Outcome at Age Five Years or Older for Children with Perinatal Brain Injury Treated with Neurohabilitation or Neurodevelopmental Therapy

Abstract

Background: To evaluate the outcome at age five years or older for children with perinatal brain injury who received Katona's neurohabilitation therapy or neurodevelopmental therapy (Bobath therapy) at birth, a blinded evaluation of the infant groups was performed by an expert neuropediatrician. Methods: Twenty-two infants with a gestational age (GA) ranging from 25 to 40 weeks were treated with neurohabilitation (n=11) or with neurodevelopmental therapy (n=11), with both procedures initiated before three months of corrected age. The groups were matched by sex and GA. Treatments were intensive, were sustained for at least 24 months, and required family participation. At birth, neuropediatric examinations and MRI were performed. Children were followed up, and at three-year-old Bayley-II scales were administered; the follow-up continued up to the present age. Findings: Abnormal MRI findings were observed in 21 (95%) infants. At three years old, among children treated with Katona's method, the Bayley-II score was slightly abnormal in one patient for both indices, another child had a lower performance on the mental index, and a third patient showed a very low psychomotor index; four patients treated with the Bobath procedure had very abnormal results on both indices. The outcome of a blind evaluation of the group showed that eight of 11 children treated with Katona had a normal evaluation, and only four of the children treated with the Bobath method were normal; the risk ratio (RR) was 37% (0*73-0*36= 0*37). Interpretation: The resulting outcomes after five years or more using Katona's neurohabilitation in newborns with perinatal brain damage were better than the outcomes for children treated with the Bobath procedure, even if the latter was initiated early and with great intensity. Funding Statement: This manuscript was partially supported by Project PAPIIT IN200917 from DGAPA, UNAM, and Project 4971 from CONACYT. Declaration of Interests: The authors state: There were no conflicts of interest. Ethics Approval Statement: The Ethics Committee of the Instituto de Neurobiologia of the Universidad Nacional Autonoma de Mexico approved this study, which also complies with the Ethical Principles for Medical Research Involving Human Subjects established by the Helsinki Declaration. Informed written parental consent for participation in this study was obtained for all subjects.