Tactile-kinesthetic Stimulation Research Articles

Factors determining outcome of tactile kinesthetic stimulation in preterm neonates.

Tactile kinesthetic stimulation (TKS) has been the subject of clinical research since the 1960 s, when it was proposed as a way to promote preterm growth and development. To find out the effect of TKS on weight gain in preterm neonates and the factors affecting TKS in relation to outcome. TKS was demonstrated to mothers in department of paediatrics. 124 Preterm neonates fulfilling inclusion criteria were enrolled. The time for which they are doing TKS was noted. Their weight was monitored daily by digital weighing scale till discharge and at one month of age and then average weight gain was calculated and correlated with various factors. There is a significant increase in weight of neonates at discharge (1.73 kg; p < 0.001) and at one month (1.96 kg; p < 0.001) when compared to enrollment (1.686 kg). There was a significant positive correlation between TKS session duration and mean weight change at 1 month follow up (r = 0.269; P = 0.003) and per day weight gain (r = 0.889; p < 0.001), as well as a positive correlation between average TKS session and weight gain when pearson correlation was performed. TKS sessions of 15 minutes or three sessions per day were effective in increasing the weight of preterm neonates. It was noticed that those who received three sessions per day had a shorter hospital stay (7.68 days) than two sessions per day (10.23 days). The education level of the mother, care giver, type of feed, and gender of the preterm have no significant effect on weight gain.

The Effect of Tactile – Kinesthetic Stimulation on Bone Mineralization, Osteocalcin Levels and Body Height Among Stunting Children Among Stunting Children Aged 6-11 Months

Introduction: Stunting is growth faltering caused by as poor nutrition, recurrent infections, a lack of psychosocial stimulation. Growth faltering is associated to bone growth disorder. In order to prevent and overcome stunting not only nutrition but also an adequate stimulation is needed. Objective: This study looked at the effects of tactile–kinesthetic stimulation on bone mineralization, osteocalcin levels and body height among stunting children. Methods: Eighty (80) stunting children (mean of age 8 ± 1,71) were randomly assigned into two groups. Tactile–Kinesthetic Stimulation (TKS) was administrated by trained parents twice daily for three months in the intervention group. The control group was given a routine care of stunting program from public health center. The bone mineralization (osteocalcin serum) and length of body in both groups were measured at enrollment and after week twelve. Results: During three (3) months TKS period, the intervention group had a significant increment in length and osteocalcin serum compared to control group (p 0.005) at 3.17 cm and 11.5 ng/ml respectively. Moreover, this study also showed that providing TKS demonstrated a strong correlation in a positive direction to length. The TKS treatment could increase the body height of stunting children by 86.5%. There was a positive correlation among osteocalcin levels, intake of vitamin A, protein and calcium on improving length (p0.05). Conclusion: TKS was significantly effective in promoting bone mineralization particularly osteocalcin levels and length among stunting children. There was also a strong correlation that TKS could elevate the length of 0.865-times.

The impact of an early intervention home-based program on body composition in preterm-born preschoolers with very low birth weight.

Early child interventions focused on the family prevented neurodevelopmental and behavioral delays and can provide more knowledge regarding responsive feeding, thus creating learning opportunities to promote better quality nutrition and preventing failure to thrive. The aim is to verify the impact of a continuous program of early home-based intervention on the body composition of preschool infants who were born preterm with very low birth weight (VLBW). This is a longitudinal analysis from a randomized controlled trial, including VLBW preterm children, born in a tertiary hospital in Southern Brazil and followed up at the high-risk institutional ambulatory clinic. Participants were divided into the intervention group (IG): skin-to-skin care with the mother (kangaroo care), breastfeeding policy, and tactile-kinesthetic stimulation by mothers until hospital discharge. Subsequently, they received a program of early intervention with orientation and a total of 10 home visits, independently from the standard evaluation and care that was performed following the 18 months after birth; conventional group (CG): standard care according to the routine of the newborn intensive care unit (NICU), which includes kangaroo care, and attending to their needs in the follow-up program. Body composition estimation was performed using bioelectrical impedance analyses (BIA), and physical activity and feeding practices questionnaires were evaluated at preschool age, as well as anthropometric measurements and biochemical analysis. Data of 41 children at 4.6 ± 0.5 years old were evaluated (CG n = 21 and IG n = 20). Body weight, height, body mass index, waist and arm circumferences, and triceps and subscapular skinfold did not differ between groups. The IG presented higher segmented fat-free mass (FFM) when compared to the CG (right arm FFM: 0.74 vs. 0.65 kg, p = 0.040; trunk FFM: 6.86 vs. 6.09 kg, p = 0.04; right leg FFM: 1.91 vs. 1.73 kg, p = 0.063). Interaction analyses showed that segmented FFM and FFM Index were associated with higher iron content in the IG. In the CG, interaction analyses showed that increased visceral fat area was associated with higher insulin resistance index. An early intervention protocol from NICU to a home-based program performed by the mothers of VLBW preterm children of low-income families presents a small effect on FFM.

