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General movement based therapy to support neurodevelopment of preterm infants: a randomized clinical trial
Anna Badura1, Annika Dietz2, Florian Zeman3
1Department of Neonatology, University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John of God, University of Regensburg, Regensburg, Germany. Anna.badura@barmherzige-regensburg.de.
Insights
This study found that a parent-led General Movement (GM) intervention did not significantly improve neurodevelopment or parental mental health in very preterm infants. However, the approach showed promise for infants with early neurodevelopmental challenges.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Preterm birth (before 32 weeks gestation) is linked to neurodevelopmental impairments.
- Early intervention is crucial for improving outcomes in high-risk infants.
- General Movement (GM) based interventions are a potential therapeutic approach.
Purpose of the Study:
- To assess the feasibility and effectiveness of a parent-led GM intervention for very preterm infants.
- To evaluate the impact of GM intervention on infant neurodevelopment and parental mental health.
- To explore the role of GM therapy in mitigating neurodevelopmental risks associated with preterm birth.
Main Methods:
- A prospective, randomized-controlled trial involving very preterm infants (gestational age <32 weeks or birth weight <1500g).
- Intervention group received 10 weeks of parent-led GM treatment (3x daily) starting at 34 weeks postmenstrual age (PMA), with telehealth support.
- Control group received standard care. Neurodevelopment was assessed until 2 years corrected age; parental mental health and biomarkers were secondary outcomes.
Main Results:
- Sixty-six infants were randomized (32 control, 34 intervention).
- No significant differences were found between groups in neurodevelopmental outcomes or parental mental health.
- A notable observation was that all three infants in the intervention group with initial poor neuromotor features achieved good neurodevelopment at follow-up.
Conclusions:
- Parent-led GM intervention is feasible and well-received in very preterm infants.
- While overall outcomes were similar, the intervention may benefit infants showing early signs of neurodevelopmental difficulties.
- Further research is needed to optimize participant selection and adherence for GM-based therapies in preterm populations.
Background:
Preterm birth increases the risk of neurodevelopmental impairments, emphasizing the need for early interventions. This study aimed to assess the feasibility and effectiveness of a General Movement (GM)-based intervention on infant neurodevelopment and parental mental health.
Method:
In a prospective, randomized-controlled trial, very preterm infants (gestational age <32 weeks or birth weight <1500 g) were enrolled between October 1, 2021, and June 6, 2023. Infants received a three times daily GM-based treatment by trained parents over 10 weeks starting at 34 weeks PMA or standard care. Primary outcome was neurodevelopment until 2 years' corrected age, secondary outcomes included parental mental health and serum levels of brain damage biomarkers.
Results:
Sixty-six infants were randomized (32 control, 34 intervention). The median birth weight was 1243 g (IQR, 919-1623 g) in the control group and 1035 g (IQR, 853-1230 g) in the GM group. No significant group differences were observed for neurodevelopment outcome and parental mental health. Interestingly, all three infants displaying poor neuromotor features in the intervention group before treatment showed good neurodevelopment in the follow-up.
Conclusion:
Our findings suggest a potential role of GM-based intervention in high-risk preterm infants. Future research should focus on improved participant selection and adherence.
Impact:
A General Movement (GM)-based early intervention starting at 34 weeks PMA, led by parents with telehealth support over 10 weeks from pediatric physiotherapists, was both feasible and well-received. Infant neurodevelopment until 2 years' corrected age and parental mental health were similar in both the intervention and control groups. The approach may be especially helpful for preterm infants who show early signs of neurodevelopmental challenges. As one of the first studies of its kind, this RCT adds valuable knowledge about GM-based therapy for very preterm infants. The results support the importance of personalized early interventions to meet the unique needs of each infant.
