The effects of an early physical therapy intervention for very preterm, very low birth weight infants: a randomized controlled clinical trial

Abstract

Purpose: A randomized controlled clinical trial was used to investigate effects of physical therapy (PT) intervention on motor outcome of infants born very preterm with very low birth weight (VLBW).

Methods: Seventy-two infants born very preterm with VLBW were randomly assigned to a nontreatment (NT) (n = 38) or treatment (T) (n = 34) group. The T group received developmental PT from birth until four months corrected age (CA) weekdays during the infant's neonatal stay and on a needs- and problem-orientated basis thereafter. The NT group received no intervention. Both groups were assessed at four months CA using the Alberta Infant Motor Scale (AIMS) as was a control group of 14 infants born full term. Parental compliance was measured using a parent questionnaire.

Results: PT intervention had no significant effect on the T group's motor performance. However, no T group subjects had abnormal motor development at four months CA when compared to the NT group (16%) and the control group (14%) (p = 0.09). The T group subjects with high levels of parental compliance had better scores on the AIMS than those with lower parental compliance (p = 0.05).

Conclusion: PT intervention does not significantly affect motor performance of infants born very preterm with VLBW at four months CA. Parental compliance and intervention frequency may have influenced the outcome. Preliminary evidence suggests that neonatal and early PT may reduce the incidence of motor delay among infants born very preterm with VLBW. Follow-up of this group is recommended to ascertain the long-term benefits of this type of early PT.