Shen Y-J1,2, Chen L-C2,3, Tsao P-N4, Wang L-Y2,5, Jeng S-F2,5
1Far Eastern Memorial Hospital, Department of Rehabilitation, Taipei, Taiwan, 2School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, 3Fooyin University, Department of Physical Therapy, Kaohsiung, Taiwan, 4National Taiwan University Children's Hospital, Department of Pediatrics, Taipei, Taiwan, 5Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
Background: Infants born preterm are at risk for neurodevelopmental disorders and adverse long-term health outcomes. Previous studies have shown short- to mid-term efficacy of early intervention for preterm children; however, the investigation of longer-term effects was rare. Our research team designed family-centered early intervention programs for preterm infants with very low birth weight (VLBW, birth weight 1,500 g) lasting from hospitalization to one year of corrected age and demonstrated their short-term developmental benefits compared to a usual care program in a randomized controlled trial.
Purpose: The purpose of the present study was to examine the effectiveness of these intervention programs on motor function, lung function, physical activity, behavior and health-related quality of life (HRQL) in preterm children with VLBW at school age compared to the usual care program. A group of full-term children served as the normative reference.
Methods: Preterm children with VLBW and full-term children who had participated in our previous intervention study were recruited at 9-10 years of age. Children's motor function was examined using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition; lung function was measured by pulmonary function test with a computerized spirometer; physical activity was recorded for seven consecutive days using an accelerometer; behavior was assessed using the Child Behavior Checklist; HRQL was assessed using the Pediatric Quality of Life Inventory (PedsQL). Meanwhile, family impacts due to the child's condition was assessed using the PedsQL- Family Impact Module (version 2.0).
Results: Sixty-two preterm children with VLBW (intervention: N=44; usual care: N=18) and 17 full-term children returned for follow-up assessments. Compared to full-term children, preterm children in the usual care group had significantly poorer motor performance, lung function, attention and social functioning (all adjusted p .05). Preterm children in the intervention group were comparable with full-term children in most outcome measures and exhibited significantly better body coordination (adjusted p=.006), bilateral coordination (adjusted p=.01), balance (adjusted p=.048) and total motor performance (adjusted p=.002) than those in the usual care group. Early intervention showed borderline effects on preterm children's lung function, emotional behaviors and social functioning. In addition to child outcomes, positive effect of early intervention was also revealed in reducing parental distress (adjusted p=.04).
Conclusion(s): Preterm children with VLBW remained to show adverse outcomes in motor performance, lung function, behaviors and social functioning at school age. Family-centered care was effective to enhance both physical and psychosocial health of preterm children with VLBW and to reduce parental distress at school age.
Implications: Family-centered care should be provided with comprehensive child-, parent- and dyad-focused services from hospitalization to one year for preterm infants to enhance long-term outcomes of children and their families.
Keywords: Early intervention, Preterm children, School Age
Funding acknowledgements: National Health Research Institute and Ministry of Science and Technology of Taiwan
Purpose: The purpose of the present study was to examine the effectiveness of these intervention programs on motor function, lung function, physical activity, behavior and health-related quality of life (HRQL) in preterm children with VLBW at school age compared to the usual care program. A group of full-term children served as the normative reference.
Methods: Preterm children with VLBW and full-term children who had participated in our previous intervention study were recruited at 9-10 years of age. Children's motor function was examined using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition; lung function was measured by pulmonary function test with a computerized spirometer; physical activity was recorded for seven consecutive days using an accelerometer; behavior was assessed using the Child Behavior Checklist; HRQL was assessed using the Pediatric Quality of Life Inventory (PedsQL). Meanwhile, family impacts due to the child's condition was assessed using the PedsQL- Family Impact Module (version 2.0).
Results: Sixty-two preterm children with VLBW (intervention: N=44; usual care: N=18) and 17 full-term children returned for follow-up assessments. Compared to full-term children, preterm children in the usual care group had significantly poorer motor performance, lung function, attention and social functioning (all adjusted p .05). Preterm children in the intervention group were comparable with full-term children in most outcome measures and exhibited significantly better body coordination (adjusted p=.006), bilateral coordination (adjusted p=.01), balance (adjusted p=.048) and total motor performance (adjusted p=.002) than those in the usual care group. Early intervention showed borderline effects on preterm children's lung function, emotional behaviors and social functioning. In addition to child outcomes, positive effect of early intervention was also revealed in reducing parental distress (adjusted p=.04).
Conclusion(s): Preterm children with VLBW remained to show adverse outcomes in motor performance, lung function, behaviors and social functioning at school age. Family-centered care was effective to enhance both physical and psychosocial health of preterm children with VLBW and to reduce parental distress at school age.
Implications: Family-centered care should be provided with comprehensive child-, parent- and dyad-focused services from hospitalization to one year for preterm infants to enhance long-term outcomes of children and their families.
Keywords: Early intervention, Preterm children, School Age
Funding acknowledgements: National Health Research Institute and Ministry of Science and Technology of Taiwan
Topic: Paediatrics
Ethics approval required: Yes
Institution: National Taiwan University Hospital
Ethics committee: Research Ethics Committee of the National Taiwan University Hospital
Ethics number: 201512195RIND
All authors, affiliations and abstracts have been published as submitted.
