Movement Imitation Therapy for Preterm Babies (MIT-PB): a Novel Approach to Improve the Neurodevelopmental Outcome of Infants at High-Risk for Cerebral Palsy

Marina Soloveichick; Peter B Marschik; Ayala Gover; Michal Molad; Irena Kessel; Christa Einspieler

doi:10.1007/s10882-019-09707-y

Movement Imitation Therapy for Preterm Babies (MIT-PB): a Novel Approach to Improve the Neurodevelopmental Outcome of Infants at High-Risk for Cerebral Palsy

J Dev Phys Disabil. 2020;32(4):587-598. doi: 10.1007/s10882-019-09707-y. Epub 2019 Nov 18.

Authors

Marina Soloveichick^{1

2}, Peter B Marschik^{3

4

5

6}, Ayala Gover^{1

2}, Michal Molad^{1

2}, Irena Kessel^{1

2}, Christa Einspieler³

Affiliations

¹ Neonatal Intensive Care Unit, Lady Davis Carmel Medical Center, Haifa, Israel.
² The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
³ Research Unit iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria.
⁴ Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
⁵ Leibniz ScienceCampus Primate Cognition, Göttingen, Germany.
⁶ Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Abstract

To improve the neurodevelopmental outcome in infants with high grade intraventricular haemorrhage and cramped-synchronised (CS) general movements (GMs). Four very preterm infants with intraventricular haemorrhage grade III (n = 3) or intraventricular haemorrhage with apparent periventricular haemorrhagic infarction (n = 1) were diagnosed with CS GMs at 33 to 35 weeks postmenstrual age. A few days later MIT-PB [Movement Imitation Therapy for Preterm Babies], an early intervention programme, was commenced: the instant an infant showed CS movements, the therapist intervened by gently guiding the infant's limbs so as to manoeuvre and smoothen the movements, thereby imitating normal GM sequences as closely as possible (at least for 10 min, 5 times a day, with increasing frequency over a period of 10 to 12 weeks). After a period of consistent CS GMs, the movements improved. At 14 weeks postterm age, the age specific GM pattern, fidgety movements, were normal in three infants, one infant had abnormal fidgety movements. At preschool age, all participants had a normal neurodevelopmental outcome. This report on four cases demonstrates that mimicking normal and variable GM sequences might have a positive cascading effect on neurodevelopment. The results need to be interpreted with caution and replication studies on larger samples are warranted. Nonetheless, this innovative approach may represent a first step into a new intervention strategy.

Keywords: Cerebral palsy; Early intervention; General movements; Intraventricular haemorrhage.