IJPR.2020.181
Type of Article: Original Research
Volume 9; Issue 1 (January 2021)
Page No.: 3730-3735
DOI: https://dx.doi.org/10.16965/ijpr.2020.181
Effect of individualized home-based intervention program in preterm infants at 35-36 weeks gestational age using prechtl’s general movement assessment: a pre-post experimental study
Jinali Jain *1, Deepa Metgud 2.
*1 KAHER JNMC Nehru Nagar, Belagavi, Karnataka-India.
2 KAHER JNMC Nehru Nagar, Belagavi, Karnataka-India.
Corresponding Author: Dr. Jinali Jain, PT., KAHER JNMC Nehru Nagar, Belagavi, Karnataka-India; Contact Number: 8879101753. E-Mail: jainjinali471@gmail.com
ABSTRACT
Background: Preterm birth associated with various abnormalities can have a detrimental impact on an infant’s developmental outcome which marks the need of a landmark tool to detect an abnormality at an early age and incorporate specific intervention strategies. Positive effects of intervention on developmental outcomes have been noted, however tailored home-based intervention programs on developmental enhancements are essential.
Purpose: To evaluate the impact of Individualized Home Based Developmental Program on the neurodevelopmental outcome of preterm infants using Prechtl’s General Movement Assessment.
Methodology: Ninety preterm infants admitted to the NICU (Neonatal Intensive Care Unit)of a tertiary care hospital in Tertiary care hospital at Belagavi, Karnataka, India. The study was carried out for a duration of 12 months. Participants were conveniently selected from a population-based sample from May 2018 to March 2019. Based on the inclusion criteria of the study, these infants were screened for the movement trajectories on Prechtl’s GMA at 3-36- and 38-40-weeksGA(Gestational Age) respectively. Out of the 90 infants, 19 infants showing abnormal movement trajectories were recruited for individualized home-based developmental program for a duration of 12 weeks followed by re-evaluation at 3 months post term age.
Results: The results were statistically significant (p<0.001) with 14 out of 19 infants exhibiting 70% improvement with normal Fidgety movements at 3 months post term age.
Conclusion: IHBP delivered for 12 weeks was found to be effective in promoting developmental outcome in preterm infants.
Key words: Preterm infants, Prechtl’s General Movement Assessment, home-based early intervention.
REFERENCES
[1]. Shapiro-Mendoza CK, Lackritz EM. Epidemiology of late and moderate preterm birth. Semin Fetal Neonat. 2012;17(3): 120-125
[2]. Bos AF, Einspieler C, Prechtl HF. Intrauterine growth retardation, general movements, and neurodevelopmental outcome: a review. Dev Med Child Neurol. 2001;43(1):61-8.
[3]. Meis PJ, Ernest JM, Moore ML. Causes of low birth weight births in public and private patients. Am. J. Obstet. Gynecol. 1987;156(5):1165-8
[4]. Allen MC. Neurodevelopmental outcomes of preterm infants. Curr Opin Neurol. 2008;21(2):123-8
[5]. Ohlsson A, Jacobs SE. NIDCAP: a systematic review and meta-analyses of randomized controlled trials. Pediatrics. 2013;131(3):e881-93
[6]. Sehgal A, Stack J. Developmentally supportive care and NIDCAP. Indian J. Pediatr. 2006;73(11):1007-10.
[7]. Als H, Gilkerson L. The role of relationship-based developmentally supportive newborn intensive care in strengthening outcome of preterm infants. Semin Perinatol. 1997: 21 (3)178-189
[8]. Øberg GK, Campbell SK, Girolami GL, Ustad T, Jørgensen L, Kaaresen PI. Study protocol: an early intervention program to improve motor outcome in preterm infants: a randomized controlled trial and a qualitative study of physiotherapy performance and parental experiences. BMC pediatrics. 2012;12(1):15.
[9]. Spittle AJ, Ferretti C, Anderson PJ, Orton J, Eeles A, Bates L, Boyd RN, Inder TE, Doyle LW. Improving the outcome of infants born at< 30 weeks’ gestation-a randomized controlled trial of preventative care at home. BMC pediatrics. 2009;9(1):73
[10]. Levi D, Ibrahim R, Malcolm R, MacBeth A. Mellow Babies and Mellow Toddlers: Effects on maternal mental health of a group-based parenting intervention for at-risk families with young children. J. Affect. Disord. 2019; 246: 820-7.
