Ustad T1,2, Fjørtoft T1, Jørgensen L3,4, Kaaresen PI5, Øberg GK3,4
1St. Olavs Hospital, Clinic of Clinical Services, Trondheim, Norway, 2Norwegian University of Science and Technology, Department of Clinical and Molecular Medicine, Trondheim, Norway, 3University of Tromsø, The Arctic University of Norway, Department of Health and Care Sciences, Tromsø, Norway, 4University Hospital North Norway, Section of Physiotherapy, Tromsø, Norway, 5University Hospital North Norway, The Newborn Intensive Department, Tromsø, Norway
Background: We have conducted a multi-centre randomised controlled trial, “the Norwegian Physiotherapy Study in Preterm Infants” (NOPPI). One aim was to investigate change in motor performance after parent-administrated physiotherapy conducted before term-equivalent age. We found a significant group difference from week 34 to 37 postmenstrual age (PMA) in favour of the intervention group. The infants spontaneous movements, week 34 and 36 PMA, were video-recorded for later assessment of general movements (GMs).
Purpose: The aim of this study was to compare GMs in the intervention and the control group.
Methods: Video-recordings of 140 infants, mean birth weight 1400 grams and mean gestational age 29.7 weeks, were assessed by two paediatric physiotherapists, blinded for group belongings. The GMs were classified as normal if variable and complex and abnormal if monotonous, repetitive, cramped synchronised or chaotic.
Results: In the control group (n=76) 35% were classified with normal GMs at week 34 and 31% at week 36 PMA. In the intervention group (n=64) 20% were classified with normal GMs at week 34 and 28% at week 36 PMA. Abnormal GMs in preterm infants, which normalises as the infants develop, are expected. In our study, during a period of three weeks, this was only evident in the intervention group.
Conclusion(s): In this study we have shown that more infants in the intervention group had normalisation of their GMs compared to controls. But further research on long-term effect of early intervention is needed, before we can make conclusions about the consequences of this finding.
Implications: General movement assessment, used at three months of age, can predict cerebral palsy. The method is less valid when assessing younger infants, and it has not earlier been used as an outcome measure in a randomised controlled study. Thus it is too early to make any conclusions about its usefulness in this respect or the clinical implications of this finding.
Keywords: General movements, Early intervention, Preterm born infants
Funding acknowledgements: The Norwegian ExtraFoundation for Health and Rehabilitation through EXTRA funds (2013-2016). The Norwegian Fund for Post-Graduate training in Physiotherapy
Purpose: The aim of this study was to compare GMs in the intervention and the control group.
Methods: Video-recordings of 140 infants, mean birth weight 1400 grams and mean gestational age 29.7 weeks, were assessed by two paediatric physiotherapists, blinded for group belongings. The GMs were classified as normal if variable and complex and abnormal if monotonous, repetitive, cramped synchronised or chaotic.
Results: In the control group (n=76) 35% were classified with normal GMs at week 34 and 31% at week 36 PMA. In the intervention group (n=64) 20% were classified with normal GMs at week 34 and 28% at week 36 PMA. Abnormal GMs in preterm infants, which normalises as the infants develop, are expected. In our study, during a period of three weeks, this was only evident in the intervention group.
Conclusion(s): In this study we have shown that more infants in the intervention group had normalisation of their GMs compared to controls. But further research on long-term effect of early intervention is needed, before we can make conclusions about the consequences of this finding.
Implications: General movement assessment, used at three months of age, can predict cerebral palsy. The method is less valid when assessing younger infants, and it has not earlier been used as an outcome measure in a randomised controlled study. Thus it is too early to make any conclusions about its usefulness in this respect or the clinical implications of this finding.
Keywords: General movements, Early intervention, Preterm born infants
Funding acknowledgements: The Norwegian ExtraFoundation for Health and Rehabilitation through EXTRA funds (2013-2016). The Norwegian Fund for Post-Graduate training in Physiotherapy
Topic: Paediatrics; Neurology
Ethics approval required: Yes
Institution: Regional Committee for Medical and Health Research Ethics North Norway
Ethics committee: Regional Committee for Medical and Health Research Ethics North Norway
Ethics number: REC North: 2009/916-7
All authors, affiliations and abstracts have been published as submitted.
