Effectiveness of Neuro-Developmental Treatment Protocol to Improve Motor Control in Preterm Infants: An Experimental study

INTRODUCTION: In humans, preterm birth is birth before full gestational period (37 weeks); a "premature" infant is one that has not yet reached the level of foetal development that generally allows a life outside the womb. Several organ systems mature between 34 and 37 weeks in the normal human fetus, and the fetus reaches adequate maturity by the end of this period. Preterm birth is one of the major problems faced nowadays. Pre term infants have a lower chance of survival which is due to the motor, cognitive and sensory impairments. AIM OF THE STUDY: Earlier studies revealed that minimal stimulation would elicit good neurobehavioral responses in Neonatal intensive care unit (NICU). Some other studies indicate that positioning and special nursing care improves weight gain in pre term babies. The purpose of this study was to evaluate the efficacy of a Neuro-Developmental Treatment protocol designed to improve motor control in infants born prematurely and at high risk for developmental disability. OBJECTIVES: To find out the efficacy of a Neuro–Developmental Treatment program to improve motor control in pre-term infants. MATERIALS AND METHODOLOGY: PARTICIPANTS: Thirty preterm infants were randomly assigned to receive Neuro-Developmental Treatment protocol two times per day for 7 days. MATERIALS: Cotton rolls, Towel, Data collection and recording sheet. METHODOLOGY: STUDY DESIGN: This is a study with two groups. One received routine nursing care with positioning and other received Neuro-Development Treatment protocol. The results were compared. STUDY SETTING: The study was carried out in NICU, Sri Ramakrishna Hospital, Coimbatore. SAMPLING TECHNIQUE: Convenient random sampling. SAMPLE SIZE 30 pre-term infants were assigned into two groups of 15 each. STUDY DURATION: The study was conducted for a period of 7-20 days. SELECTION CRITERIA: Inclusion criteria: Gestational age below 35 weeks, Birth weight less than 1800 gm, NICU stay for minimum 7 days, Should evidence at least 3 of the following medical complications, 5-minute Apgar score of 5 or less, Intraventricular haemorrhage documented by ultrasound, Central nervous system depression, Asphyxia, Birth weight less than 1000 gm, Respiratory arrest, Respiratory distress syndrome, Need for mechanical ventilation, Thermal instability. Exclusion Criteria: Genetic anomalies, Congenital malformations, Human - immuno deficiency virus, Hepatitis B, Birth weight above 2000 gms. DATA ANALYSIS: Thirty pre term babies were assigned for treatment. They were divided into two groups each group contain fifteen babies. One group received routine nursing care and positioning and; The other group received Neuro-Developmental Treatment protocol. The outcomes were measured by two scales and they are : Supplemental motor test, Neonatal behavioral assessment scale. RESULTS: In this study, the pretest and posttest values were obtained by using NBAS and SMT scales. For comparison of the groups independent t test was used. Both scales showed a significant value than the tabulated value. ‘t’ value for SMT : 3.06 and ‘t’ value for NBAS: 2.84. The tabulated value for these scales at 28 degrees of freedom at 5% Level significance is 2.763. Hence there was a significant change seen in SMT scale for motor control and mild increase in NBAS scale for behaviour. CONCLUSION: According on the statistical analysis and review of literature, it has been clearly concluded that Neuro-Developmental Treatment protocol is found to improve the motor control in pre-term infants. Hence the alternate hypothesis is accepted and there is “There is a significant improvement of motor control with Neuro–Developmental Treatment program in pre-term infants”