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Early Parent-Administered Physical Therapy for Preterm Infants: A Randomized Controlled Trial
Tordis Ustad1, Kari Anne I Evensen2, Suzann K Campbell3
1Department of Clinical Services, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, tordis.ustad@gmail.com.
Insights
Parent-administered physical therapy for preterm infants improved motor skills by 37 weeks postmenstrual age. This short-term intervention showed significant benefits compared to usual care, with long-term effects to be evaluated.
Area of Science:
- Neonatal care
- Pediatric physical therapy
- Infant motor development
Background:
- Preterm infants often experience developmental delays.
- Early motor interventions can positively impact infant outcomes.
- Parental involvement in therapy can enhance treatment efficacy.
Purpose of the Study:
- To assess the short-term impact of parent-administered physical therapy on motor performance in preterm infants.
- To compare motor outcomes between preterm infants receiving early physical therapy and those receiving usual care.
Main Methods:
- A pragmatic, multicenter randomized controlled trial involving 153 preterm infants (gestational age ≤32 weeks).
- Intervention group received 3 weeks of parent-administered physical therapy focusing on postural control, head control, and midline orientation.
- Control group received usual care; motor performance assessed using the Test of Infant Motor Performance at baseline and 37 weeks' postmenstrual age.
Main Results:
- The intervention group showed a significant improvement in motor performance z scores compared to the control group (difference = 0.42, P = .005).
- The effect size for the intervention was 0.40, indicating a moderate positive impact.
- Baseline motor performance z scores were comparable between groups before the intervention.
Conclusions:
- Parent-administered physical therapy before term-equivalent age significantly enhances motor performance in preterm infants.
- This brief intervention offers a promising approach to improving early motor development in this population.
- Long-term follow-up is ongoing to determine sustained effects up to 2 years corrected age.
Objective:
To investigate the short-term effect of parent-administered physical therapy in the preterm period on motor performance in medically stable infants.
Methods:
This study was a pragmatic, multicenter, randomized controlled trial including 153 infants born at gestational age ≤32 weeks and randomized to an intervention (n = 74) or a control (n = 79) group. The intervention promoted postural control, head control, and midline orientation. Parents, supervised by a physical therapist, conducted the intervention 10 minutes twice a day for 3 weeks from 34 to 36 weeks' postmenstrual age (PMA). The control group received usual care. The Test of Infant Motor Performance Screening Items was used at baseline and the Test of Infant Motor Performance postintervention (week 37 PMA). Linear mixed models were used to assess change in motor performance between groups from 34 to 37 weeks' PMA by using z scores. Effect size was measured by using Cohen's d.
Results:
The mean baseline z score was 0.06 (95% confidence interval, -0.48 to 0.60). After the intervention, there was a significant group difference, indicating a change in motor performance from week 34 to 37 PMA favoring the intervention group. The estimated difference in z scores was 0.42 (95% confidence interval, 0.13 to 0.72; P = .005), and the effect size was 0.40.
Conclusions:
Parent-administered physical therapy conducted before term-equivalent age improved motor performance at 37 weeks' PMA more than conventional care. All infants will be followed up until 2 years' corrected age to evaluate the long-term effects of this brief intervention.
