. Children with cortical visual impairment and complex communication needs: Identifying gaps between needs and current practice. Lang. Speech Hear. Serv. Sch. 2021;52:612–629. doi: 10.1044/2020_LSHSS-20-00088.
    1. Philip S.S., Dutton G.N. Identifying and characterising cerebral visual impairment in children: A review. Clin. Exp. Optom. 2014;97:196–208. doi: 10.1111/cxo.12155.
    1. Chorna O.D., Guzzetta A., Maitre N.L. Vision assessments and interventions for infants 0–2 years at high risk for cerebral palsy: A systematic review. Pediatric Neurol. 2017;76:3–13. doi: 10.1016/j.pediatrneurol.2017.07.011.
    1. Philip S.S., Guzzetta A., Chorna O., Gole G., Boyd R.N. Relationship between brain structure and cerebral visual impairment in children with cerebral palsy: A systematic review. Res. Dev. Disabil. 2020;99:103580. doi: 10.1016/j.ridd.2020.103580.
    1. Lehman S.S. Cerebral Palsy. Springer; Berlin/Heildeberg, Germany: 2020. Cortical Visual Impairment in the Child with Cerebral Palsy; pp. 1049–1055.
    1. Pavão S.L., Rocha N.A.C.F. Sensory processing disorders in children with cerebral palsy. Infant Behav. Dev. 2017;46:1–6. doi: 10.1016/j.infbeh.2016.10.007.
    1. Shams A.A., Holizas M. Effect of sensory integration therapy on gross motor function in children with cerebral palsy. Iran. J. Child Neurol. 2009;3:43–48.
    1. Olfatian Y., Hemayattalab R., Bagherzadeh F. Examine the effectiveness of sensory integration therapy approach on fine motor skills in children with spastic cerebral palsy. J. Mot. Learn. Mov. 2021 doi: 10.22059/JMLM.2021.140180.1027.
    1. Seyam M., Sherief A., Waly M.I., Kashoo F.Z., Elfakharany M.S. Effect of sensory integration on gait for children with mild hemiplegic cerebral palsy. Egypt. J. Phys. Ther. 2021;7:1–6. doi: 10.21608/ejpt.2021.49878.1022.
    1. Abd El-Maksoud G.M., Gharib N.M.M., Hussein R. Visual-based training program for motor functions in cerebral palsied children with cortical visual impairment. Int. J. Ther. Rehabil. Res. 2016;5:265–277.
    1. Edmond J.C., Foroozan R. Cortical visual impairment in children. Curr. Opin. Ophthalmol. 2006;17:509–512. doi: 10.1097/ICU.0b013e3280107bc5.
    1. Morse M.T. Cortical Visual Impairment in Young Children with Multiple Disabilities. J. Vis. Impair. Blind. 1990;84:200–203. doi: 10.1177/0145482X9008400501.
    1. Malkowicz D.E., Myers G., Leisman G. Rehabilitation of cortical visual impairment in children. Int. J. Neurosci. 2006;116:1015–1033.
    1. Zhao Z. Effects of visual impairment on sensory integration and new opportunities for inclusive e-learning managing. Int. J. Disabil. Dev. Educ. 2021;68:1–15. doi: 10.1080/1034912X.2021.1983777.
    1. Van Balen L.C., Dijkstra L.J., Dirks T., Bos A.F., Hadders-Algra M. Early intervention and postural adjustments during reaching in infants at risk of cerebral palsy. Pediatric Phys. Ther. 2019;31:175–183. doi: 10.1097/PEP.0000000000000585.
    1. Ward R., Hennessey N., Barty E., Elliott C., Valentine J., Cantle Moore R. Clinical utilisation of the Infant Monitor of vocal Production (IMP) for early identification of communication impairment in young infants at-risk of cerebral palsy: A prospective cohort study. Dev. Neurorehabilit. 2022;25:101–114. doi: 10.1080/17518423.2021.1942280.
