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Effectiveness of oro-motor sensory stimulation in preterm neonates: A systematic review and meta-analysis
Abhishek Sharma1, Aksh Chahal2, Richa Hirendra Rai3
1Department of Physiotherapy, Graphic Era College of Paramedical Sciences, Graphic Era (Deemed to Be University), Dehradun, Uttarakhand, India.
Insights
Oral Sensory-Motor Stimulation (OSMS) significantly improves feeding ability, weight gain, and reduces hospital stays for preterm infants. This intervention also shows promise for enhancing neuromotor behavior in Neonatal Intensive Care Units (NICUs).
Area of Science:
- Neonatal Intensive Care
- Developmental Pediatrics
- Evidence-Based Medicine
Background:
- Preterm neonates frequently experience feeding difficulties, neuromotor challenges, and extended hospitalizations.
- Oral Sensory-Motor Stimulation (OSMS) is a potential intervention to mitigate these issues in Neonatal Intensive Care Units (NICUs).
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of OSMS compared to standard care for preterm neonates.
- To evaluate OSMS's impact on feeding ability, motor function, weight gain, and length of hospital stay.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials and cohort studies (2000-2024).
- Included 9 studies with 611 preterm neonates; excluded those with severe complications or on assisted ventilation.
- Data analyzed using random-effects models with heterogeneity assessed via I² and Cochran's Q tests.
Main Results:
- OSMS significantly reduced time to voluntary feeding by 3.5 days (95% CI: -4.2 to -2.8).
- Associated with increased daily weight gain of 7g (95% CI: 6-10g) and decreased hospital stay by 5.1 days (95% CI: -6.4 to -3.8).
- Qualitative synthesis indicated potential improvements in neuromotor behavior.
Conclusions:
- OSMS is an effective intervention for preterm neonates in NICUs, improving feeding, weight gain, and reducing hospital stay.
- Evidence suggests OSMS also positively impacts neuromotor development, warranting further investigation.
Abstract:
BackgroundPreterm neonates often face challenges with feeding ability, neuromotor behavior, weight gain, and prolonged hospital stays. Oral Sensory-Motor Stimulation (OSMS) has been suggested as a beneficial intervention to address these issues. This systematic review and meta-analysis aim to evaluate the effectiveness of OSMS compared with standard care on feeding ability, motor function, weight gain, and length of hospital stay in preterm neonates admitted to Neonatal Intensive Care Units (NICUs).MethodsA thorough literature search was conducted across databases including PubMed, Scopus, Web of Science, Cochrane Library, CINAHL, and Embase focusing on studies published between 1, January 2000 and 10 December 2024. Randomized controlled trials (RCTs) and cohort studies examining the impact of OSMS on the specified outcomes in preterm neonates were included. Neonates with severe medical, neurological, congenital, or cardiorespiratory complications, along with those on assisted ventilation, formula feeding, or presenting clinical instability, were excluded. Data extraction and quality assessment were performed independently by two reviewers, and meta-analyses were conducted using random-effects models to account for heterogeneity among studies. Results were synthesized using random-effects models and presented through forest plots, with heterogeneity assessed using I2 and Cochran's Q tests. Subgroup analyses were performed to evaluate result stability and explore potential sources of variability. RevMan 5.4.1 was used to conduct data analysis.ResultsA total of nine studies met the inclusion criteria with total 611 participants. Across studies, random sequence generation and selective reporting were consistently low risk, while allocation concealment was adequate in seven of nine studies. The meta-analysis revealed that OSMS significantly improved feeding ability, as evidenced by a reduction in time to achieve voluntary feeding (mean difference: -3.5 days; 95% CI: -4.2 to -2.8). Weight gain was positively affected, with an average increase of 7 g per day (95% CI: 6-10 g). Additionally, OSMS was associated with a reduced length of hospital stay (mean difference: -5.1 days; 95% CI: -6.4 to -3.8). Improvements in neuromotor behavior were observed based on qualitative synthesis, rather than meta-analytic pooled estimates.ConclusionOSMS is an effective intervention for improving feeding ability, motor function, weight gain, and reducing the length of hospital stay in preterm neonates admitted to NICUs. In addition to the meta-analytically supported benefits of OSMS on feeding ability, weight gain, and reduced hospital stay, qualitative evidence from select studies suggests potential improvements in neuromotor behavior.
