START-Play Physical Therapy Intervention Blends Motor With Cognitive Development

In this report filmed in Omaha, Nebraska, USA, Peter Goodwin interviews the authors of a research study investigating the “START-Play” combined physical therapy intervention in which motor and cognitive skills are developed together to improve outcomes among children with motor delay.

INTERVIEWEES:
Natalie A Koziol PhD, Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln NE
Sandra Jensen-Willett PT, Ph.D., PCS, Director of Physical Therapy, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha NE
Andrea Baraldi Cunha PT, PhD, University of Nebraska Medical Center, University of Nebraska, Omaha, NE
Sara Garcia DPT, PCS, Physical Therapy Department, Munroe-Meyer Institute, Nebraska Medical Center, Omaha NE

SOURCE:
“START-Play Physical Therapy Intervention Indirectly Impacts Cognition Through Changes in Early Motor-Based Problem-Solving Skills”

REFERENCE: Pediatr Phys Ther 2023;00:1–10 (Pediatric Physical Therapy, Issue 35 Number 3, 2023)

FULL LIST OF AUTHORS:
Natalie A. Koziol, PhD;
Kari S. Kretch, PT, DPT, PhD;
Regina T. Harbourne, PT, PhD, FAPTA;
Michele A. Lobo, PT, PhD;
Sarah W. McCoy, PT, PhD;
Rebecca Molinini, PT;
Lin-Ya Hsu, PT, PhD;
Iryna Babik, PhD;
Andrea Baraldi Cunha, PT, PhD;
Sandra L. Willett, PhD, PT, PCS;
James A. Bovaird, PhD;
Stacey C. Dusing, PT, PhD, FAPTA

FULL LIST OF INSTITUTIONS:
Nebraska Center for Research on Children, Youth, Families and Schools (Dr Koziol), University of Nebraska-Lincoln, Lincoln, Nebraska; Division of Biokinesiology and Physical Therapy (Drs Kretch and Dusing),
University of Southern California, Los Angeles, California; Physical Therapy Department (Dr Harbourne),
Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania; Biomechanics and Movement Science Program and Physical Therapy Department (Dr Lobo),
University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine (Drs McCoy and Hsu),
University of Washington, Seattle, Washington; Rehabilitation and Movement Science (Ms Molinini),
Virginia Commonwealth University, Richmond, Virginia;
Department of Psychological Science (Dr Babik), Boise State University, Boise, Idaho;
University of Nebraska Medical Center (Dr Cunha), University of Nebraska, Omaha, Nebraska;
Munroe Meyer Institute (Dr Willett), University of Nebraska Medical Center, Omaha, Nebraska;
Department of Educational Psychology (Dr Bovaird), University of Nebraska-Lincoln, Lincoln, Nebraska.

PURPOSE:
This study tested whether the Sitting Together and Reaching to Play (START-Play) physical therapy intervention indirectly impacts cognition through changes in perceptual-motor skills in infants with motor delays. Methods: Participants were 50 infants with motor delays randomly assigned to START-Play plus Usual Care Early Intervention (UC-EI) or UC-EI only. Infants’ perceptual-motor and cognitive skills were assessed at baseline and 1.5, 3, 6, and 12 months post-baseline. Results: Short-term changes in sitting, fine motor skills, and motor-based problem-solving, but not reaching, predicted long-term changes in cognition. START-Play indirectly impacted cognition through motor-based problem-solving but not sitting, reaching, or fine motor skills.
CONCLUSIONS:
This study provided preliminary evidence that early physical therapy interventions that blend activities across developmental domains and are supported by an enriched social context can place infants on more optimal developmental trajectories. (Pediatr Phys Ther 2023;00:1–10)

CORRESPONDENCE:
Natalie A. Koziol, PhD, Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, 840 N 14th St, CPEH 75, Lincoln, NE 68588 ([email protected]).
(Grant Support: This work was supported by the US Department of Education, Institute of Education Sciences; National Center for Special Education Research, Early Intervention and Early Learning in Special Education under grant no. R324A150103. Opinions reflect those of the authors and do not necessarily reflect those of the funder. Rebecca Molinini is a graduate student in the Rehabilitation and Movement Science PhD program at Virginia Commonwealth University in Richmond, Virginia.)