Pijat Bayi Terapi Komplementer untuk Optimalkan Tumbuh Kembang Anak

The development of a child is very important for parents. Every parent wants their child to grow up well and be a strong and good quality child. One of the efforts that parents can do from an early age is to stimulate with the baby massage method. Massage therapy is one of the complementary therapies that can stimulate tactile-kinesthetic stimulation. Massage therapy given since infancy can increase the stimulation of receptors on the skin, affect brain cells, increase interaction between mother and child, and increase body weight so that children's growth becomes optimal. This community service activity aims to increase community knowledge at the Sinar Gunung VI Posyandu, about baby massage and how to do it, so that babies can grow and develop properly. The method used is lecturing and practicing as well as distributing leaflets on how to do a baby massage that will optimize the growth and develop optimally of children. This activity was attended by 18 mothers who have babies. The results of this activity were increased knowledge and skills of mothers who came to Posyandu Sinar Gunung VI who had babies. The conclusion is that there is an increase in the knowledge and skills of mothers who have infants and higher confidence in practicing complementary therapy for infant massage therapy with mentoring and coaching to optimize the growth and develop optimally of infants.

Effects of hydrotherapy and tactile-kinesthetic stimulation on weight gain of preterm infants admitted in the Neonatal Intensive Care Unit

ObjectiveThe present study aimed to evaluate the effects of hydrotherapy and tactile-kinesthetic stimulation on the birth weight of preterm infants admitted in the Neonatal Intensive Care Unit. MethodIt was a randomized controlled trial, without blinding, in which 44 preterm infants of both sexes with gestational age between 32 and 34 weeks were included into two groups: hydrotherapy group (n = = 22) and tactile-kinesthetic stimulation group (n = 22). Weight gain was the parameter assessed daily. ResultsIn the tactile-kinesthetic stimulation group there was a variation in weight gain, but without significant difference (p = 0,43). However, in the hydrotherapy group, it was observed that increased weight gain started from the 2nd day (p < 0,001). ConclusionsHydrotherapy group presented significantly increased weight after the interventions, indicating that this technique can interfere with weight gain in preterm infants.

Effect of tactile–kinesthetic stimulation on growth, neurobehavior and development among preterm neonates

BackgroundPreterm neonates are at risk of delayed growth and development. Hence, early tactile–kinesthetic stimulation (TKS) is required to improve their growth and development. ObjectiveTo evaluate the effect of TKS on growth, neurobehavior and development among preterm neonates. MethodAn interventional study was conducted from August 2015 to July 2017 in the neonatal unit of Dr. Cipto Mangunkusumo Hospital. Preterm neonates were recruited via random sampling and divided into two groups (the intervention group and control group). TKS was performed for 15 min, three times a day, for 10 days. The anthropometric measurements, neurobehavior (Dubowitz score) and development (Capute Scale score) of neonates in both groups were assessed. ResultsThere were 126 preterm neonates (n = 63 in each group). During the 10-day TKS period, the intervention group had a significant increment in weight and length compared to the control group (p < 0.05) at 11–14 days, at term and 3 months. Moreover, increased tone, reflexes, and improvement in behavior based on the Dubowitz score were observed during monitoring. However, the result did not differ significantly (p > 0.05). There was no significant difference in terms of cognitive and language development in both groups (Developmental Quotient of Clinical Linguistic Adaptive Milestone Scale, Developmental Quotient of Clinical Adaptive Test and Full Scale Developmental Quotient scores, p > 0.05). ConclusionTKS was significantly effective in promoting growth, particularly weight and length, among preterm neonates. However, it did not significantly influence neurobehavior and development at 3 months of chronological age.