    1. Hielkema T., Hamer E.G., Boxum A.G., La Bastide-Van Gemert S., Dirks T., Reinders-Messelink H.A., Maathuis C.G., Verheijden J., Geertzen J.H., Hadders-Algra M., et al. Learn2move 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: Neuromotor, cognitive, and behavioral outcome. Disabil. Rehabil. 2020;42:3752–3761. doi: 10.1080/09638288.2019.1610508.
    1. Maitre N.L., Jeanvoine A., Yoder P.J., Key A.P., Slaughter J.C., Carey H., Needham A., Murray M.M., Heathcock J. Kinematic and somatosensory gains in infants with cerebral palsy after a multi-component upper-extremity intervention: A randomized controlled trial. Brain Topogr. 2020;33:751–766. doi: 10.1007/s10548-020-00790-5.
    1. Kim E.J., Choi Y.I. A systematic review and meta-analysis of sensory integration intervention studies in children with cerebral palsy. J. Digit. Converg. 2013;11:383–389.
    1. Chorna O., Heathcock J., Key A., Noritz G., Carey H., Hamm E., Nelin M.A., Murray M., Needham A., Slaughter J.C., et al. Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: A randomised clinical trial protocol. BMJ J. 2015;5:e010212. doi: 10.1136/bmjopen-2015-010212.
    1. Schulz K.F., Altman D.G., Moher D., Fergusson D. CONSORT 2010 changes and testing blindness in RCTs. Lancet. 2010;375:1144–1146. doi: 10.1016/S0140-6736(10)60413-8.
    1. DeGangi G.A., Greenspan S.I. Test of Sensory Functions in Infants (TSFI) Western Psychological Services; Los Angeles, CA, USA: 1989.
    1. Arıcıkül A. Master’s Thesis. Marmara University Institute of Educational Sciences, Department of Special Education; İstanbul, Turkey: 2014. Adaptation of Sensory Function Test for Infants.
    1. Amiel-Tison C. Update of the Amiel-Tison neurologic assessment for the term neonate or at 40 weeks corrected age. Pediatric Neurol. 2002;27:196–212. doi: 10.1016/S0887-8994(02)00436-8.
    1. Piper M.C., Pinnell L.E., Darrah J., Maguire T., Byrne P.J. Construction and validation of the Alberta Infant Motor Scale (AIMS) Can. J. Public Health Rev. Can. De Sante Publique. 1992;83:46–50.
    1. Pekçetin S., Akı E., Üstünyurt Z., Kayıhan H. The efficiency of sensory integration interventions in preterm infants. Percept. Mot. Ski. 2016;123:411–423. doi: 10.1177/0031512516662895.
    1. Parham L.D., Roley S.S., May-Benson T.A., Koomar J., Brett-Green B., Burke J.P., Cohn E.S., Mailloux Z., Miller L.J., Schaaf R.C. Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration® intervention. Am. J. Occup. Ther. 2011;65:133–142.
    1. Yakut Y., Özalp Ö., Habibzadeh A., Gürşen C., Yagci G. Better presentation of the intervention: The Template for Intervention Description and Replication (TIDieR) checklist and guide. J. Exerc. Ther. Rehabil. 2020;7:302–320.
    1. Cohen J. A power primer. Psychol. Bull. 1992;112:155. doi: 10.1037/0033-2909.112.1.155.
    1. Kashoo F.Z., Ahmad M. Effect of sensory integration on attention span among children with infantile hemiplegia. Int. J. Health Sci. 2019;13:29.
    1. Ju J.O., Lee H.R., Kim K.M. The effects of sensory integrative intervention on the self-regulation capacities of children with cerebral palsy: Single-subject research design. J. Korean Acad. Sens. Integr. 2011;9:15–28.
    1. Hsieh H.Y., Chen L.Y., Ko K.L., Liu H.H., Chou W.J., Chou M.C., Tsai C.S., Wang L.J. Adjunctive sensory integration therapy for children with developmental disabilities in a family-based early intervention program. Taiwan J. Psychiatry. 2020;34:121.
    1. Lecuona E., Van Jaarsveld A., van Jaarsveld J., Van Heerden R. Sensory integration intervention and the development of the premature infant: A controlled trial. South Afr. Med. J. 2017;107:976–982.
