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Open Access Highly Accessed Study protocol

Study protocol: an early intervention program to improve motor outcome in preterm infants: a randomized controlled trial and a qualitative study of physiotherapy performance and parental experiences

Gunn Kristin Øberg13*, Suzann K Campbell6, Gay L Girolami6, Tordis Ustad5, Lone Jørgensen1 and Per Ivar Kaaresen24

Author affiliations

1 Faculty of Health Sciences, Department of Health and Care Sciences, University of Tromsø, 9037 Tromsø, Norway

2 Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway

3 Clinic of Rehabilitation, Physical Therapy Section, University Hospital of Northern Norway HF, 9038 Tromsø, Norway

4 BUK, University Hospital of Northern Norway HF, 9038 Tromsø, Norway

5 Clinic of Clinical Services, University Hospital Trondheim, St.Olavs Hospital HF, 7006 Trondheim, Norway

6 University of Illinois at Chicago, Chicago, USA

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Citation and License

BMC Pediatrics 2012, 12:15  doi:10.1186/1471-2431-12-15

Published: 15 February 2012

Abstract

Background

Knowledge about early physiotherapy to preterm infants is sparse, given the risk of delayed motor development and cerebral palsy.

Methods/Design

A pragmatic randomized controlled study has been designed to assess the effect of a preventative physiotherapy program carried out in the neonatal intensive care unit. Moreover, a qualitative study is carried out to assess the physiotherapy performance and parents' experiences with the intervention. The aim of the physiotherapy program is to improve motor development i.e. postural control and selective movements in these infants. 150 infants will be included and randomized to either intervention or standard follow-up. The infants in the intervention group will be given specific stimulation to facilitate movements based on the individual infant's development, behavior and needs. The physiotherapist teaches the parents how to do the intervention and the parents receive a booklet with photos and descriptions of the intervention. Intervention is carried out twice a day for three weeks (week 34, 35, 36 postmenstrual age). Standardized tests are carried out at baseline, term age and at three, six, 12 and 24 months corrected age. In addition eight triads (infant, parent and physiotherapist) are observed and videotaped in four clinical encounters each to assess the process of physiotherapy performance. The parents are also interviewed on their experiences with the intervention and how it influences on the parent-child relationship. Eight parents from the follow up group are interviewed about their experience. The interviews are performed according to the same schedule as the standardized measurements. Primary outcome is at two years corrected age.

Discussion

The paper presents the protocol for a randomized controlled trial designed to study the effect of physiotherapy to preterm infants at neonatal intensive care units. It also studies physiotherapy performance and the parent's experiences with the intervention.

ClinicalTrials.gov NCT01089296

Keywords:
Preterm infants; early intervention; Physiotherapy; Motor development; Parental experience