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Published on: October 11, 2011
Effects of a Parent-Administered Exercise Program in the Neonatal Intensive Care Unit: Dose Does Matter-A Randomized
Gunn Kristin Øberg1, Gay L Girolami2, Suzann K Campbell3
1Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, PB 6050 Langnes, Tromsø, 9037 Norway; and Department of Clinical Therapeutic Services, University Hospital North Norway, Tromsø, Norway.
Insights
A parent-administered exercise program in the neonatal intensive care unit (NICU) did not significantly improve motor skills in preterm infants. However, higher intervention doses correlated with better motor outcomes at three months corrected age.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Preterm infants face risks of delayed motor development.
- Interventions within the neonatal intensive care unit (NICU) and their dosing effects require further investigation.
Purpose of the Study:
- To assess a parent-administered exercise program's effectiveness on preterm infants' motor outcomes at 3 months corrected age (CA).
- To determine the impact of intervention dosage on motor performance in this population.
Main Methods:
- A randomized clinical trial involving 153 infants born before 32 weeks gestational age.
- A 3-week, twice-daily, 10-minute parent-administered exercise program in the NICU.
- Motor outcome assessed using the Test of Infant Motor Performance (TIMP) at 3 months CA.
Main Results:
- No significant difference in TIMP z-scores between intervention and control groups at 3 months CA.
- A significant positive association between total intervention dose and TIMP z-scores.
- Infants receiving less than the median intervention time had approximately 6 times higher odds of a clinical z-score < 0.
Conclusions:
- The parent-administered exercise program showed no overall difference in motor performance at 3 months CA.
- Increased intervention dosage was positively linked to improved motor outcomes.
- Further research is needed, considering limitations such as small sample size for extremely preterm infants and potential spillover effects.
Background:
Despite the risk of delayed motor development in infants born preterm, knowledge about interventions in the neonatal intensive care unitt (NICU) and the effects of dosing is sparse.
Objective:
The objectives of this study were to examine the effectiveness of a parent-administered exercise program in the NICU on motor outcome at 3 months corrected age (CA) and the effect of dosing on motor performance.
Design:
This was a randomized clinical trial.
Setting:
The study was conducted at 3 university hospitals in Tromsø, Trondheim, and Oslo, Norway.
Participants:
A total of 153 infants with gestational age <32 weeks at birth were randomly assigned to intervention or control groups.
Intervention:
A 3-week parent-administered intervention designed to facilitate movements in preterm infants was performed in the NICU. Parents were asked to administer the intervention 10 minutes twice a day.
Measurements:
Test of Infant Motor Performance (TIMP) was used to assess short-term outcome at 3 months CA.
Results:
No significant difference in the TIMP z-score was found between intervention and control groups at follow-up 3 months CA, but a significant positive relationship was found between total intervention dose and TIMP z-scores. The adjusted odds of having a clinical z-score < 0 at 3 months CA was about 6 times higher for infants with less than median intervention time than for infants with a longer intervention time.
Limitations:
The number of infants born before 28 weeks was small. A spillover effect in favor of the control group was possible. We do not know if the infants received physical therapy after discharge from the hospital.
Conclusions:
There was no difference in motor performance between the intervention group and the control group at 3 months CA. However, an increased intervention dose was positively associated with improved motor outcome.
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