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Effect of physical activity on bone mineralization in premature infants
L Moyer-Mileur1, M Luetkemeier, L Boomer
1Department of Pediatrics, University of Utah, Salt Lake City 84132, USA.
Insights
Physical activity programs promote bone health in preterm infants. This study found that a daily physical activity regimen significantly improved bone mineralization and weight gain in very low birth weight infants.
Area of Science:
- Neonatal Medicine
- Pediatric Bone Health
- Physical Therapy in Neonates
Background:
- Preterm infants, especially those with very low birth weight, are at increased risk for osteopenia and impaired bone development.
- Optimal nutrition is crucial, but its effects on bone mineralization may be enhanced by other interventions.
Purpose of the Study:
- To evaluate the impact of a 4-week physical activity program on bone mineralization in preterm infants.
- To assess if physical activity influences weight gain and bone mineral content in this vulnerable population.
Main Methods:
- A pilot study involving 26 preterm infants, randomly assigned to a physical activity group (EX) or a control group (C).
- Physical activity involved passive range of motion exercises for 5-10 minutes daily.
- Bone mineral analyses and serum biochemical markers were measured at baseline and after 4 weeks.
Main Results:
- Infants in the physical activity group showed significantly greater weight gain compared to controls.
- Radial bone mass and density significantly increased in the EX group, while the control group experienced losses.
- The physical activity program enhanced bone width, mineral density, and content, with notable improvements in the EX group versus declines in the C group.
Conclusions:
- A physical activity program can augment the benefits of adequate nutrition in preterm infants.
- This intervention promotes weight gain and enhances bone mass development, potentially reducing the risk of osteopenia in very low birth weight infants.
Objective:
A 4-week pilot study was done with 26 preterm infants to evaluate whether a physical activity program would result in greater bone mineralization.
Design:
Subjects were matched by birth weight, gender, and gestational age, and randomly assigned to the physical activity program (group EX; n = 13) or to the control group (group C; n = 13). Physical activity consisted of range of motion with passive resistance to all extremities for 5 to 10 minutes daily. Baseline and 4-week values were determined for both bone mineral analyses and serum levels of calcium, phosphate, alkaline phosphatase, parathyroid hormone, and 25-hydroxy-vitamin D.
Results:
Despite similar nutrient intake at advised levels for preterm infants, EX infants gained more weight than control subjects (17.8 vs 13.4 gm/kg body weight per day; p = 0.01). A difference in radial bone mass and density change as determined by single-beam photon absorptiometry (+/- 2% error) was found between groups (p = 0.006 by analysis of covariance). Changes in bone width and in bone mineral content and density were enhanced by physical activity. Group EX infants had 12%, 18%, and 34% gains in bone width and in bone mineral density and content, respectively; group C infants had only a 2% gain in bone width and 11% and 14% losses from baseline in bone mineral content and density, respectively, during the 4-week study. Serum biochemical values were similar in the groups except for lower alkaline phosphatase levels in group EX. There was a negative association between bone mineral content and parathyroid hormone values: r = -0.83, p = 0.01.
Conclusions:
A physical activity program may increase the effects of adequate nutrition in healthy preterm very low birth weight infants by promoting weight gain and bone mass and by decreasing the risk of osteopenia.