Two-year motor outcomes associated with the dose of NICU based physical therapy: The Noppi RCT

Øberg, Gunn Kristin; Handegård, Bjørn Helge; Campbell, Suzann K.; Ustad, Tordis; Fjørtoft, Toril; Kaaresen, Per Ivar; Girolami, Gay L.

doi:10.1016/j.earlhumdev.2022.105680

Cited by 7 publications

(6 citation statements)

References 33 publications

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“…In contrast to other intervention studies that focus on specific populations of high-risk infants [ 30 , 43 , 47 , 58 , 59 ], we will recruit infants with different risk levels. Although many infants at mild risk of neuromotor delay will develop typically [ 105 ], which may mask the effectiveness of the intervention, some infants at apparent mild risk may subsequently develop atypically.…”

Section: Discussionmentioning

confidence: 99%

“…Ideally, to improve these intervention outcomes, not only do infants need to be motivated during the learning process, caregivers also must be encouraged to think optimistically about their child's potential, to focus on opportunities for growth [35][36][37][38], and to be confident and engaging during interactions with their infant [39][40][41][42]. Finally, higher dose interventions are typically more effective compared to lower dose interventions in promoting motor development and positive neuronal adaptations [14,16,28,[43][44][45].…”

Section: Introductionmentioning

confidence: 99%

“…Current evidence also encourages early initiation of therapeutic intervention to mitigate neuromotor conditions and improve cognitive and motor skills for infants at risk of neuromotor delay [8,9,43,[46][47][48][49][50]. Research suggests that an infant's brain has greater potential for neural plasticity early in life, which may enable adaptation and reorganization after perinatal injury [8,[48][49][50]].…”

Section: Introductionmentioning

confidence: 99%

“…Research suggests that an infant's brain has greater potential for neural plasticity early in life, which may enable adaptation and reorganization after perinatal injury [8,[48][49][50]]. An early onset intervention (e.g., beginning in the neonatal intensive care unit, (NICU) may result in greater restoration of neural circuitry and functional skill compared to an intervention initiated later in life [8,38,43,48]. However, although infants at risk of developmental disabilities may receive physical therapy in the NICU, access to further standard-of-care therapy services is often delayed until well after NICU discharge [45,[51][52][53][54][55][56][57].…”

Section: Introductionmentioning

confidence: 99%

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Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay

Deng,

Anastasopoulos,

deRegnier

et al. 2023

PLoS ONE

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Introduction Developmental disabilities and neuromotor delay adversely affect long-term neuromuscular function and quality of life. Current evidence suggests that early therapeutic intervention reduces the severity of motor delay by harnessing neuroplastic potential during infancy. To date, most early therapeutic intervention trials are of limited duration and do not begin soon after birth and thus do not take full advantage of early neuroplasticity. The Corbett Ryan–Northwestern–Shirley Ryan AbilityLab–Lurie Children’s Infant Early Detection, Intervention and Prevention Project (Project Corbett Ryan) is a multi-site longitudinal randomized controlled trial to evaluate the efficacy of an evidence-based physical therapy intervention initiated in the neonatal intensive care unit (NICU) and continuing to 12 months of age (corrected when applicable). The study integrates five key principles: active learning, environmental enrichment, caregiver engagement, a strengths-based approach, and high dosage (ClinicalTrials.gov identifier NCT05568264). Methods We will recruit 192 infants at risk for neuromotor delay who were admitted to the NICU. Infants will be randomized to either a standard-of-care group or an intervention group; infants in both groups will have access to standard-of-care services. The intervention is initiated in the NICU and continues in the infant’s home until 12 months of age. Participants will receive twice-weekly physical therapy sessions and caregiver-guided daily activities, assigned by the therapist, targeting collaboratively identified goals. We will use various standardized clinical assessments (General Movement Assessment; Bayley Scales of Infant and Toddler Development, 4th Edition (Bayley-4); Test of Infant Motor Performance; Pediatric Quality of Life Inventory Family Impact Module; Alberta Infant Motor Scale; Neurological, Sensory, Motor, Developmental Assessment; Hammersmith Infant Neurological Examination) as well as novel technology-based tools (wearable sensors, video-based pose estimation) to evaluate neuromotor status and development throughout the course of the study. The primary outcome is the Bayley-4 motor score at 12 months; we will compare scores in infants receiving the intervention vs. standard-of-care therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay

Deng,

Anastasopoulos,

deRegnier

et al. 2023

PLoS ONE

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“…In contrast to other intervention studies focusing on specific populations of high-risk infants [25,[28][29][30][31], we recruited infants with high-risk levels because of their very early prematurity that all infants were born at 30th or under 30 weeks of gestational age. All the infants had nearly the same medical condition and were at the same risk of neuromotor delay [32].…”

Section: Discussionmentioning

confidence: 99%

Effect of Physiotherapy in Early Preterm Infants in the Neonatal Intensive Care Unit Based on the Framework of the International Classification of Function

Çömük Balcı,

Takçı,

Akın

2023

Preprint

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Introduction: Physiotherapy exercises administered to preterm infants in the NICU can enhance motor skills and expedite the discharge process for infants born before 30 weeks of gestational age. The research delves into the influence of physiotherapy programs on these preterm infants' activity and participation levels. Methods: The intervention group received a one-month physiotherapy program including massage around the mouth, mobilization and weight-bearing exercises, and massage therapy for the extremities, while the control group did not. The motor skills were evaluated by the Test of Infant Motor Performance (TIMP), Dubowitz Neurological examination, and Preterm Oral Feeding Readiness Scales (POFRAS). Results: There was a significant difference in The TIMP, Dubowitz Optimal Score, Type of Non-Invasive Ventilation, TIMP Range, and POFRAS scores in the physiotherapy group rather than the control group (p<0.05). There were no differences in the length of stay in the NICU, respiration rate, heart rate, body temperature, oxygen saturation, body weight on the evaluation day, body weight at discharge, head circumference at discharge between the groups (p>0.05) Discussion: We conclude that physiotherapy in NICU improves the motor outcomes, activity and participation in preterm infants rather than the body functions and structure like vital signs and infants’ body weight.

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Early interventions with parental participation and their implications on the neurodevelopment of premature children: a systematic review and meta-analysis

Bernabe-Zuñiga,

Rodriguez-Lucenilla,

Alias-Castillo

et al. 2024

Eur Child Adolesc Psychiatry

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Two-year motor outcomes associated with the dose of NICU based physical therapy: The Noppi RCT

Cited by 7 publications

References 33 publications

Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay

Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay

Effect of Physiotherapy in Early Preterm Infants in the Neonatal Intensive Care Unit Based on the Framework of the International Classification of Function

Early interventions with parental participation and their implications on the neurodevelopment of premature children: a systematic review and meta-analysis

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