Abstract
Objective:
To study the effect of physical therapy on bone mineralization, weight gain and growth in preterm infants.
Method:
After fulfilling the inclusion criteria, preterm infants were matched for gestational age and birth weight and then randomly assigned to the physiotherapy group (PG, n=15) and control group (CG, n=14). The PG received motor physical therapy for 15 min daily, 5 times per week until hospital discharge. Bone mineralization was measured by total body dual energy X-ray beam absorptiometry (DEXA) at the onset and end of the study. Statistical analysis was realized by ANCOVA and linear correlation tests.
Result:
The physical therapy group (PG) presented greater body weight gain per day (27.4±2.4 vs 21.01±4.4 g, P<0.001) and length (1.3±0.3 vs 0.8±0.2 cm week−1, P<0.001) than did the control group (CG). Body composition values verified by DEXA were greater for the PG. The mean gain in bone mineral content (BMC) (mg) was greater in the PG (434±247.5 vs −8.9±11.4, P<0.001), as was the mean bone mineral density (BMD) gain (mg cm−2) (8.4±5.6 vs −3.1±5.5, P<0.001). The gain in bone area (BA,cm2) was 10.3±5 in the PG vs 1.5 ±2 in the CG (P<0.001). The gain in lean mass (LM) (g) in the PG was also greater than in the CG (271.1±21.4 vs 109.1±1.0, P<0.009). The fat mass (g) was similar between the groups (P=0.432).
Conclusion:
These results showed that physiotherapy in preterm infants produced greater gains in growth, body weight, BMC, BMD, BA and LM.
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References
Greer FR, McCormick A . Bone growth with low bone mineral content in very low birth weight preterm infant. Pediatr Res 1986; 20: 925–928.
Helm I, Londin LA . Bone mineral content in preterm infants at age 4–16. Acta Paediatr Scan 1985; 74: 264–267.
Koo WW, Sherman R, Succop P, Ho M, Buckley D, Tsang RC . Serum vitamin metabolites in very low birth-weight infants with and without rickets and fractures. J Pediatr 1989; 114: 1017–1021.
Mora S, Weber G, Bellini A, Bianchi C, Chiumello G . Bone modeling alteration in preterm infants. Arch Pediatr Adolesc Med 1994; 148: 1215–1217.
Rodriguez JI, Palacios J, Garcia-Alix A, Pastor I, Paniagua R . Effects of immobilization on fetal bone development. A morphometric study in newborns with congenital neuromuscular diseases with intrauterine onset. Calcif Tissue Int 1988; 43: 335–339.
Rodriguez JI, Palacios J, Ruiz A, Sanchez M, Alvarez I, Demiguel E . Morphological changes in long bone development in fetal akinesia deformation sequence: an experimental study in curarized rat fetuses. Teratology 1992; 45: 213–221.
Kakebeeke TJ, Von Siebenthal K, Largo RH . Differences in movement quality at term among preterm and term infants. Biol Neonate 1997; 71: 367–378.
Koo WW, Sherman R, Succop P, Oestrech AE, Tsang RC, Krug-Wispe SK et al. Sequential bone mineral content in small preterm infants with and without fractures and rickets. J Bone Miner Res 1988; 3: 193–197.
Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C . Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339: 261–264.
Juskelien V, Magnus P, Bakketeig LS, Dailidiene N, Jurkuvenas V . Prevalence and risk factors for asymmetric posture in preschool children aged 6–7 years. Int J Epidemiology 1996; 25: 1053–1059.
Larson CM, Henderson RC . Bone mineral density and fractures in boys with Duchenne muscular dystrophy. J Pediatr Orthop 2000; 20: 71–74.
Tubbs RS, Webb D, Abdullatif H, Conklin M, Doyle S, Oakes WJ . Posterior cranial fossa volume in patients with rickets: insights into the increased occurrence of Chiari I malformation in metabolic bone disease. Neurosurgery 2004; 55: 380–383.
Mcintyre L, Specker BL, Hudson P . Effect of exercise on bone mineral content in infants 1 to 15 months of age. Pediatr Res 1992; 31: 97–108.
Pimay F, Bodeax M, Crielaard JM . Bone mineral content and physical activity. Int J Sports Med 1987; 8: 331–335.
Miller M . The bone disease of preterm birth: a biomechanical perspective. Pediatr Research 2003; 53: 10–15.
