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Effects of Self-Regulated Physical Activity in Premature Infants on Bone Density and Length of Stay: A Pilot Study
Barbara Kozol1, Patricia Jett2
1Barbara Kozol, MS, OTL, is Occupational Therapist, Rogue Regional Medical Center, Medford, OR; rickbarbkozol@gmail.com.
Insights
Premature infants wearing "prepod" garments showed reduced bone density loss and a significant decrease in length of stay compared to traditional exercises. This innovative approach supports infant development and hospital cost savings.
Area of Science:
- Neonatal care
- Pediatric physical therapy
- Bone metabolism in premature infants
Background:
- Premature infants possess underdeveloped physical, developmental, and cognitive skills necessary for typical newborn survival.
- Assessing interventions to mitigate health complications in premature infants is crucial for improving outcomes.
Purpose of the Study:
- To evaluate the efficacy of spontaneous physical activity induced by "prepod" garments in premature infants for slowing bone density loss.
- To compare the effectiveness of "prepod" garments against traditional physical therapy exercises in maintaining bone density.
Main Methods:
- A nonrandomized study involving preterm, very low birth weight infants (28-32 weeks postmenstrual age) without medical complications.
- Infants were divided into two groups: a control group receiving traditional exercises and an experimental group wearing "prepod" garments for nearly 24 hours daily.
- Bone density was assessed using tibial ultrasound, with weight gain, head circumference growth, and length of stay (LOS) also measured.
Main Results:
- The "prepod" group exhibited less bone density loss than the traditional exercise group, exceeding expectations for bone health maintenance.
- A notable and unexpected finding was a significant reduction in the length of stay (LOS) for infants in the "prepod" group.
- While not statistically significant, ultrasound results indicated a positive trend in bone density preservation with "prepod" use.
Conclusions:
- Spontaneous physical activity facilitated by "prepod" garments effectively decreases bone loss and reduces length of stay in premature infants.
- Improved bone health and enhanced developmental maturity contribute to better developmental outcomes and significant hospital cost savings.
- The "prepod" offers a simple, cost-effective, and noninvasive tool for occupational therapy practitioners to support premature infant development and positively impact healthcare delivery.
Importance:
Premature infants are not prepared developmentally, physically, or cognitively with the multiple survival skills of the typical newborn.
Objective:
To determine whether physical activity generated spontaneously by premature infants stretching against the resistance of "prepod" garments is as effective as exercises provided by therapists in slowing bone density loss.
Design:
Preterm very low birth weight infants were placed in two nonrandomized parallel groups according to birth age.
Setting:
Infants routinely started in a traditional intense intervention setting and graduated to a special care section with private rooms that allowed parents to remain with their child.
Participants:
Healthy infants without medical complications, born between 28 and 32 wk postmenstrual age.
Intervention:
The control group received traditional exercises. The experimental group wore a prepod almost 24 hr a day. Outcomes and Measures: An ultrasound of the tibia was obtained at 31 to 32 wk and 4 wk later. Weight gain, head circumference growth, and length of stay (LOS) were also measured.
Results:
Although not statistically significant, the ultrasound results showed that the prepod group had less loss of bone density than the traditional therapy exercise group. The desired outcome was for pods to be as effective at reducing bone loss as traditional exercise, so the results exceeded expectations. The unexpected, and more notable, finding was a striking drop in LOS for the prepod group.
Conclusions And Relevance:
Spontaneous exercise by premature infants decreases bone loss and LOS. Better bone health and increased developmental maturity increase the chances of a positive developmental outcome and save the hospital significant expense. What This Article Adds: The prepod is a simple, cost-effective, noninvasive treatment tool occupational therapy practitioners can use to support a premature infant's development. This study has considerable potential to affect how infants are served, both developmentally and financially.
