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Published on: November 20, 2015
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.
Insights
The Homeostasis-Enrichment-Plasticity (HEP) Approach significantly improved motor skills and sensory functions in preterm infants compared to Traditional Treatment. Both interventions also reduced caregiver anxiety.
Area of Science:
- Developmental Pediatrics
- Neurorehabilitation
- Infant Health
Background:
- Preterm infants face increased developmental risks.
- Early intervention is crucial for optimizing outcomes.
- The Homeostasis-Enrichment-Plasticity (HEP) Approach offers a novel therapeutic strategy.
Purpose of the Study:
- To compare the effectiveness of the HEP Approach against Traditional Treatment (TT) for physical and occupational therapy in high-risk preterm infants.
- To evaluate the impact of HEP and TT on motor skills, sensory functions, and parental anxiety.
Main Methods:
- A randomized controlled trial involving 29 preterm infants (4-10 months adjusted age).
- Infants were assigned to either the HEP Approach or TT group for 12 weekly sessions.
- The Peabody Developmental Motor Scales-2 (PDMS-2), Test of Sensory Functions in Infants (TSFI), and Beck Anxiety Inventory (BAI) were used for pre- and post-intervention assessments.
Main Results:
- Both groups showed significant improvements in motor skills (PDMS-2) and sensory functions (TSFI).
- The HEP Approach group demonstrated significantly greater improvements in Fine Motor Quotient, Gross Motor Quotient, and Total Motor Quotient compared to the TT group.
- The HEP Approach group also showed superior gains in Adaptive Motor Functions and Visual-Tactile Integration, as well as overall TSFI scores.
- Parental anxiety (BAI) decreased significantly in both groups, with no significant difference between interventions.
Conclusions:
- The HEP Approach is a more effective intervention than TT for enhancing motor and sensory development in preterm infants.
- Both HEP and TT interventions contribute to reducing caregiver anxiety.
- These findings support the integration of the HEP Approach in clinical practice for preterm infants with developmental risks.
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.
