Early Physical Activity Intervention Prevents Decrease of Bone Strength in Very Low Birth Weight Infants

Litmanovitz, Ita; Dolfin, Tzipora; Friedland, Orit; Arnon, Shmuel; Regev, Rivka; Shainkin-Kestenbaum, R.; Lis, Monika; Eliakim, Alon

doi:10.1542/peds.112.1.15

Cited by 105 publications

(91 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, similar to our results, bone resorption markers remained constant and did not differ between intervention and CTL infants. 24,27,28 The discrepancies in bone turnover markers study between our results and those of earlier investigators may be due to inclusion of smaller, more immature infants and/or infants who were fed premature infant formula in earlier studies. Despite these subtle differences, bone biomarker results provide further evidence that physical activity promotes or maintains bone formation and mineral deposition during postnatal growth in premature VLBW infants.…”

Section: Discussioncontrasting

confidence: 82%

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

et al. 2008

View full text Add to dashboard Cite

Objective: To determine if physical activity delivered by an infant's mother would be as effective in promoting bone mineral acquisition in preterm very low birth weight (VLBW) infants as the same intervention administered by a trained therapist.Patients and methods: Preterm VLBW infants were randomized to receive daily physical activity administered by the infant's mother (MOM, n ¼ 11) or a trained therapist (OT, n ¼ 11), or control (n ¼ 11). Physical activity consisted of range of motion movements against passive resistance to all extremities for 5 to 10 min daily. All infants were fed mother's milk with fortification to 24 kcal oz À1 . Dual energy x-ray of the forearm bone area (BA, cm 2 ), mineral content (BMC, g), and density (BMD, g/cm 2 ) and measurement of bone formation (bone-specific alkaline phosphatase, BAP) and resorption (urine pyridinium crosslinks of collagen, Pyd) were obtained at study entry and at 2.0 kg of body weight.Result: Forearm BA and BMC gains were greater in MOM and OT infants compared to the control infants despite similar postnatal growth rate and nutrient intake. Serum BAP levels decreased in controls but remained unchanged in MOM and OT infants. Urine Pyd levels were similar at baseline to 2.0 kg for all groups. These findings suggest greater bone growth and mineral acquisition in MOM and OT infants than control infants. Conclusion:This study demonstrates that a physical activity program administered by the infant's own mother is as equally effective as therapist-administered physical activity in promoting greater bone growth and mineral acquisition in preterm VLBW infants.

show abstract

Section: Discussioncontrasting

confidence: 82%

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

et al. 2008

View full text Add to dashboard Cite

show abstract

“…This is consistent with other studies that evaluated daily physical activity programs alone, without the additional periods of massage. Moyer-Mileur et al, 20,21 and others utilizing a similar protocol, 22,23 demonstrated that infants receiving 5 min of daily range-of-motion exercise had improved weight gain compared to control infants who received a 5 min daily interactive period of holding and stroking. One might argue that this 'holding and stroking' may not have the same effects as a systematic protocol of moderate pressure massage.…”

Section: Discussionmentioning

confidence: 99%

“…19 Improved bone mineralization and skeletal growth have been associated with programs of daily physical activity in preterm infants. 8,[20][21][22][23] Thus physical activity may improve weight gain through a variety of mechanisms affecting body mass of all typesFadipose, muscle and bone. Additional mechanisms have been proposed that provide a basis for the benefits of massage alone in the promotion of growth.…”

Section: Discussionmentioning

confidence: 99%

Massage with kinesthetic stimulation improves weight gain in preterm infants

et al. 2009

View full text Add to dashboard Cite

Objective: The aim of this study was to evaluate the effects of massage with or without kinesthetic stimulation on weight gain and length of hospital stay in the preterm infant.Study Design: A prospective randomized clinical trial was conducted evaluating the effects of massage with or without kinesthetic stimulation (KS) on weight gain and length of stay (LOS) in medically stable premature (<1500 g and/or p32 weeks gestational age) neonates. Infants were randomized either to receive no intervention (control), massage therapy alone (massage), or massage therapy with KS (M/KS). Linear regression analysis was performed to evaluate differences in the primary outcomes between the groups after controlling for covariates. Post hoc analysis with stratification by birthweight (BW> and <1000 g) was also performed.Result: A total of 60 premature infants were recruited for this study; 20 infants in each group. Average daily weight gain and LOS were similar between the groups after controlling for covariates. For infants with BW>1000 g, average daily weight gain was increased in the intervention groups compared to control. This effect was mainly attributable to the M/KS group. Conclusion:Massage with KS is a relatively simple and inexpensive intervention that can improve weight gain in selected preterm infants. Length of hospital stay is not impacted by massage with or without KS. Further studies are needed to evaluate the effect of massage in the extremely low BW(<1000 g) infant.