Effect of Tactile-Kinesthetic Stimulation on Weight in Preterm Neonates in Neonatal Intensive Care Unit

This study evaluated the efficacy of tactile kinesthetic stimulation on the weight of 40 preterm (28 weeks to <37 weeks) infants. Experimental group received two sessions per day of tactile-kinesthetic stimulation, for 10 consecutive days along with routine hospital care (RHC) and control group received only RHC. Increase in mean (SD) weight gain was significantly higher in the experimental group as compared to control group [10.79 (0.62) g vs 4.03 (0.89) g; P< 0.001].

Effect of Auditory and Tactile-kinesthetic Stimulation on Preterm Neonates

Effect of Auditory and Tactile-kinesthetic Stimulation on Preterm Neonates

Tactile-kinesthetic stimulation to gain weight and reduce the length of stay care for premature baby at public hospitals of Semarang, Indonesia

Background: Premature babies are susceptible to a variety of health problems in early of their lives, thus, management of premature care should be designed to optimize the growth and development, with no more cost extension. The management of premature care by non-pharmacological treatments becomes popular nowadays, and applied in the hospital unit care, including the Tactile-Kinesthetic Stimulation (TKS) and Kangaroo Mother Care (KMC).Aims: This study is to present the effect of Tactile-Kinesthetic Stimulation (TKS) on weight gain and reduction length of stay care for premature babies, and to compare the results with the standard Kangaroo Mother Care (KMC) given at the hospital care unit.Methods: The study used a quasi-experimental design with pretest-posttest with a control group. A total of 32 premature babies was equally divided to a control group given a standard KMC procedure and an intervention group receiving the TKS. Sampling was done using a consecutive sampling method where the low birth weight infants were selected from two public hospitals in Semarang of Indonesia, with consent from the parents. Data was then analyzed by a repeated measure ANOVA, general linear model and Mann-Whitney test to find the significant mean difference at p value less than 0.05.Results: The data shows that the babies’ weight significantly increased day by day only if the premature neonates received Tactile-Kinesthetic Stimulation, gained 148.75 gram only 3 days after the initial measurement. However, from this study we noted that the premature babies’ weight at the control group provided only with Kangaroo Mother Care slightly decreased at 35.69 gram at the third day of observation. In average, premature babies receiving TKS need only 3 days before return home, while if receiving the standard KMC the preterm babies required 5 days in the hospital care.Conclusion: Not only effective to gain the weight, giving Tactile-Kinesthetic Stimulation to the low birth weight baby shorter the length of stay in the hospital unit care. It suggests that the TKS intervention will provide good result in maintaining the weight of the low birth weight baby and will reduce the costs of staying in the hospital unit care. Keywords: Tactile-Kinesthetic Stimulation, Kangaroo Mother Care, Low birth weight, Length of stay care, Premature baby.

Tactile-kinesthetic stimulation to gain weight and reduce the length of stay care for premature baby at public hospitals of Semarang, Indonesia

Background: Premature babies are susceptible to a variety of health problems in early of their lives, thus, management of premature care should be designed to optimize the growth and development, with no more cost extension. The management of premature care by non-pharmacological treatments becomes popular nowadays, and applied in the hospital unit care, including the Tactile-Kinesthetic Stimulation (TKS) and Kangaroo Mother Care (KMC).Aims: This study is to present the effect of Tactile-Kinesthetic Stimulation (TKS) on weight gain and reduction length of stay care for premature babies, and to compare the results with the standard Kangaroo Mother Care (KMC) given at the hospital care unit.Methods: The study used a quasi-experimental design with pretest-posttest with a control group. A total of 32 premature babies was equally divided to a control group given a standard KMC procedure and an intervention group receiving the TKS. Sampling was done using a consecutive sampling method where the low birth weight infants were selected from two public hospitals in Semarang of Indonesia, with consent from the parents. Data was then analyzed by a repeated measure ANOVA, general linear model and Mann-Whitney test to find the significant mean difference at p value less than 0.05.Results: The data shows that the babies' weight significantly increased day by day only if the premature neonates received Tactile Kinesthetic Stimulation, gained 148.75 gram only 3 days after the initial measurement. However, from this study we noted that the premature babies' weight at the control group provided only with Kangaroo Mother Care slightly decreased at 35.69 gram at the third day of observation. In average, premature babies receiving TKS need only 3 days before return home, while if receiving the standard KMC the preterm babies required 5 days in the hospital care.Conclusion: Not only effective to gain the weight, giving Tactile-Kinesthetic Stimulation to the low birth weight baby shorter the length of stay in the hospital unit care. It suggests that the TKS intervention will provide good result in maintaining the weight of the low birth weight baby and will reduce the costs of staying in the hospital unit care. Keywords: Tactile-Kinesthetic Stimulation, Kangaroo Mother Care, Low birth weight, Length of stay care, Premature baby Received: 06 September 2018, Reviewed: 13 September 2018, Received: in revised form 24 October 2019, Accepted: 26 February 2019 DOI: 10.35898/ghmj-31553

