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Physical Therapy to Prevent Osteopenia in Preterm Infants: A Systematic Review
Galaad Torró-Ferrero1, Francisco Javier Fernández-Rego2, Antonia Gómez-Conesa3
1International School of Doctorate of the Univesity of Murcia (EIDUM), University of Murcia, 30100 Murcia, Spain.
Insights
Physiotherapy, including daily passive mobilizations with joint pressure, can improve bone mineralization in preterm infants. This intervention helps prevent and treat osteopenia in vulnerable newborns.
Area of Science:
- Neonatal care
- Pediatric physiotherapy
- Bone metabolism
Background:
- Preterm infants experience reduced bone mineralization due to lower calcium incorporation in the third trimester.
- Osteopenia is a common concern in infants born prematurely.
- Physiotherapy interventions are being explored for their potential in managing neonatal bone health.
Purpose of the Study:
- To systematically review and synthesize evidence on physiotherapy modalities for preventing and treating osteopenia in preterm infants.
- To evaluate the effectiveness of different physiotherapy approaches in improving bone mineralization.
Main Methods:
- A comprehensive literature search was conducted across multiple databases from September 2019 to February 2021.
- Data extraction included study design, participant characteristics, interventions, and outcomes.
- Methodological quality and risk of bias were assessed using PEDro and ROB-2 scales.
Main Results:
- Sixteen studies were analyzed, with methodological quality scores ranging from 3 to 8.
- All included studies raised some concerns regarding risk of bias.
- Passive mobilizations with joint pressure were the most common intervention (15/16 studies) for osteopenia prevention, varying in intensity and frequency.
Conclusions:
- A daily exercise program incorporating passive mobilizations with joint pressure demonstrates a positive effect on bone mineralization in preterm infants.
- Physiotherapy interventions, specifically joint pressure mobilizations, are beneficial for improving bone health in neonatal units.
Background:
During the last trimester of pregnancy, about 80% of the infant's calcium is incorporated, and for this reason, preterm infants have less bone mineralization compared to those born at term. The aim of the present systematic review was to identify, evaluate and summarize the studies that deal with the effect of physiotherapy modalities in the prevention and treatment of osteopenia in preterm infants.
Methods:
A comprehensive search (09/2019-02/2021) using PubMed, Web of Science, SCOPUS, ProQuest, SciELO, Latindex, ScienceDirect, PEDro and ClinicalTrials.gov was carried out. The following data were extracted: The number of participants, characteristics of the participants, design, characteristics of the intervention, outcome measures, time of evaluation and results. A non-quantitative synthesis of the extracted data was performed. The methodological quality and risk of bias were assessed using a PEDro scale and ROB-2 scale, respectively.
Results:
A total of 16 studies were analyzed, presenting a methodological quality that ranged from 3 to 8 points, and all showed some concerns regarding their risk of bias. Almost all studies (15/16) used passive mobilizations with joint pressure to prevent osteopenia, but they differed in the intensity and frequency of application.
Conclusions:
A daily exercise program of passive mobilizations with joint pressure, improves bone mineralization in preterm infants admitted to neonatal units.
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