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Influence of varied stimuli on development of motor patterns in the premature infant
Insights
This study investigated the impact of patterned sound on premature infants. While the majority of infants showed normal limb activity and laterality, the auditory interventions did not yield statistically significant group differences.
Area of Science:
- Neonatal Development
- Auditory Stimulation
- Infant Motor Activity
Background:
- Premature infants face risks of mortality and morbidity.
- The extrauterine environment lacks the patterned stimuli of the womb, potentially affecting development.
- Auditory stimulation is a promising modality for modulating infant motility and cortical activity.
Purpose of the Study:
- To assess the effects of patterned sound on gross motor activity, limb activity patterns, and laterality in premature infants.
- To determine if specific auditory interventions could normalize motor development by 36 weeks gestation.
- To compare the effects of ambient noise, mother's voice, and Brahm's Lullaby on infant neurodevelopmental markers.
Main Methods:
- A randomized controlled trial involving 203 premature infants (gestational age 26-33 weeks).
- Infants were assigned to three groups: routine ambient noise, mother's voice recording, or Brahm's Lullaby.
- Limb activity was measured using accelerometers over 48 hours, assessing gross motor activity, upper vs. lower limb predominance, and laterality.
Main Results:
- No statistically significant differences in limb activity patterns were found among the three auditory intervention groups.
- High intragroup variation in gross motor activity limited the ability to detect between-group differences.
- Most infants, regardless of group, exhibited a predominance of upper limb activity and developed laterality.
Conclusions:
- The studied patterned sound interventions did not produce statistically significant differences in motor activity or laterality compared to ambient noise.
- Further research with larger sample sizes or different auditory paradigms may be needed to explore the potential benefits of sound stimulation.
- Premature infants generally demonstrate a predominance of upper limb activity and laterality by the time of discharge.
Abstract:
The premature infant is at risk for both mortality and morbidity. His writhing contributes to weight loss, and his extrauterine environment does not contain the multi-modality patterned afferent stimuli that impinge upon the developing brain in utero. Sound is the most effective modality to achieve concurrent decrement in motility along with enhancement of cortical activity. It was anticipated that subjects exposed to 5 minutes of patterned sound 6 times a day would, by 36 weeks gestation, evidence: (a) less gross motor activity, (b) the normal predominance of upper over lower limb activity, and (c) beginning laterality. The sample consisted of 80 males and 73 females whose gestational age at birth was 26--33 weeks. By random assignment 52 subjects were exposed to the routine ambient noise of the isolette and nursery, 50 to a tape recording of their mother's voice, and 51 to an orchestral arrangement of Brahm's Lullaby. Limb activity was measured just prior to discharge by accelerometers worn unilaterally for a 24-hour period on the ankle and wrist prior to transfer to the alternate side for an additional 24 hours. No statistically significant differences were demonstrated among the limb patterns of the 3 groups. Large intragroup variation in gross activity precluded demonstration of between-group differences. The majority of subjects evidenced predominance of upper limb activity and laterality.