Early intervention program for very low birth weight preterm infants and their parents: a study protocol

BackgroundPreterm infants are high risk for delayed neurodevelopment. The main goal is to develop a program of early intervention for very preterm infants that allows families to apply it continuously at home, and quantify the results of early parental stimulation on improvement of cognition and motor skills.MethodsRandomized clinical Trial including inborn preterm infants with gestational age less than 32 weeks or birth weight less than 1500 g at 48 h after birth. Eligible for begin the intervention up to 7 days after birth. Study Protocol approved by the Brazilian national Committee of ethics in Research and by the institutional ethics committee.Intervention group (IG): skin-to skin care by mother (kangaroo care) plus tactile-kinesthetic stimulation by mothers from randomization until hospital discharge when they receive a program of early intervention with 10 parents’ orientation and a total of 10 home visits independently of the standard evaluation and care that will be performed. Systematic early intervention program will be according to developmental milestones, anticipating in a month evolutionary step acquisition of motor and / or cognitive expected for corrected age. Active comparator with a Conventional Group (CG): standard care according to the routine care of the NICU and their needs in the follow up program. Neurodevelopment outcome with blinded evaluations in both groups between 12 and 18 months by Bayley Scales of Infant and Toddler Development third edition and Alberta Motor Infant scale will be performed. All evaluations will be conducted in the presence of parents or caregivers in a safe room for the child move around during the evaluation.DiscussionIf we can show that a continuous and global early intervention at home performed by low income families is better than the standard care for very preterm infants, this kind of program may be applied elsewhere in the world. We received grants by Bill and Melinda Gates Foundation, DECIT, Cnpq and Health Ministry. Grand Challenges Brazil: All Children Thriving.Trial registrationThe study was restrospectively registered in ClinicalTrials.gov. in July 15 2016 (NCT02835612).

Fisioterapia motora na prevenção e tratamento da osteopenia da prematuridade: uma revisão integrativa

Introdução: A cada ano, um em cada 10 bebês, em todo o mundo, nasce prematuro os quais são suscetíveis a osteopenia da prematuridade. A osteopenia da prematuridade é caracterizada por alterações de mineralização esquelética decorrentes do deficiente acréscimo do conteúdo mineral ósseo.Objetivo: Revisar na literatura atual os ensaios clínicos randomizados sobre os efeitos da fisioterapia motora nos recém-nascidos prematuros em relação à prevenção e/ou tratamento da osteopenia da prematuridade, bem como, observar quais as técnicas mais utilizadas nessa assistência.Materiais e Métodos: Trata-se de uma revisão integrativa da literatura, incluindo ensaios clínicos randomizados que utilizaram técnicas de fisioterapia motora como intervenção. Buscou-se nas principais bases de dados (Pubmed, Cochrane Central, Lilacs e PEDro), estudos publicados de 2005 até 2016, utilizando os descritores: “prematuro”, “mineralização óssea”, “fisioterapia”, “osteopenia da prematuridade” e seus equivalentes em inglês.Resultados: Foram incluídos sete estudos e as técnicas utilizadas foram mobilizações passivas nas articulações dos membros superiores e inferiores, com suaves compressões articulares e um protocolo de estimulação tátil-cinestésica, massagem atividade física previne o desequilíbrio entre a formação e absorção da matriz óssea.Conclusão: Embora haja poucos ensaios clínicos randomizados, pode-se observar que a fisioterapia motora utiliza técnicas que são efetivas no ganho de peso, crescimento, massa muscular e na prevenção do desequilíbrio entre a formação e absorção da matriz óssea em prematuros, tendo um papel importante na prevenção e no tratamento da osteopenia da prematuridade.

