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Stimulating the motor development of very premature infants: effects of early crawling training on a mini-skateboard
Marie-Victorine Dumuids-Vernet1, Vincent Forma1, Joëlle Provasi2
1Université Paris Cité, CNRS, Integrative Neuroscience and Cognition Center (INCC), Paris, France.
Insights
Early crawling intervention using the Crawliskate significantly improved gross motor and general development in very premature infants. This home-based therapy also promoted mature crawling skills by 9 months corrected age.
Area of Science:
- Neonatal development
- Pediatric physical therapy
- Developmental pediatrics
Background:
- Very premature infants often experience developmental delays.
- Early intervention is crucial for optimizing outcomes in this population.
- Standard care may not fully address the specific motor needs of preterm infants.
Purpose of the Study:
- To evaluate the impact of an 8-week home-based crawling intervention on very premature infants.
- To assess the effects on gross motor and general development up to 12 months corrected age.
- To determine if early crawling practice influences later crawling maturity.
Main Methods:
- 44 infants born before 32 weeks gestation were randomized into three groups: Crawliskate (Crawli), Mattress (prone positioning), or Control (standard care).
- The Crawli and Mattress groups received 8 weeks of daily 5-minute home training post-NICU discharge.
- Motor development (Bayley-III) and general development (ASQ-3) were assessed at multiple time points up to 12 months corrected age.
Main Results:
- Crawli group infants demonstrated significantly higher gross motor scores (Bayley-III) compared to Mattress and Control groups.
- The Crawli group showed superior performance in specific motor skills, including crawling at 9 months corrected age.
- Significant improvements were observed in ASQ-3 total, communication, and fine motor scores for the Crawli group compared to controls.
Conclusions:
- Home-based crawling intervention with the Crawliskate is effective in enhancing motor and general development in very premature infants.
- The study provides evidence for a direct link between early crawling practice and improved motor milestones.
- This intervention offers a promising strategy for supporting developmental trajectories in high-risk infants.
Aim:
To examine the effects of an early home-based 8-week crawling intervention performed by trained therapists on the motor and general development of very premature infants during the first year of life.
Methods:
At term-equivalent age, immediately following discharge from the Neonatal Intensive Care Unit (NICU), we randomly allocated 44 premature infants born before 32 weeks' gestation without major brain damage to one of three conditions in our intervention study: crawling on a mini-skateboard, the Crawliskate (Crawli), prone positioning control (Mattress), or standard care (Control). The Crawli and Mattress groups received 5 min daily at-home training administered by trained therapists for 8 consecutive weeks upon discharge from the NICU. The outcomes of greatest interest included gross motor development (Bayley-III) at 2, 6, 9, and 12 months (primary outcome) corrected age (CA), mature crawling at 9 months CA and general development at 9 and 12 months CA [Ages and Stages Questionnaires-3 (ASQ-3)]. The study was registered at www.clinicaltrials.gov; registration number: NCT05278286.
Results:
A 3 (Condition) × 4 (Age) repeated measures ANOVA revealed that Crawli group infants had significantly higher Bayley-III gross motor development scores than Mattress and Control group infants. Crawli group infants also scored significantly higher on groups of Bayley-III items related to specific motor skills than infants in the other groups, including crawling at 9 months CA. We found significant differences in favor of the Crawli group in separate one-way ANOVAs at each of the ages we examined. A 3 (Condition) × 2 (Age) repeated measures ANOVA revealed that the Crawli group scored significantly higher than the Control group for the ASQ-3 total score and communication score and significantly higher for the fine motor score than the Control and Mattress groups. We found additional significant differences in favor of the Crawli group for other dimensions of the ASQ-3 in separate one-way ANOVAs at 9 and 12 months CA.
Interpretation:
Early crawling training on a Crawliskate provides an effective way to promote motor and general development in very premature infants. The findings also provide clear evidence for a link between newborn crawling and more mature crawling later in development.
