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Effect of postural supports on neuromotor function in very preterm infants to term equivalent age
L Monterosso1, L J Kristjanson, J Cole
1King Edward Memorial and Princess Margaret Hospitals, Edith Cowan University, Perth, Western Australia, Australia. leanne.monterosso@health.wa.gov.au
Insights
Using a postural support nappy and roll together improves hip posture in very preterm infants. A postural support roll alone also enhances shoulder posture up to term equivalent age.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Neuromotor function
Background:
- Very preterm infants often experience neuromotor challenges.
- Prone positioning is a common practice in neonatal intensive care units.
- Postural support may influence infant development.
Purpose of the Study:
- To assess the impact of postural support nappies and rolls on neuromotor function in very preterm infants.
- To evaluate the effects of these interventions when infants are nursed in the prone position until term equivalent age.
Main Methods:
- A randomized, observer-blind controlled trial involving 123 very preterm infants.
- Infants were stratified by gestational age and randomized into three groups: postural support nappy, combined postural support nappy and roll, or disposable nappy with postural support roll.
- Measurements of shoulder and hip posture were taken at baseline, 5 weeks post-intervention, and at term postmenstrual age.
Main Results:
- Combined use of a postural support roll and nappy significantly improved hip posture compared to using either alone.
- The postural support roll, with or without the nappy, led to improved shoulder posture.
- Improvements in posture were observed up to term equivalent age.
Conclusions:
- The combined use of a postural support roll and nappy is effective in improving hip posture in very preterm infants nursed prone.
- A postural support roll alone also enhances shoulder posture in this population up to term equivalent age.
Objective:
To determine the effect of a postural support nappy and/or a postural support roll on neuromotor function in very preterm infants when nursed prone to term equivalent age.
Methods:
A randomized observer blind controlled trial of 123 very preterm infants was conducted in the neonatal intensive care unit of the sole tertiary referral centre in Western Australia. Infants were stratified by gestational age (< 29 weeks or 29-30 weeks), then randomized into one of three intervention groups: postural support nappy, postural support nappy and postural support roll, or disposable nappy and postural support roll. Interventions started when infants were stable and ceased when routine side-lying commenced. Measurements of shoulder and hip posture were performed pre-intervention, 5 weeks post-intervention and term postmenstrual age.
Results:
Infants nursed with a postural support roll and a postural support nappy demonstrated improved hip posture to term equivalent age compared with infants nursed with either a postural support roll only, or a postural support nappy only. Infants nursed with a postural support roll either with or without a postural support nappy demonstrated improved shoulder posture to term equivalent age.
Conclusions:
Combined use of a postural support roll and a postural support nappy while very preterm infants are nursed prone improves hip posture up to term postmenstrual age. Use of a postural support roll improves shoulder posture up to term equivalent age.