PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial

Abstract

PurposeInvestigate feasibility of PreEMPT: a novel participation-focused, early physiotherapy intervention for preterm infants in regional Australia. Materials and methodsParticipants were infants born <35 weeks, residing in regional Australia. Sixteen infants were recruited then randomised to usual physiotherapy care (UPC: n = 8) or PreEMPT (n = 8). PreEMPT involved 14-weeks of alternating clinic- or telehealth-based, participation-focused intervention. Feasibility was evaluated by: demand, practicality, acceptability, implementation and limited efficacy testing for infants (motor, participation) and parents (mental well-being, self-efficacy). ResultsDemand was lower than expected (45% recruitment rate). For practicality, attrition was high in the PreEMPT group (mean assessment attendance 3.8/5 sessions, range 2–5) compared to UPC (4.8/5 sessions, range 4–5). In addition, mean PreEMPT treatment dose received was approximately half intended (overall: 7.3/14 sessions, range 0–12; equivalent for face-to-face: 3.9/7, range 0–6, versus telehealth 3.4/7, range 0–6). The most common reason cited for treatment non-attendance was maternal mental health (22 sessions). Treatment acceptability for parents was high, with PreEMPT parents reporting they were offered choices in sessions (p = .02), and increased their knowledge (p = .01) and confidence (p = .009). There was a large effect size in favour of PreEMPT for increased parental self-efficacy (p = .021, ES = 1.34). ConclusionEarly post-discharge physiotherapy for preterm infants in regional Australia is beneficial according to families but logistically challenging.