title: Infant positioning in daily life may mediate associations between physiotherapy and child development-video-analysis of an early intervention RCT.
abstract: BACKGROUND
  Paediatric physiotherapy (PPT) in high-risk infants comprises family involvement, but it is unclear whether parents mediate the intervention effect. We demonstrated in a randomized controlled trial in high-risk infants comparing the family centred programme Coping and Caring for infants with special needs (COPCA) and Traditional Infant Physiotherapy (TIP) that process evaluation revealed associations between COPCA-characteristics and outcome.
  
  
  OBJECTIVE
  To assess whether PPT affects how parents position their infant during bathing and whether this is associated with child outcome.
  
  
  METHODS
  21 infants received COPCA and 25 TIP between 3 and 6 months corrected age. Bathing sessions were videotaped at 3, 6 and 18 months. Time spent with specific infant positions was correlated with quantified PPT-actions and functional mobility at 18 months measured with the Paediatric Evaluation of Disability Inventory (PEDI).
  
  
  RESULTS
  At 3 and 18 months bathing position was similar in both groups, but differed at 6 months (time spent on sitting: COPCA 77.7%, TIP 39.2%; median difference 32.0% (95% CI: 10.6-50.5%). Sitting-time at 6 months was associated with higher PEDI functional mobility scores.
  
  
  CONCLUSIONS
  Early PPT may affect parental behaviour, such as infant positioning during bathing, which, in turn, may affect child development.
authors.affiliation: University of Groningen, University Medical Center, Groningen, Dept of Paediatrics, Div. Developmental, Neurology, Groningen, the Netherlands.
authors.forename: Tineke
authors.initials: T
authors.lastname: Dirks
authors.affiliation: University of Groningen, University Medical Center, Groningen, Dept of Paediatrics, Div. Developmental, Neurology, Groningen, the Netherlands; University of Groningen, University Medical Center, Groningen, Dept of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands.
authors.forename: Tjitske
authors.initials: T
authors.lastname: Hielkema
authors.affiliation: University of Groningen, University Medical Center, Groningen, Dept of Paediatrics, Div. Developmental, Neurology, Groningen, the Netherlands; Radboudumc, Department of Neurology, Nijmegen, the Netherlands.
authors.forename: Elisa G
authors.initials: EG
authors.lastname: Hamer
authors.affiliation: University of Groningen, University Medical Center, Groningen, Dept of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands; Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, the Netherlands.
authors.forename: Heleen A
authors.initials: HA
authors.lastname: Reinders-Messelink
authors.affiliation: University of Groningen, University Medical Center, Groningen, Dept of Paediatrics, Div. Developmental, Neurology, Groningen, the Netherlands. Electronic address: m.hadders-algra@umcg.nl.
authors.forename: Mijna
authors.initials: M
authors.lastname: Hadders-Algra
mesh_terms: D002657:Child Development; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods*; D008297:Male; D065886:Neurodevelopmental Disorders; D010290:Parents; D056888:Patient Positioning / Q000379:methods*; D026741:Physical Therapy Modalities; D011187:Posture; D012306:Risk; D014741:Video Recording
keywords: Early intervention; Family involvement; Functional mobility; Infant bathing; Paediatric physiotherapy