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Assisted exercise improves bone strength in very low birthweight infants by bone quantitative ultrasound
Hsiu-Lin Chen1, Chia-Ling Lee, Hsing-I Tseng
1Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Insights
Assisted exercise in premature infants with very low birthweight can improve bone strength. This intervention helps prevent osteopenia of prematurity, but biochemical markers like osteocalcin are not reliable early indicators.
Area of Science:
- Neonatal care
- Pediatric orthopedics
- Developmental pediatrics
Background:
- Osteopenia of prematurity is a common complication in very low birthweight infants.
- Early intervention is crucial to prevent bone fragility and fractures in this vulnerable population.
Purpose of the Study:
- To investigate the efficacy of assisted exercise in preventing osteopenia of prematurity in very low birthweight infants.
- To assess the impact of assisted exercise on bone strength parameters.
Main Methods:
- A randomized controlled trial involving 16 very low birthweight premature infants.
- Assisted exercise group received 4 weeks of passive range of motion exercises 5 days/week.
- Tibial bone speed of sound measured bi-weekly using quantitative ultrasound.
Main Results:
- No significant differences in baseline characteristics between exercise and control groups.
- The exercise group showed statistically significant less decrease in tibial bone speed of sound.
- No significant differences in biochemical markers (calcium, phosphorus, osteocalcin, etc.) between groups.
Conclusions:
- Early assisted exercise can improve bone strength in very low birthweight infants.
- Assisted exercise may be a viable strategy to mitigate osteopenia of prematurity.
- Osteocalcin and osteoprotegerin are not suitable early diagnostic indicators for osteopenia of prematurity.
Aim:
To evaluate whether assisted exercise could prevent the development of osteopenia of prematurity, we performed assisted exercise in the study group of very low birthweight (VLBW) premature infants.
Methods:
Sixteen premature infants with birthweight below 1500 g were enrolled in this study and randomly assigned into the exercise (n = 8) and control (n = 8) groups. Assisted exercise involved full extension and flexion range of motion of the upper and lower extremities by a trained nurse with a schedule of 5 days a week for a total of 4 weeks. Bone strength was determined by quantitative ultrasound measurement of tibial bone speed of sound every 2 weeks during the study period.
Results:
No difference in gender, birthweight, and gestation age between the exercise and control groups was noted. There was statistically significant less tibial bone speed of sound decrease in the exercise group on the sixth and eighth week of life. During the study period, there were no statistically significant differences in blood biochemistry data, including calcium, phosphorus, magnesium, alkaline phosphatase, osteocalcin and osteoprotegerin, between the two groups.
Conclusions:
This study revealed that early assisted exercise could improve bone strength in very low birthweight infants. The biochemical markers of bone metabolism, osteocalcin and osteoprotegerin, could not be the indicators for early diagnosis of osteopenia of prematurity.
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