Vaivre-Douret L, Ennouri K, Jrad I, Garrec C, Papiernik E
Service de gynécologie obstétrique, Groupe hospitalier Cochin-St Vincent de Paul. Maternité Port-Royal Baudelocque, Paris, France.
Eur J Paediatr Neurol. 2004;8(1):21-34. doi: 10.1016/j.ejpn.2003.10.001.
BACKGROUND. The preterm infant is subject to the force of gravity: when its body lies pressed against the mattress on which it is placed.
The purpose of this study was to investigate short-term effects of varied post-natal lying positions in order to prevent neuromuscular and postural abnormalities.
60 low risk preterm infants of 31-36 weeks gestational age were enrolled for this randomised clinical trial. Initially each child underwent neurological and psychomotor assessments which included tonus and reflex protocols as well as behavioral, sensory motor and postural examinations. The lying positions of the treated group were varied (back, prone, and side) using a specially designed moldable mattress that maintained the functional position of the infant's body. The control group was placed on their stomachs, (the standard lying position used in 1994) with a standard orthopaedic bolster support under their hips. All infants underwent a second round of examinations upon discharge to assess any changes in neurological and psychomotor outcomes.
The sensory-motor skills examinations showed significant abnormalities in the control group: (1) dominance of the extensor muscles due to muscle shortening, (2) hyper abduction and flexion of the arms, and (3) global neuromuscular rigidity. Psychomotor and neurological exams of the control and treatment groups showed delayed developmental muscular acquisitions for infants in the control group.
Regular changes in posture, while retaining correct functional positions, allowed maintenance of normal neuromuscular and osteo-articular function and permitted the development of spontaneous and functional motor activity in low-risk perterm infants.
背景。早产儿会受到重力影响：当其身体压在放置它的床垫上时。
本研究旨在调查不同产后躺卧姿势的短期影响，以预防神经肌肉和姿势异常。
本随机临床试验纳入了60名孕龄31 - 36周的低风险早产儿。最初，每个孩子都接受了神经和心理运动评估，包括肌张力和反射检查以及行为、感觉运动和姿势检查。治疗组使用专门设计的可塑形床垫改变躺卧姿势（仰卧、俯卧和侧卧），该床垫能保持婴儿身体的功能位置。对照组则采用1994年使用的标准躺卧姿势，即趴着，并在臀部下方放置标准矫形垫支撑。所有婴儿出院时都接受了第二轮检查，以评估神经和心理运动结果的任何变化。
感觉运动技能检查显示对照组存在明显异常：（1）由于肌肉缩短导致伸肌占优势，（2）手臂过度外展和屈曲，以及（3）全身神经肌肉僵硬。对照组和治疗组的心理运动和神经检查显示，对照组婴儿的肌肉发育延迟。
保持正确功能位置的同时定期改变姿势，可维持低风险早产儿正常的神经肌肉和骨关节功能，并促进自发和功能性运动活动的发展。
