5. Conclusions and Implications for Clinical Practice
Our pilot study indicated no significant differences between intervention groups on manual ability. Both the EI-UL and EI-UL–MuSSAP home-based intervention with video coaching may be feasible and potentially effective with regard to improving manual ability in infants at high risk of developing uCP. As it is not (yet) possible to predict what intervention and what intervention duration is most likely to induce permanent improvement of upper limb function in each individual infant, the choice of intervention should be based on clinical reasoning, feasibility, and the preferences of the family. From the results of the current pilot study, we could form the following hypothesis: infants who do not (yet) initiate goal-directed movements and who show diminished attention for the contralesional upper limb, may benefit more from an additional (multisensory) MuSSAP training than from EI-UL alone. Our hypothesis should be further investigated in a in a larger study comparing the results of an EI-UL and EI-UL–MuSSAP home-based intervention, stratifying participants by the absence of goal-directed movements of the affected upper limb at baseline. By adding brain-based measures, possible effects of the interventions on cortical reorganisation can be monitored.