Related Experiment Video
Updated: Oct 4, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A feasibility randomized controlled trial of a NICU rehabilitation program for very low birth weight infants
Lisa Letzkus1,2, Mark Conaway3, Claiborne Miller-Davis4
1Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA. lmc8c@virginia.edu.
Insights
The NeoRehab program, involving parents in preterm infant care, was acceptable and feasible for very low birthweight infants. A goal of 3 interventions per week, rather than 5, appears achievable for parents.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Motor disabilities are common in preterm infants.
- Parental involvement in NICU care can improve outcomes.
- The NeoRehab program offers sensory and motor interventions by parents.
Purpose of the Study:
- To assess the acceptability, feasibility, and fidelity of the NeoRehab program.
- To evaluate parent engagement with NeoRehab interventions for VLBW infants.
- To determine optimal dosing for parent-delivered interventions in NICU settings.
Main Methods:
- A randomized controlled trial compared NeoRehab to usual care in VLBW infants (≤32 weeks GA or ≤1500g).
- Parents delivered interventions 5 days/week as the goal.
- Acceptability, feasibility, and fidelity were primary outcomes.
Main Results:
- Recruitment was 71%, retention 98%.
- No infants met the 5-day/week goal, but 97% performed interventions ≥3 times/week.
- The program was acceptable to parents; motor interventions were most challenging.
Conclusions:
- The NeoRehab program is acceptable and feasible for parents of VLBW infants.
- A goal of 3 interventions/week is feasible in the US, unlike 5 days/week.
- Future studies should explore alternative strategies for motor interventions and dosing impact on long-term outcomes.
Abstract:
Motor disability is common in children born preterm. Interventions focusing on environmental enrichment and emotional connection can positively impact outcomes. The NICU-based rehabilitation (NeoRehab) program consists of evidence-based interventions provided by a parent in addition to usual care. The program combines positive sensory experiences (vocal soothing, scent exchange, comforting touch, skin-to-skin care) as well as motor training (massage and physical therapy) in a gestational age (GA) appropriate fashion. To investigate the acceptability, feasibility and fidelity of the NeoRehab program in very low birthweight (VLBW) infants. All interventions were provided by parents in addition to usual care. Infants (≤ 32 weeks' GA and/or ≤ 1500 g birthweight) were enrolled in a randomized controlled trial comparing NeoRehab to usual care (03/2019-10/2020). The a priori dosing goal was for interventions to be performed 5 days/week. The primary outcomes were the acceptability, feasibility and fidelity of the NeoRehab program. 36 participants were randomized to the intervention group and 34 allocated to usual care. The recruitment rate was 71% and retention rate 98%. None of the interventions met the 5 days per week pre-established goal. 97% of participants documented performing a combination of interventions at least 3 times per week. The NeoRehab program was well received and acceptable to parents of VLBW infants. Programs that place a high demand on parents (5 days per week) are not feasible and goals of intervention at least 3 times per week appear to be feasible in the context of the United States. Parent-provided motor interventions were most challenging to parents and alternative strategies should be considered in future studies. Further studies are needed to evaluate the relationship between intervention dosing on long term motor outcomes.
