ABSTRACT
Background: Premature infants often have feeding difficulties leading to morbidity or developmental co-morbidities. Premature infant oral motor intervention (PIOMI), has shown the positive effects on feeding progression of the premature infants. PIOMI with the massage technique, may help in improving oral motor activity, weight gain in preterm infants along with better neurobehavioral organization. The study was done to analyse effect of this combined protocol on achieving oral motor control and Neurobehavioral state regulation and evaluate its efficacy against PIOMI.Methods: A total 72 clinically stable infants admitted in premature care unit, fulfilling inclusion criterion were enrolled. They were allocated in control and experimental group. Infants from control group received PIOMI and experimental group received PIOMI with massage therapy (M technique), for 10 minutes each day. Data was collected for oral motor abilities, behavioural assessment, weight and day of achieving full feeds.Results: Gestational age at full feeds was 33.65 weeks and 32.89 weeks in control and experimental groups respectively with ‘p’ value 0.002. The number of days of full feed in experimental group was 3.7 days earlier (p=0.04). Infants from experimental group showed higher oral motor score and more weight gain with significant difference The behavioral regulation in infants of both the groups improved after 8 day.Conclusions: PIOMI with M technique was well tolerated by preterm infants. The modified protocol has resulted in achieving early oral feeds and reducing hospital stay. It has also shown the benefit of behavioural regulation along with better oral motor control.
ABSTRACT
Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.