Effects of a parent-administered exercise program in the neonatal intensive care unit: Dose does matter-a randomized controlled trial

• Published in: Physical Therapy
• Main Authors: Øberg, Gunn Kristin, Girolami, Gay L, Campell, Suzann K., Ustad, Tordis, Heuch, Ivar, Jacobsen, Bjarne K., Kaaresen, Per Ivar, Aulie, Vibeke Smith, Jørgensen, Lone
• Format: Article in Journal/Newspaper
• Language: English
• Published: American Physical Therapy Association (APTA); Oxford University Press 2020
• Subjects: Norway; Tromsø
• Online Access: https://hdl.handle.net/11250/3034814; https://doi.org/10.1093/ptj/pzaa014

Background - Despite the risk of delayed motor development in infants born preterm, knowledge about interventions in the neonatal intensive care unitt (NICU) and the effects of dosing is sparse. Objective - The objectives of this study were to examine the effectiveness of a parent-administered exercise program in the NICU on motor outcome at 3 months corrected age (CA) and the effect of dosing on motor performance. Design - This was a randomized clinical trial. Setting The study was conducted at 3 university hospitals in Tromsø, Trondheim, and Oslo, Norway. Participants - A total of 153 infants with gestational age <32 weeks at birth were randomly assigned to intervention or control groups. Intervention - A 3-week parent-administered intervention designed to facilitate movements in preterm infants was performed in the NICU. Parents were asked to administer the intervention 10 minutes twice a day. Measurements - Test of Infant Motor Performance (TIMP) was used to assess short-term outcome at 3 months CA. Results - No significant difference in the TIMP z-score was found between intervention and control groups at follow-up 3 months CA, but a significant positive relationship was found between total intervention dose and TIMP z-scores. The adjusted odds of having a clinical z-score < 0 at 3 months CA was about 6 times higher for infants with less than median intervention time than for infants with a longer intervention time. Limitations - The number of infants born before 28 weeks was small. A spillover effect in favor of the control group was possible. We do not know if the infants received physical therapy after discharge from the hospital. Conclusions - There was no difference in motor performance between the intervention group and the control group at 3 months CA. However, an increased intervention dose was positively associated with improved motor outcome. acceptedVersion