Specker BL, Mulligan L, Ho M . Longitudinal study of calcium intake, physical activity and bone mineral content in infants 6–18 months of age. J Bone Miner Res 1999; 14 (Suppl 4): 569–576.
Moyer-Mileur L, Luetkemeier M, Boomer L, Chan GM . Effect of physical activity on bone mineralization in premature infants. J Pediatr 1995; 1127: 620–625.
Moyer-Mileur L, Brunstetter V, McNaught TP, Gil G, Chan GM . Daily physical activity program increases bone mineralization and growth in preterm very low birth weight infants. Pediatrics 2000; 106: 1088–1092.
Nemet T, Dolfin I, Litmanowitz R, Shainkin-Kestenbaum M, Lis E . Evidence for exercise induced bone formation in premature infants. Int J Sports Med 2002; 23: 82–85.
Litmanovitz I, Dolfin T, Regev R . Bone turnover markers and bone strength during the first week of life in very low birth weight premature infants. J Perinatal Med 2004; 32: 58–61.
Aly H, Moustafa M, Hassanein SM, Massaro AN, Amer HA, Patel K . Physical activity combined with massage improves bone mineralization in premature infants: a randomized trial. J Perinatol 2004; 24: 305–309.
Rosemberg SN, Verzo B, Engstron JL . Reliability of length measurements for preterm infants. Neonatal Network 1992; 11: 23–27.
Koo WK, Hockman EM, Hammami M . Dual energy X-Ray absorptiometry measurements in small subjects: conditions affecting clinical measurements. J Am Coll Nutr 2004; 23: 212–219.
Litmanovitz I, Dolfin T, Regev R . Bone turnover markers and bone strength during the first weeks of life in very low birth weight premature infants. J Perinat Med 2004; 32: 58–61.
Yeh JK, Aloia JF, Yasumura S . Effect of physical activity on calcium and phosphorus metabolism in the rat. Am J Physiol 1989; 256: E1–E6.
Johnston CC, Selmenda CW . The relative importance of nutrition compared to genetic factors in the development of bone mass. In: Burckhardt P, Heaney RP (eds). Nutritional Aspects of Osteoporosis. Raven Press: New York, 1991, pp 11–21.
Kuschel CA, Harding JE . Multicomponent fortified human milk on promoting growth in preterm infants. Cochrane Database Syst Rev 2004; 1: CD000343.
Schulzke SM, Trachel D, Patole SK . Physical activity programs for promoting bone mineralization and growth in preterm infants. Cochrane Database Syst Rev 2007; 18: CD005587.
Beyers N, Alheit B, Taljaard JF, Hall JM, Hough SF . High turnover osteopenia in preterm infants. Bone 1994; 15: 5–13.
Karlen J, Aperia A, Zetterstrom R . Renal excretion of calcium and phosphate in preterm and term infants. J Pediatr 1985; 106: 814–819.
Shiff Y, Eliakim A, Sheinkin-Kestenbaum R, Arnon S, Lis M, Dolfin T . Measurements of bone turnover markers in premature infants. J Pediatr Endocrinol Metab 2001; 14: 389–395.
Koo WWK, Hammami M, Hockman EM . Use of fan beam dual energy X-ray absorptiometry to measure body composition of piglets. J Nutr 2002; 132: 1380–1383.
Rigo J, Nyamugabo K, Picaud JC, Gerard P, Pieltain C, Decurtis M . Reference values of body composition obtained by dual energy X-ray absorptiometry in preterm and term neonates. J Pediatr Gastroenterol Nutr 1998; 27: 184–190.
Rigo J, De Curtis M, Pieltain C, Picaud JC, Salle BL, Senterre J . Bone mineral metabolism in the micropremie. Clin Perinatol 2000; 27: 147–170.
Picaud JC, Nyamugabo K, Braillon P, Lapillonne A, Claris O, Delmas P et al. Dual-energy X-ray absorptiometry in small subjects: Influence of dual-energy X-ray equipment on assessment of mineralization and body composition in newborn piglets. Pediatr Res 1999; 4: 772–777.
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Conflicts of interest: Nothing to declare.
Funding source: FIPE (Hospital de Clínicas de Porto Alegre) and Graduate Studies in Pediatrics, Federal University of RS.
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Vignochi, C., Miura, E. & Canani, L. Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study. J Perinatol 28, 624–631 (2008). https://doi.org/10.1038/jp.2008.60
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DOI: https://doi.org/10.1038/jp.2008.60