Effects of Vojta Therapy on the Motor Function of Children with Neuromotor Disorders: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Infantile cerebral palsy is a neurological pathology that causes great morbidity, mortality, and disability in people who suffer from it, mainly affecting motor development. There are a multitude of non-pharmacological methods or therapies for its treatment. One of the main methods is Vojta therapy. This methodology acts on ontogenetic postural function and automatic postural control. OBJECTIVE: This study aims to demonstrate that there are changes in the motor development of children with cerebral palsy with the application of Vojta therapy. METHODS AND ANALYSIS: This is a randomized controlled trial on the effectiveness of two neurorehabilitation techniques in patients with cerebral palsy conducted at the Physical Medicine and Rehabilitation Service of the Teresa Herrera Maternal and Child Hospital of the A Coruña and Cee Health Area. The study will be conducted from January 2023 to December 2024. There will be two groups: the Vojta therapy group (n = 30) and the conventional physiotherapy group (n = 30). The measurement variables will be gross motor function as measured by the Gross Motor Function Measure (GMFM) and Infant Motor Profile (IMP) scales. ETHICS AND DISSEMINATION: The study was approved by the Research Ethics Committee of the University of Murcia (1823/2018) and Comité de Ética de la Investigación de A Coruña-Ferrol (2022/099). TRIAL REGISTRATION NUMBER: ClinicalTrials.gov; identifier: NCT06092619.

Changes in social functioning and engagement during canine-assisted intervention for children with neurodevelopmental disorders in the context of an early intervention service.

PURPOSE: The objectives were to evaluate the feasibility of early implementation of a canine-assisted intervention (CAI) for children with neurodevelopmental disorders, and to determine the changes in social functioning and in engagement experienced by the participants. MATERIALS AND METHODS: A CAI consisting of 24 sessions was piloted in an intra-subject quasi-experimental longitudinal design. The outcome measures were the Assessment of Communication and Interaction Skills (ACIS) and Individual Child Engagement Record-Revised (ICER-R). RESULTS: No adverse events or side-effects were noted. The sample consisted of 44 participants (median age 37 months). A total of 33 children (75%) attended all sessions. Main results showed that after completing the intervention, the overall ACIS score improved significantly (p < 0.001); the effect size was large. There was a significant improvement in the scales of the ICER-R from baseline to the final assessment: overall engagement (p < 0.001), frequency of repetitive behaviours (p < 0.001), frequency of interaction between the child and adults (p < 0.001), and the quality of this interaction (p < 0.001); the effect sizes ranged from medium to large. CONCLUSIONS: The early application was feasible. The results in the areas of social functioning and engagement suggest that this CAI may be a useful complementary strategy in early therapeutic intervention with these children. WHAT THIS PAPER ADDS?: The results of implementation of a canine-assisted intervention (CAI) at an early therapeutic intervention unit for children with neurodevelopmental disorders are not known. This research supported the feasibility and positive impact of a CAI in a population consisting of children with neurodevelopmental disorders in the earliest stages of their life, with similar proportions of participants with global developmental delay and autism spectrum disorder. The study was pioneering in the development of this form of actions in an early intervention service for children with these health conditions. The intervention appears feasible and the results extend the existing evidence base for this intervention modality. The findings suggest significant improvements of a medium to large size in the domains of communication skills and social relations, engagement levels, frequency and quality of interaction with adults and repetitive behaviours after 12 and 24 weekly CAI sessions.

Improving social participation of children with autism spectrum disorder: Pilot testing of an early animal-assisted intervention in Spain.

Children with autism spectrum disorder (ASD) experience moderate to profound challenges in relation to the skills required for social participation. Animal-assisted intervention (AAI) is increasingly used within early community care. However, the results of its early application in this population group are not known. This pilot study aimed to explore the feasibility of an early intervention based on the use of therapy dogs and to examine their impact on communication and social interaction skills. A within-subject quasi-experimental longitudinal design was used. The instruments for measuring results were the Assessment of Communication and Interaction Skills (ACIS) and Animal-assisted Therapy Flow Sheet, both based on observation. A total of 19 children with confirmed or probable ASD (with mean age of 46.2 months), cared for in a Spanish therapeutic unit, participated in a median of nine AAI sessions, with a mean duration of 19.9 min per session. The total ACIS score increased significantly between the initial and final assessments of the study, with communication and social interaction skills improving with a large effect size. In the Animal-assisted Therapy Flow Sheet instrument, statistically significant improvements were found in most of the items that evaluate the frequency of child-dog social relationships (look at the dog, touch it, talk to it and get involved in an activity with the animal) and child-therapist relationships (look at the therapist and talk to him/her); the effect sizes ranged from medium to large. In conclusion, the early application of an AAI is feasible and seems to improve communication and social interaction skills, both essential elements for social participation. The results suggest that this intervention may be a beneficial non-pharmacological therapy as a complementary approach within community care for children with ASD in the early years of their life.