PreEMPT（早产儿早期干预运动和参与试验）：一项随机对照试验的可行性结果。

PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial.

机构信息

School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia 4072, Qld, Australia; Toowoomba Hospital, Darling Downs Health Service, Queensland Health, Toowoomba 4350, Qld, Australia.

School of Physiotherapy, University of Melbourne, Parkville 3052, Vic, Australia; Murdoch Children's Research Institute, Flemington Rd, Parkville 3052, Vic, Australia.

出版信息

Early Hum Dev. 2022 Mar;166:105551. doi: 10.1016/j.earlhumdev.2022.105551. Epub 2022 Feb 3.

DOI:10.1016/j.earlhumdev.2022.105551

PMID:35152175

Abstract

PURPOSE

Investigate feasibility of PreEMPT: a novel participation-focused, early physiotherapy intervention for preterm infants in regional Australia.

MATERIALS AND METHODS

Participants were infants born <35 weeks, residing in regional Australia. Sixteen infants were recruited then randomised to usual physiotherapy care (UPC: n = 8) or PreEMPT (n = 8). PreEMPT involved 14-weeks of alternating clinic- or telehealth-based, participation-focused intervention. Feasibility was evaluated by: demand, practicality, acceptability, implementation and limited efficacy testing for infants (motor, participation) and parents (mental well-being, self-efficacy).

RESULTS

Demand was lower than expected (45% recruitment rate). For practicality, attrition was high in the PreEMPT group (mean assessment attendance 3.8/5 sessions, range 2-5) compared to UPC (4.8/5 sessions, range 4-5). In addition, mean PreEMPT treatment dose received was approximately half intended (overall: 7.3/14 sessions, range 0-12; equivalent for face-to-face: 3.9/7, range 0-6, versus telehealth 3.4/7, range 0-6). The most common reason cited for treatment non-attendance was maternal mental health (22 sessions). Treatment acceptability for parents was high, with PreEMPT parents reporting they were offered choices in sessions (p = .02), and increased their knowledge (p = .01) and confidence (p = .009). There was a large effect size in favour of PreEMPT for increased parental self-efficacy (p = .021, ES = 1.34).

CONCLUSION

Early post-discharge physiotherapy for preterm infants in regional Australia is beneficial according to families but logistically challenging.

摘要

目的

研究 PreEMPT 的可行性：一种针对澳大利亚偏远地区早产儿的新型以参与为重点的早期物理治疗干预方法。

材料与方法

参与者为出生时胎龄<35 周、居住在澳大利亚偏远地区的婴儿。招募了 16 名婴儿，然后随机分为常规物理治疗组（UPC：n=8）或 PreEMPT 组（n=8）。PreEMPT 包括 14 周的交替诊所或远程医疗为基础的、以参与为重点的干预措施。通过以下方面评估可行性：需求、实用性、可接受性、实施情况以及对婴儿（运动、参与）和父母（心理健康、自我效能感）的有限疗效测试。

结果

需求低于预期（招募率为 45%）。在实用性方面，PreEMPT 组的失访率很高（平均评估出勤率为 3.8/5 次，范围为 2-5），而 UPC 组为 4.8/5 次，范围为 4-5）。此外，PreEMPT 组实际接受的治疗剂量大约为预期剂量的一半（总体：14 次治疗中接受了 7.3 次，范围为 0-12；面对面治疗：3.9/7 次，范围为 0-6，远程治疗：3.4/7 次，范围为 0-6）。治疗不依从最常见的原因是母亲心理健康问题（22 次）。父母对治疗的接受度很高，PreEMPT 组的父母表示他们在治疗中得到了选择（p=0.02），并增加了他们的知识（p=0.01）和信心（p=0.009）。PreEMPT 组父母自我效能感的提高有较大的效应量（p=0.021，ES=1.34）。