Effects of increased physical therapy staffing in the neonatal intensive care unit on oral feeding maturation and neurodevelopment of extremely low birth weight infants

Yoshinori Morioka; Masayuki Nonogaki; Daiyu Kobayashi; Junji Nishimoto; Shigeru Obayashi

doi:10.1016/j.braindev.2024.03.005

Effects of increased physical therapy staffing in the neonatal intensive care unit on oral feeding maturation and neurodevelopment of extremely low birth weight infants

Brain Dev. 2024 Mar 30:S0387-7604(24)00053-6. doi: 10.1016/j.braindev.2024.03.005. Online ahead of print.

Authors

Yoshinori Morioka¹, Masayuki Nonogaki², Daiyu Kobayashi², Junji Nishimoto³, Shigeru Obayashi²

Affiliations

¹ Department of Rehabilitation Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, 350-8550, Japan. Electronic address: morioka@saitama-med.ac.jp.
² Department of Rehabilitation Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, 350-8550, Japan.
³ Department of Rehabilitation Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, 350-8550, Japan; Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima, 739-8521, Japan.

PMID: 38556384
DOI: 10.1016/j.braindev.2024.03.005

Abstract

Background: It remains a matter of debate as to what extent early intervention may facilitate long-term functional outcomes of preterm infants in the neonatal intensive care unit (NICU). We aimed to examine the effect of increasing physical therapy (PT) staff dedicated to the NICU on temporal changes (initiation, duration) of PT interventions and functional outcomes (acquisition of full oral feeding and Hammersmith Neonatal Neurological Examination).

Methods: Extremely low birth weight infants, retrospectively collected from an academic medical center, were allocated to two subgroups, either a baseline period (N = 48) without NICU-dedicated PT staff (non-dedicated group) or a quality improvement period (N = 42) with additional dedicated staff (dedicated group).

Results: Compared to those in the non-dedicated group, NICU infants in the dedicated group started PT earlier and had increased PT treatment for additional 14 min per day when achieving full oral feeding. The infants in the dedicated group significantly achieved full oral feeding earlier than the non-dedicated group. As for Hammersmith Neonatal Neurological Examination, there were significant differences in two items (total and tone) between the groups.

Conclusions: Additional NICU-dedicated PT staff facilitated earlier intervention and increased PT treatment in terms of daily duration. Moreover, the dedication shortened the completion of full oral feeding and improved neurological development, presumably resulting in better developmental outcome.

Keywords: Critical path method; Developmental outcome; Early intervention; Neonatal care; Rehabilitation.