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Length of Neuromuscular Re-education Therapy and Growth Parameters in Premature Infants
Mariana Leone1, Jessica Alsofrom2, Megan Kane3
1Department of Maternal and Child Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia.
Insights
Neuromuscular re-education (NMRE) therapy for premature infants may improve neurodevelopment without negatively impacting physical growth. Studies show NMRE is not associated with adverse effects on weight and length gain in these vulnerable infants.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Neuromuscular re-education (NMRE) therapy is utilized to enhance neurodevelopmental maturation in premature infants.
- Concerns exist that NMRE might induce stress, potentially leading to suboptimal growth or failure to thrive.
Purpose of the Study:
- To examine the association between NMRE and physical growth parameters (weight and length) in premature infants.
- To assess if NMRE therapy negatively impacts growth metrics at 36 weeks postmenstrual age and at discharge.
Main Methods:
- Analysis of data from 253 premature infants (gestational age <34 weeks or birth weight <1,800g).
- Correlation coefficient analysis was used to determine the association between NMRE duration and growth parameters.
- Multilinear regression models were employed to control for potential confounding factors.
Main Results:
- NMRE showed an inverse correlation with weight at birth and 36 weeks PMA but a direct correlation with weight change over time.
- No negative correlation was found between NMRE and daily weight gain from birth to discharge.
- Similar findings were observed for length changes, and results remained consistent after controlling for confounders.
Conclusions:
- Neuromuscular re-education therapy, while aimed at improving neurodevelopmental outcomes in premature infants, does not appear to have a detrimental effect on their physical growth.
- The findings suggest that NMRE can be safely integrated into the care of premature infants without compromising physical development.
Objective:
Neuromuscular re-education (NMRE) therapy including bracing, containment, facilitation techniques, joint compression, weight (WT) bearing, and myofascial release has been shown to improve neurodevelopmental maturation in premature infants. This study aimed to examine the association of NMRE with growth parameters including WT and length (L) at 36 weeks postmenstrual age (PMA) and at discharge.
Study Design:
We analyzed data of infants <34 weeks gestational age (GA) or <1,800 g birth weight (BW) to examine the association of NMRE with growth parameters using correlation coefficient analysis. The effect of potential confounders was examined using multilinear regression models.
Results:
Study includes 253 premature infants. Average GA was 300/7 weeks (±23/7) and BW was 1,315 g (±416), 49.8% were females and 65% were African Americans. NMRE has inverse correlation with WT at birth and at 36 weeks PMA, -0.66 (<0.001) and -0.21 (<0.001), respectively, but not at the time of discharge. NMRE has direct correlation with change in WT from birth to 36 weeks PMA and time of discharge, 0.50 (<0.001) and 0.62 (<0.001), respectively, and from the time of starting therapy to 36 weeks PMA or discharge, 0.25 (<0.001) and 0.51 (<0.001), respectively. There was no negative correlation between NMRE with daily WT gain from birth to 36 weeks PMA or to discharge, -0.05 (0.43) and -0.07 (0.23), respectively, or from the time of starting therapy to 36 weeks PMA, -0.09 (0.14). There was an inverse correlation between NMRE with average WT gain per day from the time of starting therapy to discharge, -0.26 (<0.001), Similar findings were found examining the correlation between NMRE and changes in L. Multilinear regression analysis examining the relationship while controlling for GA, BW, sex, and race; socioeconomic variables; and concurrent massage therapy and sensory integration revealed similar results.
Conclusion:
NMRE, aimed to enhance neurodevelopmental outcomes of premature infants, may not have a negative impact on their physical growth.
Key Points:
· NMRE has been introduced in the care of premature infants to improve neurodevelopmental outcomes.. · It was hypothesized that NMRE may cause stress and lead to failure to thrive or suboptimal growth.. · The association of the duration of NMRE with length and weight gain in very low birth weight infants was examined, and there was no negative correlation..
