NICU-based rehab programmes not feasible if they put heavy burden on parents

Neonatal intensive care unit (NICU)-based rehabilitation programmes for motor disability in preterm infants are feasible only if they do not place too heavy of a burden on parents, reports a recent study.

Nevertheless, parents find delivering motor training interventions to be difficult, and programmes that require them to do tend to be less feasible and acceptable.

“Programmes that place a high demand on parents (5 days per week) are not feasible and goals of intervention at least three times per week appear to be feasible in the context of the United States. Parent-provided motor interventions were most challenging to parents and alternative strategies should be considered in future studies,” the researchers said.

Sixty-seven preterm infants (mean gestational age 28.38 weeks, 17.9 percent small for gestational age) were randomly allocated to receive standard care (n=33) or to NeoRehab, a NICU-based rehabilitation programme (n=34).

Infants in the NeoRehab arm received four sensory interventions (vocal soothing, scent exchange, comforting touch, and skin-to-skin care) and two motor interventions (infant massage and physical therapy), all delivered by the parent or caregiver. The outcomes of interest were the feasibility, acceptability, and fidelity of NeoRehab.

In terms of acceptability, NeoRehab showed a 71-percent recruitment rate, with a retention rate of 98 percent. The programme encouraged families to deliver the interventions 5 days a week, but such standard was deemed not feasible.

In particular, vocal soothing was performed at least five times a week in only 41 percent of cases, while scent exchange and comforting touch were done so in 16 and 41 percent of cases, respectively. When lowering the frequency to at least three days per week, the corresponding programme fidelity jumped to 72–75 percent for each sensory intervention.

Parents found motor interventions even more challenging, with massage therapy performed at least one time per week in only 34 percent of cases. Physical therapy was performed at least once a week in only 22 percent of cases.