The Effect of Assisted Exercise Frequency on Bone Strength in Very Low Birth Weight Preterm Infants: A Randomized Control Trial (original) (raw)
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Assisted Exercise and Bone Strength in Preterm Infants
Calcified Tissue International, 2007
Studies have previously demonstrated that brief (4 weeks) passive range-of-motion exercise is beneficial for bone development in very low birth weight (VLBW) preterm infants. However, the optimal duration of exercise for bone development in preterm infants is yet unknown. The aim of the present study was to examine the effect of 8 weeks of assisted exercise on bone strength and metabolism in VLBW premature infants. Sixteen infants (mean ± standard error of the mean birth weight 1,009 ± 55 g and gestational age 27.3 ± 0.3 weeks) were randomly assigned into exercise (n = 8) and control (n = 8) groups. The intervention started at the first week of life and involved 8 weeks of daily passive extension and flexion range-of-motion exercise of the upper and lower extremities. Biochemical markers of bone turnover were measured at enrollment and after 8 weeks. Bone strength was measured weekly by quantitative ultrasound measurement of tibial bone speed of sound (SOS). Bone SOS decreased significantly in the control group ()108.1 ± 33.7 m/second, P < 0.0001) during the study period, while remaining stable in the exercise group (11.3 ± 22.8 m/second). The main beneficial effect of exercise occurred in the first 4 weeks of the intervention. There were no significant differences in the bone turnover marker changes between the groups. There is a significant postnatal decrease in bone SOS in VLBW preterm infants. Eight weeks of assisted range-of-motion exercise attenuates the decrease in bone strength and may decrease the risk of osteopenia in premature infants.
Indian pediatrics, 2018
To compare the efficacy of daily assisted physical exercise (starting from one week of postnatal age) on bone strength at 40 weeks of post menstrual age to no intervention in infants born between 27 and 34 weeks of gestation. Open-label randomized controlled trial. Tertiary-care teaching hospital in northern India from 16 May, 2013 to 21 November, 2013. 50 preterm neonates randomized to Exercise group (n=26) or Control group (n=24). Neonates in Exercise group underwent one session of physical exercise daily from one week of age, which included range-of-motion exercises with gentle compression, flexion and extension of all the extremities with movements at each joint done five times, for a total of 10-15 min. Infants in Control group underwent routine care and were not subjected to any massage or exercise. Primary: Bone speed of sound of left tibia measured by quantitative ultrasound at 40 weeks post menstrual age. Secondary: Anthropometry (weight length and head circumference) and b...
2021
BackgroundPreterm infants have a low level of bone mineralization compared to those born at term, since 80% of calcium incorporation occurs at the end of pregnancy. The purpose of the present study was to investigate the effect of reflex locomotion therapy on bone mineralization and growth in preterm infants and compare its effect against other physiotherapy procedures.MethodsA randomized controlled trial carried out over four years from February 2016 to July 2020 was conducted. 52 preterm infants born at 29-34 weeks with hemodynamical stability, full enteral nutrition, and without any metabolic, congenital, genetic, neurological or respiratory disorders, were evaluated for inclusion; 6 were discarded due to exclusion criteria; finally 46 were randomized to three groups but only 76.08% completed the study: One group received reflex locomotion therapy (EGrlt); other group received passive movements with gentle compression (EGpmc); and control group received massage (CG). All treatmen...
2022
Background: Preterm infants have a low level of bone mineralization compared to those born at term, since 80% of calcium incorporation occurs at the end of pregnancy. The purpose of the present study was to investigate the effect of reflex locomotion therapy on bone modeling and growth in preterm infants and to compare its effect with those of other Physiotherapy modalities.Methods: A multicentre randomized controlled clinical trial was conducted (02/2016 – 07/2020). 106 preterm infants born at the Virgen de la Arrixaca University Clinical Hospital, the General University Hospital of Elche and the Torrecárdenas Hospital in Almería, between 29 and 34 weeks with hemodynamic stability, complete enteral nutrition and without any metabolic, congenital, genetic, neurological or respiratory disorders were evaluated for inclusion. Infants were randomly assigned to three groups: one group received reflex locomotion therapy (EGrlt); another group received passive mobilizations with gentle joi...
Spontaneous Activity in Premature Infants Affects Bone Strength
Journal of Perinatology, 2002
OBJECTIVE: Determination of bone strength of lower extremities in very low birth weight (VLBW) premature infants with central nervous system pathology resulting in reduced unilateral spontaneous leg movements.STUDY DESIGN: Quantitative ultrasound (QUS) measurements of speed of sound (SOS) of the tibiae of both legs in three VLBW premature infants with brain insult and unilateral reduced spontaneous activity. Results were compared
Physical Therapy to Prevent Osteopenia in Preterm Infants: A Systematic Review
Children, 2021
Background: During the last trimester of pregnancy, about 80% of the infant’s calcium is incorporated, and for this reason, preterm infants have less bone mineralization compared to those born at term. The aim of the present systematic review was to identify, evaluate and summarize the studies that deal with the effect of physiotherapy modalities in the prevention and treatment of osteopenia in preterm infants. Methods: A comprehensive search (09/2019–02/2021) using PubMed, Web of Science, SCOPUS, ProQuest, SciELO, Latindex, ScienceDirect, PEDro and ClinicalTrials.gov was carried out. The following data were extracted: The number of participants, characteristics of the participants, design, characteristics of the intervention, outcome measures, time of evaluation and results. A non-quantitative synthesis of the extracted data was performed. The methodological quality and risk of bias were assessed using a PEDro scale and ROB-2 scale, respectively. Results: A total of 16 studies were...
Jorjani Biomedicine Journal, 2021
Background and Objective: Human development is influenced by genetic, environmental, and social factors whose foundation is formed from infancy and childhood. Preterm birth and low birth weight are important issues that can affect the development and threaten the public health. The aim of this study was to investigate the effect of early exercise interventions on gross motor skills of children with preterm birth aged 3 to 6 years. Material and Methods: In this Experimental study, 30 children with the average weight (2066 ±354g) were selected from the preterm infants (32 to 37 weeks less than 2500 g) admitted to NICU ward. They were divided into two groups (experimental group n=15 and control group n=15 children). To evaluate the gross motor skills of children, the second version of the Peabody developmental motor scale was used. The results were analyzed by SPSS using ANCOVA test (p≤0.05). Results: The results of this study showed that early interventions can have a positive effect on the gross motor skills of these children and the participants in the experimental group were able to obtain higher scores than the control group after participating in the training program. Conclusion: The results showed that training interventions have a significant effect on both stability and locomotion skills.
Feasibility of a Caregiver-Assisted Exercise Program for Preterm Infants
The Journal of Perinatal & Neonatal Nursing, 2013
Purpose-Mounting evidence shows that low birth weight and prematurity are related to serious health problems in adulthood, including increased body fat, decreased fitness, poor bone mineralization, pulmonary problems, and cardiovascular disease. There is data to suggest that increasing physical activity in preterm infants will have effects on short term muscle mass and fat mass, but we also hypothesized that increasing physical activity early in life can lead to improved health outcomes in adulthood. Because few studies have addressed the augmentation of physical activity in premature babies, the objective of this study was to evaluate the feasibility of whether caregivers (mostly mothers) can learn from nurses and other health care providers to implement a program of assisted infant exercise following discharge. Study Design and Methods-Ten caregivers of preterm infants were taught by nurses, along with occupational therapists and other health care providers, to perform assisted infant exercise and instructed to conduct the exercises daily for approximately three weeks. The researchers made home visits and conducted qualitative interviews to understand the caregivers' (mostly mothers') experiences with this exercise protocol. Quantitative data included a caregiver's daily log of the exercises completed to measure adherence as well as videotaped caregiver sessions, which were used to record errors as a measure of proficiency in the exercise technique. Results-On average, the caregivers completed a daily log on 92% of the days enrolled in the study and reported performing the exercises on 93% of the days recorded. Caregivers made an average of 1.8 errors on two tests (with a maximum of 23 or 35 items on each, respectively) when demonstrating proficiency in the exercise technique. All caregivers described the exercises as beneficial for their infants, and many reported that these interventions fostered increased bonding with their babies. Nearly all reported feeling "scared" of hurting their babies during the first few