scholarly journals Cardio-Respiratory Events and Food Autonomy Responses to Early Uni-Modal Orofacial Stimulation in Very Premature Babies: A Randomized, Controlled Study

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1188
Author(s):  
Sahra Méziane ◽  
Véronique Brévaut-Malaty ◽  
Aurélie Garbi ◽  
Muriel Busuttil ◽  
Gaelle Sorin ◽  
...  

Uni-modal orofacial stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants. Our study was randomized, controlled, prospective, and unicentric. The preterm included were born between 26–29 weeks gestational age (GA) with a corrected postnatal age <33 weeks GA. They were randomized into two groups: the experimental group underwent OFS, according to a protocol established, over 10 consecutive days, and the control group underwent no OFS. The primary outcome was the number of cardiorespiratory events: apnea–bradycardia (with or without desaturations) or number of isolated desaturations, which were evaluated at four separate times. Measurements occurred during the first, fourth and eighth independent feedings. Seventeen patients were included in the experimental group and 18 in the control group. The number of cardiorespiratory events for all independent feeding times was significantly reduced in the OFS group (p = 0.003) with univariate analysis, but not with multivariable analysis. The quantity of milk ingested during the first autonomous feeding was higher in the experimental group. The acquisition of food autonomy and the duration of hospitalization were similar in the two groups. While our study does not affirm that an early unimodal OFS improves premature infants’ cardiorespiratory evolution and/or the acquisition of food autonomy, it does indicate an improved food efficiency during their first autonomous feedings.

2020 ◽  
Author(s):  
Sahra Meziane ◽  
Véronique Brévaut-Malaty ◽  
Aurélie Garbi ◽  
Muriel Busuttil ◽  
Gaelle Sorin ◽  
...  

Abstract BackgroundThe Uni-modal OroFacial Stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants.MethodsRandomized, controlled, prospective, and unicentric study. Preterm included were born between 26-29 week‘s gestational age (GA) and with a corrected postnatal age <33 week’s GA. They were randomized in two groups: experimental group underwent an OFS according to a protocol established over 10 consecutive days, and the control group underwent no OFS. The primary outcome were the number of cardiorespiratory events: apnea-bradycardia (with or without desaturations) or number of isolated desaturations which were evaluated at four separate times. The measurement occurred during a first, four and eight independent feedings. Results17 patients in the experimental group and 18 in the control group were included. The number of cardiorespiratory events for all independent- feedings time was significantly reduced in the OFS group (p = 0.003) in the univariate analysis but not in multivariable analysis. There were no signs of poor tolerance noted in the protocol. The quantity of milk ingested during the first autonomous feeding was higher in the experimental group. The acquisition of food autonomy and the duration of the hospitalization stay were similar in the two groups.ConclusionsWhile our study does not affirm that an early unimodal OFS improves the premature infants’ cardiorespiratory evolution and/or the acquisition of food autonomy, it does indicate an improved food efficiency during their first autonomous feedings.The ClinicalTrials.gov identifier is NCT01116765, on May 2010.


Author(s):  
Héctor Guerrero-Tapia ◽  
Rodrigo Martín-Baeza ◽  
Rubén Cuesta-Barriuso

Background. Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. Methods: In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength. Results: After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: −2.48; p < 0.001 in the left adductor; MD: −1.48; p < 0.01 in right adductor) and control group (MD: −1.68; p < 0.001 in the left adductor; MD: −2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength. Conclusions: An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomiia Potsiurko ◽  
Dmytro Dobryanskyy ◽  
Lesya Sekretar

