Premature infant oral motor intervention (PIOMI) with and without massage therapy on social emotional development in preterm infants

Abstract

Background: Feeding functions are generally affected in preterm infants. This has long-term impact on emotional development, social learning, and health. Occupational therapists use a variety of interventions such as premature infant oral motor intervention (PIOMI), Infant massage (IM) for improving oral motor control and neuro-behavioral status of preterm infant. PIOMI has positive effects on oral motor functions. IM is recognized as a developmentally supportive intervention aimed at decreasing infant stress and optimizing the infant's sensory experience on long-term development. The current study intends to observe the effect of PIOMI and combined effect of PIOMI with IM on social and emotional development of preterm infants. Objective: The aim was to evaluate the effect of PIOMI and combined effect of PIOMI with IM on social-emotional development of preterm infants. Study Design: Prospective, experimental, design was chosen for this research. Methods: Preterm infants (32–36 weeks) who were hemodynamically stable and satisfying the inclusion criteria were allocated into Group A and Group B randomly divided into 30 subjects in each group. Group A received PIOMI of 10 min session, twice a day. Group B received PIOMI along with IM therapy (IM) of 10 min session twice a day, till they achieved full oral feeds. The infants were evaluated at 2 and 6 months of corrected age on Ages and Stages Questionnaire Social Emotional-2 (ASQ: SE-2) scale to evaluate the long-term effect of intervention on social-emotional development of preterm infants. Results: Thirty infants from Group A enrolled for study, 25 infants followed up at 2 months of corrected age. On social emotional-2 (ASQ: SE-2), they scored mean score of 30.4 ± standard deviation (SD) 7.4, 95% confidence interval CI: (27.66, 33.14), On follow-up at 6 months of corrected age, there was an increase in mean scores to 46.2 ± SD 11.2, 95% CI: (41.7, 50.7). Out of thirty infants, the twenty-eight infants from Group B followed up at 2 months of corrected age. On ASQ: SE-2 they scored as mean 18.4 ± SD 4.5, 95% CI: (16.66, 20.14).This group also showed increase of mean scores at 6 months of corrected age to 28.2 ± SD 8.14, 95% CI: (25.04, 30.36). Infants receiving PIOMI with IM showed better social-emotional development in preterm infants as compared to those received only PIOMI at 2 and 6 months. The marked improvement was seen in components such as social interaction, self-regulation, and communication. Conclusion: Preterm infants from both the groups showed good social emotional development, whereas preterm infants who received PIOMI along with IM therapy showed better self-regulation and interaction due to graded tactile stimulations received during therapy, which also enhanced interaction with caregivers.