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

Abstract

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.