Abstract Background Patent ductus arteriosus (PDA) is a common complication in very preterm infants. It is known that there is an association between PDA and development of bronchopulmonary dysplasia (BPD) or death before the postmenstrual age (PMA) of 36 weeks, but this association remains one of the most controversial aspects of the problem. The study aimed to evaluate the relationship between PDA, serum NT-proBNP levels at 2–3 and 8–9 days of life, and BPD/death in very preterm infants. Methods Data of 52 preterm infants with a gestational age < 32 weeks, chronological age < 72 h, and PDA diameter > 1.5 mm, enrolled in a randomized controlled trial, were used for the retrospective analysis. All patients underwent daily echocardiographic and two serum NT-proBNP measurements within the first 10 days after birth. Two groups of infants were formed retrospectively at PMA of 36 weeks depending on the outcome, BPD (n = 18)/death (n = 7) or survival without BPD (n = 27). Receiver operator characteristic (ROC) curve was used to evaluate the predictive performance of serum NT-proBNP levels for BPD/death occurrence. Results The percentage of infants who received pharmacological treatment for PDA did not differ between the groups. Based on the area under the ROC curve, serum NT-proBNP levels on the 2–3 day of life (AUC = 0.71; 95% confidence interval (CI): 0.56–0.9; p = 0.014)) and on the 8–9 day of life (AUC = 0.76; 95% CI: 0.6–0.9; p = 0.002) could reliably predict BPD/death in very preterm infants who had PDA diameter > 1.5 mm in the first 72 h of life. Hemodynamically significant PDA (hsPDA) was significantly more often detected in newborns with BPD/death, however, treatment of infants with hsPDA did not reduce the incidence of BPD/death. Conclusions In very preterm infants with PDA > 1.5 mm at the age of 24–48 h, serum NT-proBNP concentration could reliably predict the development of BPD or death, regardless of the persistence of PDA, with the highest diagnostic value at 8–9 days. Trial registration This study is registered in ClinicalTrials.gov - NCT03860428 on March 4, 2019.


2020 ◽  
Author(s):  
Héctor Guerrero-Tapia ◽  
Rodrigo Martín-Baeza ◽  
Rubén Cuesta-Barriuso

Abstract Background: Abdominal and lumbo-pelvic stability alterations may origin lower limb injuries, such as for example adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. Methods: This randomized controlled trial conducted over an 8-week period included 25 female footballers randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbo-pelvic stability and adductor strength.Results. Lumbo-pelvic stability after surgery was higher in the control group (MD: 4.84 vs MD: 9.58; p < .01) with differences in the analysis of repeated measures (p<.001), but not in group interaction (p =.26). Changes were found in adductor strength in the experimental group (MD: -2.48; p<.001 in the left adductor; MD: -1.48; p<.01 in right adductor) and control group (MD: -1.68; p<.001 in the left adductor; MD: -2.05; p<.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p<.001) and right (p<.001) adductor strength.Conclusions. An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength and flexibility, while improvements are maintained at four weeks follow-up. Trial Registration Number: NCT03617887.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1067-1067
Author(s):  
Ariel Salas ◽  
Maggie Jerome ◽  
Paula Chandler-Laney ◽  
Namasivayam Ambalavanan

Abstract Objectives To incorporate assessment of body composition in the routine care of preterm infants to guide feeding practices before and after hospital discharge. Methods Very preterm infants with gestational ages between 29 and 32 weeks of gestation were included. Infants with gastrointestinal or neurologic malformations and terminal illness needing to limit or withhold support were excluded. All study participants were eligible for serial assessments of body composition between birth and 32 weeks PMA, at 36 weeks PMA or hospital discharge, and at 3 months of corrected age. Infants randomly assigned to the intervention group had the information about infant body composition available to the clinicians caring for them (including reference data). Infants randomly assigned to the control group also underwent serial assessments, but this information on infant body composition was not shown to the clinicians caring for them. The primary outcome was % body fat (%BF) estimated by air displacement plethysmography. Results Fifty very preterm infants were randomized. Mean birthweight of study participants was 1387 g +/– SD 283 and median gestational age at birth was 30 weeks (IQR: 30 – 31). Sociodemographic characteristics did not differ between groups. Mean %BF between birth and 32 weeks PMA (n = 45) was 6 +/– 4, mean %BF at 36 weeks PMA (n = 35) was 14 +/– 4, and mean %BF at 3 months of corrected age (n = 25) was 20 +/– 4. Mean differences in %BF between the intervention group and the control group were not statistically significant at 36 weeks PMA (−0.8) or 3 months corrected age (−1.2). Similarly, feeding practices during hospitalization did not differ between groups. Growth outcomes did not differ between groups. Conclusions Serial assessments of body composition at birth, 36 weeks PMA, and 3 months corrected age in very preterm infants show increased %BF in both intervention and control groups without an apparent influence of the intervention on feeding practices. While 36 weeks PMA has been a common assessment point for research purposes, body composition assessments may need to be done at earlier intervals in order to make meaningful clinical changes to the infant diet in order to affect body composition later in infancy. Funding Sources UAB OHDRC.


2021 ◽  
Vol 228 ◽  
pp. 16-23.e1 ◽  
Author(s):  
Wissam Alburaki ◽  
Kamran Yusuf ◽  
Jenna Dobry ◽  
Rachel Sheinfeld ◽  
Belal Alshaikh

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