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Two-year motor outcomes associated with the dose of NICU based physical therapy: The Noppi RCT
Gunn Kristin Øberg1, Bjørn Helge Handegård2, Suzann K Campbell3
1Department of Health and Care Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Clinical Therapeutic Services, University Hospital North Norway, Tromsø, Norway.
Insights
Parental intervention for preterm infants showed no group difference in motor skills at 24 months corrected age. However, higher intervention dosage positively impacted gross and total motor scores, suggesting dosage is key for preterm infant motor development.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Parent-infant interventions show cognitive benefits but less impact on motor outcomes in preterm infants.
- Optimal timing and dosage for early intervention in preterm infants remain unclear.
- Early motor development in preterm infants requires further investigation regarding intervention effectiveness.
Purpose of the Study:
- To assess the impact of a parent-administered intervention on motor performance in preterm infants at 24 months corrected age.
- To analyze the relationship between intervention dosage and longitudinal motor performance.
- To investigate the effects of early intervention on motor outcomes in the neonatal intensive care unit (NICU) population.
Main Methods:
- Single-blinded, randomized, multicenter clinical trial involving 153 preterm infants (gestational age ≤ 32 weeks).
- Infants were randomized into intervention or control groups.
- Motor performance was assessed using the Peabody Developmental Motor Scales-2 (PDMS-2) at 24 months corrected age, alongside other motor assessments.
Main Results:
- No significant difference in overall motor performance was observed between the intervention and control groups at 24 months corrected age.
- A significant positive association was found between higher intervention dosage and improved Gross Motor and Total Motor scores on the PDMS-2.
- Longitudinal analysis revealed a decline in motor performance between 6 and 24 months corrected age in both groups.
Conclusions:
- Parent-administered interventions did not significantly improve overall motor performance in preterm infants by 24 months corrected age.
- Increased intervention dosage demonstrated a positive association with enhanced motor outcomes, particularly in gross and total motor domains.
- Further research is needed to optimize intervention strategies and timing for preterm infant motor development.
Background:
Interventions involving both the parent and the preterm infant have demonstrated lasting effects on cognitive outcomes, but motor effects are less salient. It remains unclear when to commence early intervention and if dosages have impact on motor outcomes.
Aims:
To examine the effect on motor performance at 24-months corrected age following a parent-administered intervention performed with infants born preterm in the NICU. Intervention dosing and longitudinal motor performance were also analyzed.
Study Design:
Single-blinded randomized multicenter clinical trial.
Subjects:
153 infants born, gestational age ≤ 32 weeks at birth, were randomized into intervention or control group.
Outcome Measures:
Infant Motor Performance Screening Test, Test of Infant Motor Performance, Peabody Developmental Motor Scales-2.
Results:
No significant difference was found between the intervention and the control group assessed with the PDMS-2 at 24-months CA. However, a significant positive association was found between dosing and the Gross Motor and Total Motor PDMS-2 scores. Analysis of longitudinal motor performance showed a decreasing motor performance between 6- and 24-months corrected age in both groups.
Conclusions:
There was no difference in motor performance between groups at 24-months corrected age. However, increased intervention dosage was positively associated with improved motor outcome.
