Effects on motor development of kicking and stepping exercise in preterm infants with periventricular brain injury: A pilot study

Article type: Research Article

Authors: Campbell, Suzann K.^; | Gaebler-Spira, Deborah | Zawacki, Laura | Clark, April | Boynewicz, Kara | deRegnier, Raye-Ann | Kuroda, Maxine M. | Bhat, Rama | Yu, Jinsheng | Campise-Luther, Rose | Kale, Dipti | Bulanda, Michelle | Zhou, Xiaohong Joe

Affiliations: Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, IL, USA | Department of Pediatrics and Physical Medicine and Rehabilitation, Northwestern University, Rehabilitation Institute of Chicago, Chicago, IL, USA | Physical Therapy, University of Illinois Medical Center, Chicago, IL, USA | Physical Therapy, Schwab Rehabilitation Hospital, Chicago, IL, USA | Department of Pediatrics, Northwestern University, Chicago, IL, USA | Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, Chicago, IL, USA | Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA | School of Agriculture and Food Science, Zhejiang Agricultural and Forestry University, Hangzhou, Zhejiang, Peoples Republic of China | Department of Anesthesiology, University of Illinois at Chicago and Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee, WI, USA | Physical Therapy, Five Star Quality Care Rehabilitation and Wellness, Meadowood Retirement Community, Bloomington, IN, USA | Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA | Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, USA

Note: [] Address for correspondence: Suzann K. Campbell, 1301 W. Madison St. #526, Chicago, IL 60607, USA. Tel.: +1 312 733 9604; Fax: +1 312 733 0565; E-mail [email protected]

Abstract: Background: Preterm infants with periventricular brain injury (PBI) have a high incidence of atypical development and leg movements. Objective: Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age (CA) in children with PBI improves motor function at 12 months CA when compared with control subjects. Method: In a multi-center pilot study for a controlled clinical trial, sixteen infants with PBI were randomly assigned to home exercise consisting of kicking and treadmill stepping or a no-training control condition. Development was assessed at 2, 4, 6, 10, and 12 months CA with the Alberta Infant Motor Scale (AIMS). At 12 months children were classified as normal, delayed, or with cerebral palsy (CP). Results: At 12 months CA 3 of 7 (43%) of the exercise group children walked alone or with one hand held versus 1 of 9 (11%) in the control group (p=0.262), but no significant differences in AIMS scores were found at any age. Half of the subjects had CP or delay; the outcomes of these infants were not improved by exercise. Compliance with the home program was lower than requested and may have affected results. Conclusion: Although not statistically significant with a small sample size, self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI, but improvements of the protocol to increase and document compliance are needed before a larger study is implemented.

Keywords: Infant motor development, preterm infants, periventricular brain injury, exercise intervention

DOI: 10.3233/PRM-2011-0185

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 1, pp. 15-27, 2012