show abstract

“…Studies on tactile-kinesthetic stimulation in preterm neonates regarding growth suggest that it increases weight gain 7,19,[24][25][26] and decreases the length of hospital stay. 24,25 In our study, we did not find this difference in the daily weight gain when comparing both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Intervention performed exclusively by the mothers was based on studies regarding the application of skin stimulations [13][14][15][16][17] and passive exercises 18,19 in preterm infants. The mothers were instructed to perform one stage at a time, and were supposed to end the sequence within 15 min, four times per day with an interval of 6 h. The tactile stimulation was performed on the cutaneous surface and the muscular area corresponding to the temporal, frontal, periorbital, nasal and perilabial regions of the face; the external side of the upper and lower limbs; and the soft parts of two or three fingers grouped were passed gently with moderate pressure, up to three times in one direction and three times in the opposite direction.…”

Section: Interventionmentioning

confidence: 99%

Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates

Mendes

Procianoy

2008

J Perinatol

View full text Add to dashboard Cite

Objective: To study the effect of maternal massage therapy on hospital stay in very-low-birth-weight infants who were already submitted to skin-toskin care.Study Design: A randomized study was performed including infants of birth weight X750 and p1500 g and gestational age p32 weeks. The exclusion criteria were as follows: death before completing 48 h and presence of major malformations. Neonates were divided into intervention group (IG) (standard care plus maternal massage) and control group (CG). Anthropometric data were always verified by a person blind to the group to which the newborn belonged. Maternal massage was performed four times a day on the face and limbs. Passive exercises of upper and lower limbs were also done by the mothers.Result: A total of 104 newborns were included, 52 in each group. Both groups were similar in gestational age (IG: 29.7 ± 1.6; CG: 29.4 ± 1.6 weeks), birth weight (IG: 1186±194; CG: 1156±198 g), gender, number of small-for-gestational-age infants, SNAPPE-II, deaths, gains in weight, length and head circumference. Incidence of late-onset sepsis was significantly lower in the intervention group (IG: 10.8%, n ¼ 5; CG: 38.3%, n ¼ 18; P ¼ 0.005). IG was discharged from the hospital 7 days before CG (IG: 42, confidence interval (CI) 95%: 38 to 46; CG: 49, CI 95%: 42 to 56), and presented 1.85 hazard ratio (CI 95%: 1.09 to 3.13; P ¼ 0.023) for early discharge. Keywords: massage therapy; tactile stimulation; kinesthetic stimulation; very-low-birth-weight infants; neonatal sepsis Introduction Early interruption of gestation brings consequences that still cannot be fully avoided even in neonatal units with the most modern technological resources and best survival rates. There is a high probability of preterm infants going beyond the neonatal period before reaching a growth 1 and development 2 pattern similar to that of term newborns. In addition, the need for a long hospital stay period makes the presence of parents essential for assistance, once the parents' competence to understand and provide the premature infant's needs is consolidated as one of the main medical criteria for hospital discharge. 3 Studies involving the hospital stay period of preterm infants showed that relatively simple measures improve their prognoses, such as skin-to-skin contact reduces the painful sensation of term neonates 4 and promotes the development and parental relation of preterm infants; 5 the creation of a sleep-provoking environment increases the growth rate of very-low-birth-weight (VLBW) infants; 6 the application of tactile-kinesthetic stimulation contributes to both growth and development of preterm infants between 1000 and 2000 g, without adverse effects on physiological parameters; 7 instructions to first-child parents on how to bathe and massage favors parent-infant bonding; 8 and the participation of mothers through massage with moderate pressure improves growth and development rates of term infants. 9 Despite these evidences, in two systematic revisions, one regarding the tactile-kinesthetic s...

show abstract

Early Physical Activity Intervention Prevents Decrease of Bone Strength in Very Low Birth Weight Infants

Abstract: There is a significant postnatal decrease in the bone SOS of very low birth weight infants. A brief range-of-motion exercise attenuates the decrease in bone strength and may decrease the risk of osteopenia.

Cited by 105 publications

References 24 publications

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

Massage with kinesthetic stimulation improves weight gain in preterm infants

Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates

Contact Info

Product

Resources

About