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一项针对改善住院极低出生体重儿短期运动结局的家长实施干预的随机对照试验。

A randomized-controlled trial of parent-administered interventions to improve short-term motor outcomes in hospitalized very low birthweight infants.

机构信息

Department of Pediatrics, Division of Developmental Pediatrics, University of Virginia, Charlottesville, VA, USA.

Public Health Sciences, University of Virginia, Charlottesville VA, USA.

出版信息

J Neonatal Perinatal Med. 2024;17(5):637-645. doi: 10.3233/NPM-230206.

Abstract

BACKGROUND

Premature infants are at increased risk for cerebral palsy (CP). Early interventions with a motor focus and administered by parents may improve motor outcomes.

AIMS

Secondary study evaluating the short-term motor outcomes and risk for CP in very low birthweight (VLBW) infants randomized to multimodal interventions with a motor focus provided by parents versus usual care.

STUDY DESIGN

Randomized controlled trial (intervention vs. usual care (control group)).

SUBJECTS

Infants (<32 weeks' gestational age (GA) and/or <1500 grams birthweight) born between March 2019 and October 2020.

OUTCOME MEASURES

Short-term motor outcomes and risk for CP was evaluated using the Hammersmith Infant Neurological Evaluation (HINE, primary motor outcome), the General Movement Assessment (GMA) and the Test of Infant Motor Performance (TIMP) at 3 months' postmenstrual age (PMA).

RESULTS

70 participants were enrolled (GA 28.3±2.7 weeks, birthweight 1139.2±376.6 grams, 64.3% male). The in-person follow-up rate was 73%, lower than expected, in part due to COVID-19 restrictions, resulting in 25 infants (intervention) and 26 infants (control) with outcome data available for analysis. There was not a significant difference in the HINE, GMA or TIMP at 3 months' PMA between groups.

CONCLUSION

Multimodal interventions with a motor focus and provided by parents need further investigation to determine if they can improve short-term motor outcomes in VLBW infants. These interventions are evidence-based and the evaluation of broader implementation into routine care is also needed.

摘要

背景

早产儿脑瘫(CP)的风险增加。早期以运动为重点的干预措施,并由父母实施,可能会改善运动结果。

目的

二次研究评估了有运动重点的多模式干预措施的父母与常规护理对极低出生体重(VLBW)婴儿的短期运动结果和 CP 风险的影响。

研究设计

随机对照试验(干预与常规护理(对照组))。

受试者

2019 年 3 月至 2020 年 10 月出生的(<32 周胎龄(GA)和/或<1500 克出生体重)婴儿。

结局测量

采用 Hammersmith 婴儿神经学评估(HINE,主要运动结局)、通用运动评估(GMA)和婴儿运动表现测试(TIMP)在 3 个月的月经龄(PMA)评估短期运动结果和 CP 风险。

结果

70 名参与者入组(GA 28.3±2.7 周,出生体重 1139.2±376.6 克,64.3%男性)。由于 COVID-19 限制,实际随访率为 73%,低于预期,导致 25 名婴儿(干预组)和 26 名婴儿(对照组)有结果数据可用于分析。在 3 个月的 PMA 时,两组之间 HINE、GMA 或 TIMP 没有显著差异。

结论

有运动重点的多模式干预措施,并由父母提供,需要进一步研究,以确定它们是否可以改善 VLBW 婴儿的短期运动结果。这些干预措施是基于证据的,也需要评估更广泛地将其纳入常规护理。

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