DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20175582

Effect of specific physiotherapy interventions in comparison with multisensory stimulation on neurobehavioral outcome and weight gain in preterm infants: a randomized control trial

Unis D. Nadar, Pareshkumar A. Thakkar, Chaitali Shah

Abstract


Background: A premature infant is deprived of in-utero sensory experiences which are essential for normal brain development and rather is exposed to unusual sensory stimuli in the Neonatal Intensive Care Units (NICU) that pose risk to the developing brain in terms of adverse neurodevelopmental outcomes. The objective of this study was to study and compare the effect of specific physiotherapy intervention with multisensory stimulation on neurobehavioral outcome and weight gain in preterm infants. Inclusion criteria was preterm infants appropriate for gestational age more than 32 weeks, babies who were hemodynamically stable and babies receiving full enteral feeds. Exclusion criteria were major congenital anomalies, inability to undergo intervention (any fracture) or perinatal asphyxia.

Methods: Eligible infants were randomly allocated into one of the two groups. Group A was offered multisensory stimulation: Auditory, Tactile, Visual and Vestibular (ATVV). Group B received Specific Physiotherapy Intervention (SPI) in form of kinesthetic exercises, oil massage and oral stimulation. The outcome was studied before and after intervention. Appropriate statistical tests were applied.

Results: Both the groups had better suck co-ordination and improvement on neurobehavioral scale following intervention when compared to pre-intervention status (P<0.0001). When both groups were compared, SPI group had better sucking coordination than ATVV group, improvement in neurobehavioral scale was similar in either group.

Conclusions: In preterm infants, Specific Physiotherapy Interventions are more effective in improving suck co-ordination, has better weight gain and are equally effective in improving neurobehavioral outcome compared to multisensory stimulation. 


Keywords


ATVV, Massage, Multisensory stimulation, Preterm

Full Text:

PDF

References


Ramachandran S, Dutta S. Early developmental care interventions of preterm very low birth weight infants. Indian Pediatr. 2013;50(8):765-70.

Benzies KM, Magill-Evans JE, Hayden KA, Ballantyne M. Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013;13(1):S10.

Jennische M, Sedin G. Spontaneous speech at 6 1/2 years of age in children who required neonatal intensive care in 1986-1989. Acta Paediatr. 2001;90(1):22-33.

Abubakar II, Tillmann T, Banerjee A. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;385(9963):117-71.

Cloherty, John P. Care of the extremely low birth weight infant. Manual of neonatal care (7th ed). Philadelphia: Wolters Kluwer Health/Lippincott Williams and Wilkins. 2012:146.

Jarjour IT. Neurodevelopmental outcome after extreme prematurity: a review of the literature. Pediatric Neurol. 2012;52(2):143-52.

Blencowe H, Cousens S, Oestergaard M, Chou D, Moller AB, Narwal R, et al. National, regional and worldwide estimates of preterm birth. The Lancet. 2012;9379(9832):2162-72.

Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. The Lancet. 2008;371(9608):261-9.

Arzuaga BH, Lee BH. Limits of human viability in the united states: a medicolegal review. Pediatr. 2011;128(6):1047-52.

Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJS. Cognitive and behavioral outcomes of school-aged children who were born preterm: A meta-analysis. J Am Med Assoc. 2002;288:728-37.

Berbel P, Navarro D, Ausó E, Varea E, Rodríguez AE, Ballesta JJ, et al. Role of late maternal thyroid hormones in cerebral cortex development: an experimental model for human prematurity. Cerebral Cortex. 2010;20(6):1462-75.

Aizenman E, White WF, Loring RH, Rosenberg PA. A 3, 4-dihydroxyphenylalanine oxidation product is a non-N-methyl-D-aspartate glutamatergic agonist in rat cortical neurons. Neuroscience Letters. 1990;116(1-2):168-71.

Frye RE, Landry SH, Swank PR, Smith KE. Executive dysfunction in poor readers born prematurely at high risk. Developmental Neuropsychol. 2009;34(3):254-71.

Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. New Eng J Med. 2005;352(1):9-19.

Karbasi SA, Golestan M, Fallah R, Golshan M, Dehghan Z. Effect of body massage on increase of low birth weight neonates growth parameters: a randomized clinical trial. Iranian J Reprod Med. 2013;11(7):583.

Adams-Chapman, I. Neurodevelopmental outcome of the late preterm infant. Clinical Perinatol. 2006;33:947-64.

Zohreh, Shiva, Pegah. Effect of massage on weight gain in premature infants. Iranian J Neonatol. 2012;3(2).

Massaro AN, Hammad TA, Jazzo B, Aly H. Massage with kinesthetic stimulation improves weight gain in preterm infants. J Perinatol. 2009;29:352-7.

Fucile S, McFarland DH, Gisel EG, Lau C. Oral and nonoral sensorimotor interventions facilitate suck-swallow-respiration functions and their coordination in preterm infants. Early Hum Dev. 2012;88(6):345-

Bijari BB, Iranmanesh S, Eshghi F, Baneshi MR. Gentle human touch and yakson: the effect on preterm's behavioral reactions. ISRN nursing. 2012;2012:750363.

Mohamadzadeh A, Karbandi S, Habibollah E, Mahdi B. Effect of tactile-kinesthetic stimulation on weight gaining of preterm Infants. MJIRI. 2009;23(3):148-53.

Hernandez-Reif M, Diego M, Field T. Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behav Dev. 2007;30(4):557-61.

Hwang Y, Vergara E. Effects of prefeeding oral stimulation on feeding performance of preterm infants. Indian J Pediatr. 2010;77(8):869-73.

Diego MA, Field T, Hernandez-ReifM. Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J Pediatr. 2005;147:50-5.

Hodges AL, Lynda. Preterm infants’ responses to music: an integrative literature review. Southern Online J Nurs Res. 2010;10(3):1-6.

Harrison LL. Tactile stimulation of neonatal Intensive Care Unit preterm. In: Field T, editor. Touch and massage in early child development. Johnson and Johnson Pediatric Institute LLC, USA; 2004:139-162.

John NI, Dieter, Emory EK. Supplemental stimulation of premature infants: a treatment model. J Pediatr Psychol. 1997;22(3):281-95.