Effects of a Parent-Administered Exercise Program in the Neonatal Intensive Care Unit: Dose Does Matter-A Randomized Controlled Trial.

Abstract

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. The objectives of this study were to examine the effectiveness of a parent-administered exercise program in the NICU on motor outcome at 3months corrected age (CA) and the effect of dosing on motor performance. This was a randomized clinical trial. The study was conducted at 3 university hospitals in Tromsø, Trondheim, and Oslo, Norway. A total of 153 infants with gestational age<32weeks at birth were randomly assigned to intervention or control groups. 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 10minutes twice a day. Test of Infant Motor Performance (TIMP) was used to assess short-term outcome at 3months CA. No significant difference in the TIMP z-score was found between intervention and control groups at follow-up 3months 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 3months CA was about 6 times higher for infants with less than median intervention time than for infants with a longer intervention time. The number of infants born before 28weeks 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. There was no difference in motor performance between the intervention group and the control group at 3months CA. However, an increased intervention dose was positively associated with improved motor outcome.