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Effects on motor development of kicking and stepping exercise in preterm infants with periventricular brain injury: a
Suzann K Campbell1, Deborah Gaebler-Spira, Laura Zawacki
1Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, IL, USA. skc@uic.edu
Insights
Early kicking and treadmill exercise may help preterm infants with periventricular brain injury (PBI) walk sooner. However, compliance issues suggest protocol improvements are needed for future studies on PBI motor development.
Area of Science:
- Neonatal neurology
- Pediatric physical therapy
- Developmental pediatrics
Background:
- Periventricular brain injury (PBI) in preterm infants is linked to developmental delays and atypical motor patterns.
- Early motor interventions are crucial for improving outcomes in at-risk infants.
- Targeting leg movements may address specific deficits associated with PBI.
Purpose of the Study:
- To investigate the efficacy of a home-based kicking and treadmill stepping intervention for infants with PBI.
- To assess if early intervention improves motor function at 12 months corrected age (CA).
- To compare motor outcomes between an intervention group and a control group.
Main Methods:
- A multi-center pilot study involving 16 infants with PBI, randomly assigned to intervention or control groups.
- Intervention included home-based kicking and treadmill stepping starting at 2 months CA.
- Motor development assessed using the Alberta Infant Motor Scale (AIMS) at multiple time points up to 12 months CA.
Main Results:
- The exercise group showed a trend towards earlier walking (43% vs. 11%), but this was not statistically significant.
- No significant differences in AIMS scores were observed between groups at any age.
- Intervention did not improve outcomes for infants with cerebral palsy (CP) or developmental delay; low compliance may have impacted results.
Conclusions:
- While not statistically significant in this small pilot study, early kicking and treadmill exercise show potential for improving walking age in infants with PBI and normal development.
- Further research with improved compliance protocols is warranted before conducting larger trials.
- The intervention may not benefit infants with existing CP or significant developmental delays.
Background:
Preterm infants with periventricular brain injury (PBI) have a high incidence of atypical development and leg movements.
Objective:
Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age (CA) in children with PBI improves motor function at 12 months CA when compared with control subjects.
Method:
In a multi-center pilot study for a controlled clinical trial, sixteen infants with PBI were randomly assigned to home exercise consisting of kicking and treadmill stepping or a no-training control condition. Development was assessed at 2, 4, 6, 10, and 12 months CA with the Alberta Infant Motor Scale (AIMS). At 12 months children were classified as normal, delayed, or with cerebral palsy (CP).
Results:
At 12 months CA 3 of 7 (43%) of the exercise group children walked alone or with one hand held versus 1 of 9 (11%) in the control group (p=0.262), but no significant differences in AIMS scores were found at any age. Half of the subjects had CP or delay; the outcomes of these infants were not improved by exercise. Compliance with the home program was lower than requested and may have affected results.
Conclusion:
Although not statistically significant with a small sample size, self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI, but improvements of the protocol to increase and document compliance are needed before a larger study is implemented.
