[en] Introduction. Psychomotor development is an evolutionary phenomenon of skill acquisition that occurs during the first years of life. There are multiple risk factors to experience disorders in it, among which is prematurity. These children tend to have delayed psychomotor development and atypical postural control, among others. Motor learning is also affected, since deficiencies in information processing lead to a lower tendency to explore, and opportunities to learn through action are restricted. In the long term, they often experience difficulties in carrying out activities in their daily life, difficulties at school, and their participation and social interaction are limited. Through different elements of diagnosis and early evaluation during the first months of life, we can identify children at risk of suffering psychomotor development disorders, in order to perform as soon as possible, and act when the brain is in rapid development and with greater plasticity. These interventions must have high doses of administration, and must be administered individually, repetitively and with increasing difficulty. This can be achieved with enriched environments, where the aim is to promote different motor, cognitive and social aspects to promote learning. Objective. To determine if an early physiotherapy program, based on enriched environments, is effective to improve the psychomotor development of children at risk of disorders. Methodology. 50 premature children over 28 weeks of gestational age and with definitely abnormal general movements will be recruited and randomized into two groups. The intervention group will carry out the physiotherapy program based on enriched environments, combined with postural control activities. The control group will carry out a physiotherapy program that consists exclusively of activities of postural control. The intervention will be carried out for 21 months, with 5 weekly sessions lasting 45 minutes each. Likewise, both groups carry out a weekly domiciliary program. At the beginning of the intervention, during, at the end and during the following months, the evaluation of psychomotor development, gross motor skills, participation and quality of life will be evaluated. Applicability. This project will allow us to know if the enriched environments, in combination with the postural control, are an adequate physiotherapeutic strategy to optimize the motor results in children with risk of alterations in the psychomotor development. If the results are positive, they will join new knowledge that indicates the importance of early detection for the early application of effective physiotherapy programs.

[gl] Introdución. O desenvolvemento psicomotor é un fenómeno evolutivo da adquisición de habilidades que se produce durante os primeiros anos de vida. Hai múltiples factores de risco para experimentar alteracións no mesmo, entre os que se atopa a prematuridade. Estes/as nenos/as adoitan ter un desenvolvemento psicomotor tardío e un control postural atípico, entre outros. A aprendizaxe motora tamén vese afectada, xa que as deficiencias no procesamento da información xeran unha menor tendencia á exploración e ás oportunidades de aprender a través da acción están restrinxidas. A longo prazo, a miúdo experimentan dificultades para levar a cabo actividades da vida cotiá, dificultades na escola e a súa participación e interacción social vense restrinxidas. A través de diferentes elementos de diagnóstico e avaliación precoz, podemos identificar, durante os primeiros meses de vida a nenos/as con risco de sufrir alteracións no desenvolvemento psicomotor, para intervir o antes posible e actuar cando o cerebro atópase en rápido desenvolvemento e con maior plasticidade. Estas intervencións deben ter altas doses de administración e deben aplicarse de forma individualizada, repetitiva e con dificultade crecente. Isto pódese conseguir con contornos enriquecidos, onde o obxectivo é mellorar diferentes aspectos motores, cognitivos e sociais para promover a aprendizaxe. Obxectivo. Determinar se un programa de fisioterapia precoz, baseado en cortornos enriquecidos, é eficaz para promover o desenvolvemento psicomotor dos nenos/as en risco de sufrir alteracións. Metodoloxía. Recrutaranse 50 nenos prematuros de máis de 28 semanas de idade gestacional, con movementos xerais anormais, que serán aleatorizados en dous grupos. O grupo de intervención levará a cabo o programa de fisioterapia en contornos enriquecidos, combinado con actividades de control postural. O grupo control realizará un programa de fisioterapia que consiste exclusivamente en actividades de control postural. A intervención levarase a cabo durante 21 meses, con 5 sesións semanais de 45 minutos cada unha. Así mesmo, ambos grupos realizan un programa domiciliario semanal. Ao comezo da intervención, durante, ó final e nos meses seguintes, levarase a cabo a avaliación do desenvolvemento psicomotor, a habilidade motriz bruta, a participación e a calidade de vida. Aplicabilidade. Este proxecto permitiranos coñecer se os contornos enriquecidos, en combinación co control postural, son unha estratexia fisioterapéutica adecuada para optimizar os resultados motores en nenos/as con risco de alteracións no desenvolvemento psicomotor. Se os resultados son positivos, aportará novos coñecementos que indican a importancia da detección precoz para a aplicación precoz de programas de fisioterapia eficaces.