The effect of tactile-kinesthetic stimulation on growth indices of healthy neonates

Therapeutic touch is emphasized by healthcare professionals for improvement of neonates' growth and development. However, inconsistencies exist regarding effects and methods of massage in neonates. The purpose of this clinical trial is to assess and comprise intervention and control groups regarding the effects of tactile-kinesthetic stimulation (TKS) by mothers on growth indices of healthy term neonates. Sixty healthy term neonates were randomly assigned into intervention and control groups. Mothers of neonates in the experimental group were trained to perform TKS for their newborns at home before feeding for at least 28 consecutive days, two times a day, and 15 min each time. Neonates in the control group were not required to receive this intervention. The neonates’ growth indices were measured within 24 h after birth, and then at days 14 and 28. During the study and the three consecutive measurements, no significant difference was found between the mean weights, heights, and head circumferences of the neonates in the two groups (p > 0.05).

Effect of tactile kinesthetic stimulation on preterm infants' weight and length of hospital stay in Khartoum, Sudan.

Objectives:To determine the effect of 7 days tactile kinesthetic stimulation (TKS) on preterm infants’ weight and hospital stays in Khartoum State, Sudan.Methods:This is a quasi-experimental study, it was conducted in 4 hospitals between January and June 2013, Khartoum, Sudan, and it involved 160 preterm infants randomly assigned into the case and control groups (80 neonates in each). Preterm infants in the control group received routine nursing care, while preterm infants in the case group received TKS for 3 periods, 15 minute per day for 7 constitutive days, in addition to routine care. Data was collected using a structured self-designed and validated questionnaire, checklist, and weighting scale. Weight gain and hospital stay were compared between the 2 groups.Results:Over the constitutive 7 days, the case group gained significantly more weight (1071gm versus 1104gm) compared with the control group (1077gm versus 1084gm) (1084.55±90.74) who gained only 6.9gm within the same 7 days without TKS treatment. The mean difference in weight gain was significant (p=0.00). The hospital stay for preterm infants in the case group was significantly shorter (18.05±9.36 versus 25.47±10.25; p=0.00).Conclusion:Tactile kinesthetic stimulation for preterm infants has a beneficial effect on weight gain and earlier discharge from hospital, which are sequentially efficient and cost effective.

Comparison of kangaroo mother care and tactile kinesthetic stimulation in low birth weight babies – an experimental study

AbstractLow birth weight (LBW) is the most common cause of neonatal death. The management includes admission to the neonatal intensive care unit, use of high frequency oscillator, and so on. The conventional management of LBW babies also includes kangaroo mother care and tactile kinesthetic stimulation (TKS), which are both non-invasive and easily affordable. However, very few studies have compared these two techniques. Hence, the aim of the study was to compare the effectiveness of kangaroo mother care (KMC) and TKS in LBW babies.This was an experimental study including 40 LBW babies weighing 1500–2500 g with gestational age of ≥32 weeks. Group A (n=20) was treated with KMC and group B (n=20) was treated with TKS for 5 consecutive days. The weight and parental bonding of all the neonates before and after intervention were recorded.The results of this study revealed that the neonates in both groups showed significant weight gain after 5 days of treatment (p=0.00001) However, in Group B, parental bonding scores were significantly decreased with p=0.0126.The present study concluded that KMC and TKS were equally effective in increasing the weight of the neonates and the mother-child bonding.

Therapeutic Touch Modalities and Premature Neonate’s Health Outcome: A Literature Review

Background: In Neonatal Intensive Care Unit (NICU), the premature infant is often placed under incubator, phototherapy and with several cords and tubing connected all over body. They are subjected both to highly stressful environment (noise, bright light, frequent care related handling) and are often deprived of tactile stimulation that they would otherwise experience in general mothering care. The study explored literatures searching different modalities of giving therapeutic touch and its impact on pre-term infant in NICU. Results: The study explored different modalities of therapeutic touch- Gentle Human Touch, Supporting Holding, Massage technique, tactile stimulation, Tactile-kinesthetic stimulation and Yakson. All identified therapeutic touch modalities had shown several positive outcomes for pre-term neonates in NICU. Conclusion: As a non-invasive technique, therapeutic touch in any of the therapeutic modalities may be construed as providing developmentally appropriate, family centered care to the preterm neonates in NICU.