[11]. Hadders‐Algra M, Boxum AG, Hielkema T, Hamer EG. Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review. Dev Med Child Neurol. 2017;59(3):246-58
[12]. American Academy of Pediatrics. Follow-up care of high-risk infants. Pediatrics. 2004; 114 (5):1377-97.
[13]. Øberg GK, Campbell SK, Girolami GL, Ustad T, Jørgensen L, Kaaresen PI. Study protocol: an early intervention program to improve motor outcome in preterm infants: a randomized controlled trial and a qualitative study of physiotherapy performance and parental experiences. BMC pediatrics. 2012; 12(1):15.
[14]. Dusing SC, Murray T, Stern M. Parent preferences for motor development education in the neonatal intensive care unit. Pediatr Phys Ther. 2008; 20(4):363-8.
[15]. Sgandurra G, Bartalena L, Cioni G, Greisen G, Herskind A, Inguaggiato E, Lorentzen J, Nielsen JB, Sicola E. Home-based, early intervention with mechatronic toys for preterm infants at risk of neurodevelopmental disorders (CARETOY): a RCT protocol. BMC pediatrics. 2014;14(1):268.
[16]. Becker PT, Grunwald PC, Moorman J, Stuhr S. Effects of developmental care on behavioral organization in very-low-birth-weight infants. Nurs. Res. 1993;42(4):214-20.
[17]. Lekskulchai R, Cole J. Effect of a developmental program on motor performance in infants born preterm. Aust J Physiother . 2001;47(3):169-76.
[18]. Cioni G, Prechtl HF, Ferrari F, Paolicelli PB, Einspieler C, Roversi MF. Which better predicts later outcome in fullterm infants: quality of general movements or neurological examination?. Early Hum. Dev. 1997; 50(1):71-85.
[19]. Spittle AJ, Anderson PJ, Lee KJ, Ferretti C, Eeles A, Orton J, Boyd RN, Inder T, Doyle LW. Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years. Pediatrics. 2010;126(1):171-8.
[20]. Ferrari F, Einspieler C, Prechtl H, Bos A, Cioni G. Prechtl’s method on the qualitative assessment of general movements in preterm, term and young infants. Mac Keith Press. 2004:1-104
[21]. White-Traut RC, Nelson MN, Silvestri JM, Vasan U, Littau S, Meleedy-Rey P, Gu G, Patel M. Effect of auditory, tactile, visual, and vestibular intervention on length of stay, alertness, and feeding progression in preterm infants. Dev Med Child Neurol. 2002;44(2):91-7
[22]. Nicholls A, Williams JM. Can the Prechtl method for the qualitative assessment of general movements be used to predict neurodevelopmental outcome, at eighteen months to three years, of infants born preterm?. Phys Ther Rev. 2016;21 (3-6):131-7.
[23]. Prechtl HF, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D. An early marker for neurological deficits after perinatal brain lesions. The Lancet. 1997; 349(9062):1361-3.
[24]. Guzzetta A, Mercuri E, Rapisardi G, Ferrari F, Roversi MF, Cowan F, Rutherford M, Paolicelli PB, Einspieler C, Boldrini A, Dubowitz L. General movements detect early signs of hemiplegia in term infants with neonatal cerebral infarction. Neuropediatrics. 2003; 34(02):61-6.
[25]. Hadders-Algra M. Evaluation of motor function in young infants by means of the assessment of general movements: a review. Pediatr Phys Ther. 2001;13(1):27-36.
[26]. Darsaklis V, Snider LM, Majnemer A, Mazer B. Predictive validity of Prechtl’s method on the qualitative assessment of general movements: a systematic review of the evidence. Dev. Med. Child Neurol. 2011;53(10):896-906.
[27]. Hadders-Algra M, Mavinkurve-Groothuis AM, Groen SE, Stremmelaar EF, Martijn A, Butcher PR. Quality of general movements and the development of minor neurological dysfunction at toddler and school age. Clin. Rehabil. 2004;18(3):287-99.
[28]. Hughes AJ, Redsell SA, Glazebrook C. Motor development interventions for preterm infants: a systematic review and meta-analysis. Pediatrics. 2016;138(4):20160.