    1. Kayihan H., Bumin G. Effectiveness of two different sensory-integration programmes for children with spastic diplegic cerebral palsy. Disabil. Rehabil. 2001;23:394–399. doi: 10.1080/09638280010008843.
    1. Papadelis C., Ahtam B., Nazarova M., Nimec D., Snyder B., Grant P.E., Okada Y. Cortical somatosensory reorganization in children with spastic cerebral palsy: A multimodal neuroimaging study. Front. Hum. Neurosci. 2014;8:725.
    1. Auld M.L., Ware R.S., Boyd R.N., Moseley G.L., Johnston L.M. Reproducibility of tactile assessments for children with unilateral cerebral palsy. Phys. Occup. Ther. Pediatrics. 2012;32:151–166.
    1. Sanger T.D., Kukke S.N. Abnormalities of tactile sensory function in children with dystonic and diplegic cerebral palsy. J. Child Neurol. 2007;22:289–293. doi: 10.1177/0883073807300530.
    1. Auld M.L., Ware R.S., Boyd R.N., Moseley G.L., Johnston L.M. Tactile assessment in children with cerebral palsy: A clinimetric review. Phys. Occup. Ther. Pediatrics. 2011;31:413–439. doi: 10.3109/01942638.2011.572150.
    1. Cumurcu T., Cumurcu H.B., Erkorkmaz Ü., Yardim H. Ocular findings in children with cerebral palsy. Fırat J. Med. 2007;12:48–52.
    1. Clayton K., Fleming J.M., Copley J. Behavioral responses to tactile stimuli in children with cerebral palsy. Phys. Occup. Ther. Pediatrics. 2003;23:43–62. doi: 10.1080/J006v23n01_04.
    1. Dusing S.C., Harbourne R.T., Lobo M.A., Westcott-McCoy S., Bovaird J.A., Kane A.E., Syed G., Marcinowski E.C., Koziol N.A., Brown S.E. A physical therapy intervention to advance cognitive and motor skills: A single subject study of a young child with cerebral palsy. Pediatric Phys. Ther. 2019;31:347–352. doi: 10.1097/PEP.0000000000000635.
    1. Park E.Y., Kim W.H. Effect of neurodevelopmental treatment-based physical therapy on the change of muscle strength, spasticity, and gross motor function in children with spastic cerebral palsy. J. Phys. Ther. Sci. 2017;29:966–969.
    1. Velasco M.A., Raya R., Muzzioli L., Morelli D., Otero A., Iosa M., Cincotti F., Rocon E. Evaluation of cervical posture improvement of children with cerebral palsy after physical therapy based on head movements and serious games. Biomed. Eng. Online. 2017;16:74. doi: 10.1186/s12938-017-0364-5.
    1. Das S.P., Ganesh G.S. Evidence-based approach to physical therapy in cerebral palsy. Indian J. Orthop. 2019;53:20. doi: 10.4103/ortho.IJOrtho_241_17.
    1. Bumin G., Kavak S.T. An investigation of the factors affecting handwriting performance in children with hemiplegic cerebral palsy. Disabil. Rehabil. 2008;30:1374–1385. doi: 10.1080/09638280701673609.
    1. Shams A.A. Comparison between the effect of neurodevelopmental treatment and sensory integration therapy on gross motor function in children with cerebral palsy. Iran. J. Child Neurol. 2010;4:31–38.
    1. Mahaseth P.K., Choudhary A. Sensory Integration Therapy Verses Conventional Physical Therapy Among Children with Cerebral Palsy on Gross Motor Function—A Comparative Randomized Controlled Trial. Ann. Rom. Soc. Cell Biol. 2021;25:17315–17334.
    1. Arslan C., Ünsal E., Sezer K.Ş., Tarakci D. Investigation of the Effect of Structured Neurodevelopmental Therapy and Sensory Integration Approaches on Sitting Balance in Children with Cerebral Palsy. Haliç Univ. J. Health Sci. 2020;3:107–116.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera