The objective of this review was to find out the best mode of auditory stimulation for preterm neonates admitted to the neonatal intensive care unit. We also aimed to find out the different effects of different types of auditory stimulation in these neonates. Advanced neonatal care and technological advances in neonatal intensive care units have led to increased survival of preterm-born neonates, but this in turn leads to increased incidences of disabilities like cerebral palsy, visual impairment, delayed social development, etc. Early intervention is provided to facilitate further development and prevent delays in all domains. Auditory stimulation is proven to benefit these neonates to stabilize their vitals and improve their auditory performance in later life. Different modes of auditory stimulation have been studied worldwide, but none of the studies has presented the ideal mode of auditory stimulation for these preterm neonates. In this review, we have discussed the effects produced by different types of auditory stimulation and compared their pros and cons. For conducting a systematic review, a search strategy adopted by MEDLINE is used. A total of 78 articles published between 2012 and 2017, on the effects of auditory stimulation on preterm infants' performance were reviewed. Out of that, eight studies that met the inclusion criteria and focused on shortterm and long-term effects were included in this systematic review. Search terms included preterm neonates, auditory stimulation, and early intervention. Randomized controlled trials and cohort studies were included. Auditory stimulation by maternal sound provides physiological and autonomic stability, but the behavioral states of preterm neonates improved with auditory stimulation by music therapy with lullabies. Maternal singing during kangaroo care may be recommended for providing physiological stability.
Premature birth is the most common cause for a stay in the neonatal intensive care unit (NICU) among neonates. Premature birth leads to prematurity, which is associated with complications such as respiratory distress syndrome (RDS), hyperbilirubinemia, gastroesophageal reflux (GERD), intraventricular hemorrhage (periventricular leukomalacia), retinopathy of prematurity (ROP), and so on. These secondary complications are of great concern and need to be handled with care to prevent the further deterioration of the quality of life of the baby as he grows. So, the early physiotherapeutic interventional approach comes into light and plays an important role in neonatal care. This case study demonstrates an infant boy of seven months chronological age, who had a preterm birth history with a poor APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score and NICU stay during the first three months of life. He approached the physiotherapy outpatient department with a complaint of delayed motor milestones like an absence of head holding, rolling, opening of hand, as well as delayed social-emotional development, Ryles tube (RT) in situ, with frequent episodes of GERD, neck rotated to the left side, high irritability, tactile defensiveness of both hands, and difficulty in regulating his sensory systems. Outcome measures used were gross motor function measure (GMFM), sensory profile, and rotating chair test. Early interventional physiotherapy was given including neurodevelopmental techniques (NDT), oromotor stimulation, sensory integration, passive stretching, and myofascial release for six days per week with each session of 45 minutes. The results demonstrated the achievement of motor milestones till sitting independently, reduced episodes of GERD, discontinued RT in situ, improved mobility of neck on both sides, reduced irritability, and started reaching, grasping along with bimanual tasks.
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