Effectiveness of Early Structured Multimodal Physiotherapy Intervention on Neuromotor Outcomes in Preterm Infants

Abstract

Advances in the care of preterm babies right from the NICU has led to decrease in their mortality rate and increased their survival rate The increase in survival has not reduced the morbidities which is associated with the preterm birth Many of these preterm survivors face a lifetime of disability including motor sensory visual and hearing problems and also learning disabilities When a baby is born preterm the environment that the babys brain is exposed is very different from inutero environment This change in environment can also cause brain injury because the developing brain must now process all the information from the new environment before it is developmentally ready to do so This type of sensory overload may result in abnormal brain connections and structure in preterm infants This may subsequently contribute to brain injury and abnormal development in preterm infants which predisposes the infant to impaired gross motor skills Early intervention with various sensory stimulations which is started before 40 weeks of postmenstrual age prior to any structural changes to the brain is most effective in improving the neuro motor outcomes in preterm infants To find out the effectiveness of an early structured multimodal physiotherapy intervention protocol which was developed by the researcher on neuromotor outcomes in preterm infants followed up till the corrected age of four months In the first part of the study a structured multimodal physiotherapy early intervention protocol to improve neuro motor outcomes in preterm infants was developed and validated In the second part of the study this protocol was applied to 69 preterm infants in intervention group which was initiated in the NICU when they were medically stable and this was continued in wards and at home till 4 months of corrected age and they were followed up every month The intervention was demonstrated to the mother caregiver by the physiotherapist And she was instructed to do this daily minimum 5 sessions per week at home Control group with 70 preterm