Assisted Physical Exercise for Improving Bone Strength in Preterm Infants Less than 35 Weeks Gestation: A Randomized Controlled Trial

Effects of massage therapy alone or together with passive mobilisations on weight gain and length of hospitalisation in preterm infants: Systematic review and meta-analysis

BACKGROUND

The effect of massage therapy alone or together with passive mobilisations on weight gain and length of hospitalisation in very preterm and moderate-to-late preterm infants remains to be elucidated.

AIM

To compare massage therapy alone or combined with passive mobilisations with a control group in preterm infants.

STUDY DESIGN

A systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was conducted. Randomised controlled trials comparing massage therapy alone or combined with passive mobilisations with a control group in preterm infants were included. MEDLINE, EMBASE, ENFISPO, PEDro and Cochrane databases were searched up to March 2022.

SUBJECTS

Preterm infants.

OUTCOME MEASURES

Weight gain and time of hospitalisation.

RESULTS

Compared to usual care, massage therapy combined with passive mobilisations was demonstrated to be more effective in improving weight gain (standardized mean difference [95%CI] 0.67 [0.31, 1.02]) and reducing length of hospitalisation (0.53 [0.10, 0.97]) outcomes. However, massage therapy alone was not effective in improving weight gain (1.14 [-0.22, 2.49]). No differences in the effectiveness of these therapies between groups according to gestational age were found (p > 0.05).

CONCLUSIONS

Based on fair-to-high quality evidence, massage therapy combined with passive mobilisations significantly improves weight gain and reduces length of hospitalisation in premature infants. However, massage therapy alone does not achieve these improvements.

Physical Therapy to Prevent Osteopenia in Preterm Infants: A Systematic Review

BACKGROUND

During the last trimester of pregnancy, about 80% of the infant's calcium is incorporated, and for this reason, preterm infants have less bone mineralization compared to those born at term. The aim of the present systematic review was to identify, evaluate and summarize the studies that deal with the effect of physiotherapy modalities in the prevention and treatment of osteopenia in preterm infants.

METHODS

A comprehensive search (09/2019-02/2021) using PubMed, Web of Science, SCOPUS, ProQuest, SciELO, Latindex, ScienceDirect, PEDro and ClinicalTrials.gov was carried out. The following data were extracted: The number of participants, characteristics of the participants, design, characteristics of the intervention, outcome measures, time of evaluation and results. A non-quantitative synthesis of the extracted data was performed. The methodological quality and risk of bias were assessed using a PEDro scale and ROB-2 scale, respectively.

RESULTS

A total of 16 studies were analyzed, presenting a methodological quality that ranged from 3 to 8 points, and all showed some concerns regarding their risk of bias. Almost all studies (15/16) used passive mobilizations with joint pressure to prevent osteopenia, but they differed in the intensity and frequency of application.

CONCLUSIONS

A daily exercise program of passive mobilizations with joint pressure, improves bone mineralization in preterm infants admitted to neonatal units.

Effects of physical activity on children's growth

OBJECTIVE

To describe the current scientific knowledge on the effects of physical exercise on the growth of children and adolescents since intrauterine life.

SOURCE OF DATA

A search was carried out in the Medline, Embase, Scielo, and Cochrane databases of studies published from 1990 to 2018. The authors included studies with different designs: clinical trials, cohort, cross-sectional and review studies.

SYNTHESIS OF DATA

Studies that addressed the subject of physical exercise or physical activity, and weight-height growth or bone or muscle tissue growth were identified. These studies were analyzed, classified, and presented by age group: fetuses, preterm newborns, preschoolers, schoolchildren, and adolescents. It was observed that almost all studies indicated the safety of physical exercises, of mild to moderate intensity, for pregnant women, as well as children and adolescents, including both aerobic and anaerobic exercises. The retrieve studies did not demonstrate that the practice of physical exercises or certain sports, especially basketball and floor gymnastics, influenced the linear growth of children or adolescents. Some studies showed an increase in bone and muscle tissue growth in child and adolescent athletes.

CONCLUSIONS

Despite the small number of studies with adequate methodology, especially randomized clinical trials, evidence appears to indicate that physical exercise is safe for both the pregnant woman and the child, from fetal life to adolescence. Physical exercise does not appear to impair the child's linear growth and contributes to the ideal shaping of bone and muscle tissues, ensuring possible beneficial effects throughout life.