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Effects of the HEP® (Homeostasis-Enrichment-Plasticity) Approach in preterm infants with increased developmental
Gamze Cagla Sirma1,2, Ayse Zengin Alpozgen3, Aymen Balikci4
1Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
Background And Objectives:
This study investigated the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach in preterm infants with increased developmental risk, compared to the Traditional Treatment (TT) intervention for physical and occupational therapy.
Materials And Methods:
Twenty-nine preterm infants (adjusted age, 4-10 months) were randomly assigned to two groups: the HEP Approach group and the TT group. The Peabody Developmental Motor Scales-2 (PDMS-2), Test of Sensory Functions in Infants (TSFI), and Beck Anxiety Inventory (BAI) were administered pre- and post-intervention. The intervention was implemented weekly for 12 weeks.
Results:
The baseline characteristics of the infants were similar. At the end of the treatment, a significant time effect was observed in motor skills and sensory functions across both groups, with improvements in all PDMS-2 and TSFI subtests (p < 0.05). Significant time × group interactions showed greater improvements in the HEP Approach group compared to the TT group for Fine Motor Quotient: F = 10.818, p = 0.003; Gross Motor Quotient: F = 5.691, p = 0.024; and Total Motor Quotient: F = 21.109, p < 0.001. For TSFI, the HEP Approach group showed greater improvements in Adaptive Motor Functions (F = 13.794, p = 0.001), Visual-Tactile Integration (F = 7.410, p = 0.011), and Total score (F = 11.316, p = 0.002). No significant time*group interactions were found for Reactivity to Tactile Deep Pressure, Ocular Motor Control, and Reactivity to Vestibular Stimulation (p > 0.05). Parental anxiety, measured by BAI, decreased significantly in both groups (F = 8.72, p = 0.006), but no significant time × group interaction was found (p > 0.05), indicating similar reductions in both groups.
Conclusion:
The HEP Approach demonstrated superior outcomes compared to the TT intervention in improving motor skills and sensory functions in preterm infants, while both interventions reduced caregiver anxiety.
