Extremity Movements Help Occupational Therapists Identify Stress Responses in Preterm Infants in the Neonatal Intensive Care Unit: A Systematic Review

Abstract

A set of specific extremity movements, when combined with other reliable biobehavioural measures of pain and stress, can form the basis for future research and development of a clinical stress scale for preterm infants.

Does the neonatal clinical risk for illness severity influence pain reactivity and recovery in preterm infants?

“…In our results, the preterm infants demonstrated a similar pattern in behavioural and physiological responses by exhibiting pain reactivity during the blood collection procedure, which has been seen in previous studies with preterm infants (Grunau and Craig, ; Johnston and Stevens, ; Morison et al., ; Holsti and Grunau, ). The preterm neonates of both groups exhibited a high pain response during the puncture phase (NFCS > 3 score).…”

“…Pain responses in neonates can be assessed by facial activity (Grunau and Craig, ; Stevens et al., ), body movements (Holsti and Grunau, ) and sleep‐wake states (SWSs) (Grunau et al., ). In addition, heart rate (HR), oxygen saturation (Gibbins et al., ) and salivary cortisol (Grunau et al., ) can be used as complementary physiological measures of pain reactivity.…”

Efficacy of swaddling and heel warming on pain response to heel stick in neonates: a randomised control trial

“…Facial expressions (Ahola Kohut et al . ) and body movements (Holsti & Grunau ) are considered to be behavioural indicators of pain among neonates. Facial expressions include brow bulge, eye squeeze, nasolabial furrow and mouth movement (Ahola Kohut et al .…”

Early Intervention in Pediatric Occupational Therapy

“…The NIDCAP can be integrated easily with the Person-Environment-Occupation Model, because NIDCAP assesses infant's psychological and behavioral responses to different handling types together with the environment [56]. Movements observed in NIDCAP are categorized as stress signals or stability signals.…”

“…These are general extremity movements, specific extremity movements and specific hand movements. In this approach, occupational therapists help preterm infants to self-organizing and to provide engagement in their own environment [56,57].…”