THE IMPACT OF FAMILY-CENTERED CARE ON MOTOR FUNCTION IN PRETERM INFANTS: A SYSTEMATIC REVIEW

N. Rodio¹, L. Byrne¹, D. Franceschelli¹, L. Iobst¹, H. Kenyon¹, L. Walton¹, A. Javed²

¹University of Scranton, Physical Therapy, Scranton, United States, ²University of Sharjah, Sharjah, United Arab Emirates

Background: An estimated 15 million babies are born preterm worldwide each year. The earlier an infant is born, the greater their risk for both short and long-term health problems and developmental delays. While parents are educated on the best practices prior to leaving the hospital, familial integration has only recently become a priority when treating preterm infants. Parent integration in the physical therapy plan of care and implementing caregiver-administered intervention are becoming primary components of the early intervention process to promote proper development and milestone achievement.

Purpose: The purpose of this systematic review is to evaluate the current literature on the effectiveness of caregiver-administered exercise in conjunction with a physical therapy program on motor performance in preterm infants compared to standard care.

Methods: A literature search was conducted using the search terms (“parent-administered” OR “family-centered” OR “parent education” OR “home based”) AND (“physical therapy” OR “exercise”) AND (“preterm infants” OR “premature infants”). Search limits: English, journals, human subjects, and 2012-2022. Selection criteria: preterm infants born less than 37 weeks, of no specific gender or diagnosis, and an intervention that included the parents in any setting. Each study was independently assessed by two reviewers for methodological quality based on the Oxford Levels of Evidence (2011).

Results: 538 studies were screened for eligibility. After appraisal, 14 met selection criteria with levels of evidence ranging from 2-3 with sample size ranging from 16-251 (N total=1,375). Treatment parameters ranged from 32 weeks postmenstrual age to 18 months corrected age, follow up outcomes varied from 1 month to 1 year post intervention, and all studies used motor performance as a primary outcome. Sessions ranged from 10-60 minutes for 1-14 times per week. Statistically significant improvements in motor outcomes were reported in 11 of the studies included. Improvements ranged from 4.8 - 5.2 points on the Alberta Infant Motor Scale (AIMS) after 4 weeks of intervention and from 5.5 - 18.0 points over the course of 4 weeks - 18 months on the Infant Motor Profile (IMP). Scores increased by 26.4 points after 3 weeks of intervention on the Test of Infant Motor Performance (TIMP) and by 11.6 points after 12 months of intervention on the motor domain of the Bayley Scale of Infant Development (BSID-III). Fine motor skills as measured by the Ages and Stages Questionnaire (ASQ-3) improved by 2 points over 8 months.

Conclusions: There is moderate to high level evidence that caregiver-administered interventions leads to improved motor performance in preterm infants. The amount of change on various motor outcomes described above demonstrates meaningful, functional improvements in preterm infants. Limitations included variable parental compliance and lack of blinding of subjects and therapists.

Implications: Parent involvement is a critical component of physical therapy interventions for premature infants, as those in intervention groups that received family-centered care had overall better motor performance outcomes compared to standard care. Early caregiver involvement can promote improvements in motor development. These improvements can be assessed using objective outcome measures such as the TIMP, IMP, AIMS, ASQ-3 and BSID-III.

Funding acknowledgements: None to report.

Keywords:
Parent-administered
Paediatrics
Education

Topics:
Paediatrics
Health promotion & wellbeing/healthy ageing/physical activity
Neurology

Did this work require ethics approval? No

Reason: This abstract is a systematic review.