Motor Learning Feeding Interventions for Infants at Risk of Cerebral Palsy: A Systematic Review.

Feeding difficulties and dysphagia are common in cerebral palsy (CP) and can lead to deficiencies of development and aspiration pneumonia; a leading cause of death in CP. Motor learning interventions have shown positive results in other clinical areas and may be beneficial for this population. This systematic review appraises research that addresses the question: are motor learning-based interventions more effective than compensatory strategies alone in treating dysphagia in infants with, or at risk of, CP?. Systematic searches were conducted in nine electronic databases. All levels of evidence, with at least one infant between 37 weeks post-menstrual age and 12 months corrected age who were at risk of, or diagnosed with CP, implemented interventions which aimed to improve oropharyngeal function for feeding, and aligned with at least two motor learning principles, were included. Studies were appraised by two independent reviewers using the Cho & Bero Instrument and GRADE. One historical case-control study and four case series met inclusion criteria. All involved a combination of motor learning interventions and compensatory strategies, which do not traditionally align with motor learning principles. All studies reported improvements in oral feeding outcomes, however, only three reported statistical analysis. The best available evidence collectively demonstrated a very weak positive effect for motor learning-based interventions for feeding difficulties in infants with, or at risk of, CP.