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Study examining weight gain and length of stay among preterm infants that were either massaged or massaged and given kinesthetic stimulation (KS) by trained NICU nurses. Massage therapy has previously been reported to have a positive impact on weight gain and might even contribute to decreased length of stay in the NICU for some preterm newborns. Recently, meta-analyses have raised skepticism about the reliability of the results obtained from previous studies, due to differences in the design and methods used to conduct these studies. For example, the degree of stimulation (eg. light touch, physical activity) varies among studies. The concerns raised in these meta-analyses have subsequently raised questions about the widespread use and cost-effective use of massage in the NICU. This study published by Massaro et al. in Journal of Perinatology, 2009 attempted to clarify some of the concerns raised by previous meta-analyses by conducting a randomized controlled clinical trial comparing infant massage with or without kinesthetic stimulation (i.e.. exercise) to controls. Neonates were included on the following criteria: (1) birth weight <1500g and/or gestational age <32 weeks, (2) postnatal age >7 days and current weight >1000g, and (3) relative medical stability. During the study period 147 neonates were admitted and 60 were included in the study (20 neonates per group). The groups were all similar in demographics and were fed either fortified breast milk or premature formula. The massage group received 6 strokes (10 seconds/each) to each area (1) from crown to neck, (2) middle of back to arms, (3) neck to waist, (4) thighs to ankles, (5) shoulder to wrist. This was performed twice a day for 15 minutes each by a NICU nurse trained by a certified massage therapist. The kinesthetic group received 6 movements of each arm at the elbow and leg at the knee. The kinesthetic group also received the previously described massage. The authors found no significant differences in weight gain or length of stay in the NICU among the three groups (control, massage alone, and massage with kinesthetic stimulation). However, after stratification by birth weight the authors were able to show significant differences in weight gain in the preterm infants weighing >1000g. The authors showed that among the infants weighing >1000g, the group that received massage and kinesthetic stimulation showed a greater weight gain than either the control group or massage only group. Conclusions:
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