This study provides strong evidence to support physiotherapysupervised PFMT as an effective intervention which may delay, or ultimately prevent, the need for surgery, when delivered at an effective dosage. “
“Summary of: Spittle AJ et al (2010) Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years. Pediatrics 126: e171–e178. [Prepared by Nora Shields, CAP Editor.] Question: Does a home-based preventive care program improve cognitive, language, and motor development in very preterm infants, and mental health in their primary caregivers? Design: Randomised, controlled

trial with concealed allocation and blinded outcome assessment. Setting: In the homes buy Cobimetinib of participants in Australia. Participants: Infants born at less than 30 weeks gestational age, with no major Modulators congenital brain anomalies were included. Infants were excluded if the family did not live within 100 km of the recruiting centre or if their family did not speak English. Randomisation of 120 participants allocated 61 to an education and support program group and 59 to a control group. Interventions: Both groups received standard follow-up care, including access to a maternal and child

health nurse and referral to early intervention services if deemed appropriate. In addition, the intervention group received nine, 90–120 minute visits over one year by a psychologist and a physiotherapist. The visits

consisted of education on infant self-regulation, techniques to improve postural stability, co-ordination, and see more strength, and parental support. Outcome measures: The primary outcomes were the cognitive, language, and motor aminophylline development domains of the Bayley Scales of Infant and Toddler Development III at 2 years corrected age and the Hospital Anxiety and Depression Scale for the primary caregivers. Secondary outcome measures were child behaviour and emotional regulation assessed using the four domains of the Infant- Toddler Social and Emotional Assessment (externalising, internalising, dysregulation, and competence). Results: 115 participants completed the study. At 2 years corrected age, the cognitive, language, and motor domains of the Bayley scales did not differ significantly between the groups. Three of the four domains of the Infant-Toddler Social and Emotional Assessment improved significantly more in the intervention group than in the control group at 2 years corrected age: externalising by –4.1 units (95% CI –8.2 to –0.02), dysregulation by –8.7 units (95% CI –13.2 to –4.2), and competence by 6.3 units (95% CI 0.7 to 11.8). The groups did not differ significantly on the internalising domain. The primary caregivers in the intervention group reported lower levels of anxiety and depression on the Hospital Anxiety and Depression Scale, compared with those in the control group by –2.