New Approaches in Motor Intervention for Infants Aged 0-2 Years with or at High Risk of Unilateral or Bilateral Cerebral Palsy: A Systematic Review.

Background/Objectives: Early motor intervention is increasingly recognized as a critical component in the management of infants with, or at high risk of, cerebral palsy (CP). This systematic review aimed to synthesize recent evidence on early motor interventions in infants aged 0-2 years and to identify current gaps in knowledge. Methods: We performed a systematic literature review across PubMed, Embase, CINAHL, and Scopus. Studies published between 1 January 2020 and 5 October 2024 were included. Eligible studies were Randomized Controlled Trials (RCTs), non-randomized trials, and cohort studies that involved infants aged 0-2 years diagnosed with CP or classified as at high risk of CP who received early motor interventions targeting motor outcomes. Study selection and data extraction were executed by two independent reviewers following standardized protocols. The Rob2 Checklist was used to assess the risk of bias. This systematic review protocol was registered on PROSPERO with the ID 506784. Results: Six articles representing four RCTs were included. Although intervention protocols varied, shared therapeutic principles emerged across studies. Most participants were approximately 12 months old; only one study included infants younger than 3 months, highlighting limited evidence in the earliest detectable risk period. No consistent superiority of experimental interventions over standard care was observed; however, notable within-group improvements in motor and developmental domains were reported across both study arms. Major limitations included heterogeneity of outcome measures, limited use of CP-specific standardized tools, and insufficient assessment of functional and goal-based outcomes. Conclusions: Current evidence indicates a shift toward meaningful, family-centered early motor interventions, emphasizing active participation and parental involvement. Five core principles were identified: early initiation, task specificity, active experience, guided support, and engagement of both the child and caregivers. Future research should focus on earlier intervention timing, standardized outcome measures, and caregiver-related outcomes to optimize early intervention strategies during critical developmental windows.