Tactile/kinesthetic stimulation (TKS) increases tibial speed of sound and urinary osteocalcin (U-MidOC and unOC) in premature infants (29–32 weeks PMA)

Preterm delivery (<37weeks post-menstrual age) is associated with suboptimal bone mass. We hypothesized that tactile/kinesthetic stimulation (TKS), a form of infant massage that incorporates kinesthetic movement, would increase bone strength and markers of bone accretion in preterm infants. Preterm, AGA infants (29–32weeks) were randomly assigned to TKS (N=20) or Control (N=20). Twice daily TKS was provided 6days per week for 2weeks. Control infants received the same care without TKS treatment. Treatment was masked to parents, health care providers, and study personnel. Baseline and week two measures were collected for tibial speed of sound (tSOS, m/sec), a surrogate for bone strength, by quantitative ultrasound (Sunlight8000) and urine markers of bone metabolism, pyridinium crosslinks and osteocalcin (U-MidOC and unOC). Infant characteristics at birth and study entry as well as energy/nutrient intake were similar between TKS and Control. TKS intervention attenuated the decrease in tSOS observed in Control infants (p<0.05). Urinary pyridinium crosslinks decreased over time in both TKS and CTL (p<0.005). TKS infants experienced greater increases in urinary osteocalcin (U-MidOC, p<0.001 and unOC, p<0.05). We conclude that TKS improves bone strength in premature infants by attenuating the decrease that normally follows preterm birth. Further, biomarkers of bone metabolism suggest a modification in bone turnover in TKS infants in favor of bone accretion. Taken together, we speculate that TKS improves bone mineralization.

Tactile-kinesthetic stimulation effects on sympathetic and adrenocortical function in preterm infants

The purpose of our study was to investigate the neuroendocrine response in preterm infants to a pattern of tactile-kinesthetic stimulation that facilitates their growth and development. Preterm infants (mean gestational age 30 weeks, mean birth weight 1176 gm) received normal nursery care or tactile-kinesthetic stimulation for three 15-minute periods at the start of three consecutive hours each day for 10 days. On day 1 and day 10 of the study, a 24-hour urine sample was collected for norepinephrine, epinephrine, dopamine, cortisol, and creatinine assay and a blood sample was taken by heel stick for cortisol and growth hormone assay. Urine norepinephrine and epinephrine values increased significantly only in the stimulated babies. Urine dopamine and cortisol values increased in both groups, and serum growth hormone decreased in both groups. Individual differences in urine norepinephrine, epinephrine, dopamine, and cortisol values were highly stable across the 10 days despite a 10-fold range of values among the infants. The results of this study suggest that tactile-kinesthetic stimulation of preterm infants has fairly specific effects on maturation and/or activity of the sympathetic nervous system. In addition, this study has defined catecholamine and cortisol secretion across gestational age in normal preterm infants. Finally, these data suggest that highly stable individual levels of catecholamine and cortisol secretion are established by birth in humans.

An Examination of the Effect of Tactile-Kinesthetic Stimulation on the Development of Preterm Infants

This study was designed to investigate the effects of factile-kinesthetic stimulation on the weight gain, the performance on the Neonatal Behavioral Assessment Scale (NBAS), and the length of hospital stay of preterm infants. Twenty preterm infants in a neonatal intensive care unit were divided equally into treatment and control groups. Tactile-kinesthetic stimulation was provided to the infants in the treatment group for three 15-minute periods per day for 10 days. At the end of the treatment period, the analyses revealed that the weight gains and the performance on the NBAS of the intervention group significantly increased in comparison with the weight gains and NBAS performance of the comparison group. No significant difference was found between the treatment and control groups on length of hospital stay.

Sensory Deprivation Stress and Supplemental Stimulation in the Rat Pup and Preterm Human Neonate

This article reviews the literature and presents data from our laboratories on sensory deprivation stress and supplemental stimulation of the rat pup and the preterm neonate. The data suggest that the effects of maternal deprivation in the rat pup (suppression of growth hormone release and protein synthesis) are regulated by a specific form of tactile stimulation: only brush stroking of maternally deprived rat pups returned growth parameters to normal; other forms of stimulation, including kinesthetic and vestibular stimulation, were ineffective in restoring normal functions. Other data are presented demonstrating that very small preterm neonates given tactile-kinesthetic stimulation gain more weight per day, spend more time awake and active, and show more mature habituation, orientation, motor, and range of state behaviors on the Brazelton assessment.