Daily physical activity in low-risk extremely low birth weight preterm infants: positive impact on bone mineral density and anthropometric measurements

Abstract

The aim of this study was to evaluate the changes in bone mineral density and anthropometric indices of extremely low birth weight (ELBW) preterm infants undergoing daily physical activity. Twenty-eight low-risk ELBW preterm infants (intervention group = 14, control group = 14) with a birth weight of under 1000 g and gestational age of 26-32 weeks were recruited. Preterm infants in the control group were provided with standard nursing care, whereas those in the intervention group received a daily physical activity programme in addition to standard nursing care during the study. Before and after the study, anthropometric indices and tibial speed of sound (SOS) values were measured. In this study, the tibial SOS values were found to be increased in the intervention group (+111.14 m/s) (p = 0.001) and decreased in the control group (-58.21 m/s) (p = 0.030). The increase in percentage of body weight, height, and tibial length of infants in the intervention group was significantly higher than in the control group (respectively; p = 0.002, p = 0,015, p < 0.001). A daily physical activity programme increased body weight, height, tibial length, and SOS values of the tibia in ELBW preterm infants.

Assisted Physical Exercise for Improving Bone Strength in Preterm Infants Less than 35 Weeks Gestation: A Randomized Controlled Trial

“…Post hoc, sub-group analysis was done to compare infants in each strata with GA 27 0/7 to 32 6/7 and 33 0/7 to 34 6/7 respectively, and also by their intrauterine growth Our findings are in contrast to the literature which shows either attenuation of decline in bone SOS [12,13] or increase in bone SOS with physical activity [14,15]. Our results are similar to the study by Moyer-Mileur, et al, [16] in which no difference was found in bone mineral content or bone area at 12 months of corrected age when compared between exercise and control group.…”

“…The baseline values of bone SOS in their study were significantly higher in control group as compared to intervention group and no adjustment was done during statistical analysis. Another study from Turkey [15] found a slightly higher bone SOS in exercise group in ELBW infants but the sample size was small and confidence intervals were wide. Our study population had a larger sample size, included small for gestational age infants and was racially and ethnically very different.…”

“…PE did not result in any significant difference in growth parameters such as weight, length and head circumference in our study. Previous studies have found mixed results with some showing gain in weight and length but not head circumference [7,9,15,[19][20][21] while others did not find any improvement in any of these parameters [13,22]. The possible reason would be increasing spontaneous activity of the infants as they approach term age.…”

Metabolic Bone Disease in Premature Neonates: An Unmet Challenge

“…It was noted to enhance the body weight, bone mineralization and osteogenesis. Some studies have shown that the exercise could attenuate the postnatal reduction in bone speed of sound (47)(48)(49)(50)(51). It is interesting that nutrition plays a dual role in MBD, both therapeutic and preventive.…”

Quantitative Ultrasound as a Biomarker Tool in Newborn Infants for the Bone

“…Again, these severely ill infants with prolonged mechanical ventilation and possible sedation lay immobile for long periods of time so that the antigravitational movements that could promote bone matrix deposition are absent. Erdem et al evaluated the changes in bone mineral density and anthropometric indices of ELBW preterm infants undergoing daily physical activity (Erdem et al 2015). In this small randomized controlled trial, patients who underwent daily physical activity showed increasing tibial SOS values after birth, while patients treated with standard care showed decreasing tibial SOS values.…”