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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.
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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