| چکیده انگلیسی مقاله |
Introduction: Implementing early evidence-based rehabilitation programs to improve the movement abilities of preterm infants is particularly important. The evidence about rehabilitation interventions in enhancing the motor development of preterm infants is diverse and scattered, indicating heterogeneity in therapeutic interventions' type, dose, and time. Therefore, this review study aims to identify the types of rehabilitation interventions (occupational therapy and physiotherapy) that improve the motor skills of infants hospitalized in intensive care units. In this way, the course of research in this field has become clear and will enhance motor outcomes of preterm infants.
Methods: This is a scoping review study. Research studies indexed in scientific databases, including PubMed, Web of Science, Scopus, and Google Scholar search engine were explored and reviewed. The inclusion criteria included the English and Persian papers published from 2000 to 2023 that mainly focused on early rehabilitation intervention studies (occupational therapy and physiotherapy) on developing neuromotor skills of preterm infants in neonatal intensive care units. After selecting the keywords (preterm infants, occupational therapy, physiotherapy, early intervention, sensory stimulation, play) and performing an organized search, the articles were matched with the inclusion criteria, and finally, considered studies were selected.
Results: Among the reviewed studies, 15 studies met the inclusion criteria. Studies of early neuromotor rehabilitation of preterm infants in the intensive care units differed based on the characteristics of the intervention. Among the available studies, 7 are related to multimodal interventions, and two are related to multisensory interventions; the common feature of most studies is the stimulation of auditory, tactile, visual, and vestibular senses. Two studies are related to neuro-developmental interventions. In these studies, movement and the ability to maintain body position are affected using manipulation techniques and key body control points. Two studies are related to interventions implemented by parents (parents-administered), designed based on mother-infant interaction programs and family-centered practice. In these studies, during three meetings with the parents, the therapist taught them the therapeutic technique, reviewed it, and supported the parents' learning. Also, two studies are related to interventions supporting play exploration and early developmental intervention. These studies are based on action perception theory and the synactive theory of development. These interventions are designed based on the environment's enrichment and the infant's active participation in movement-based play and problem-solving. The intervention method in these studies has two stages: hospital and home.
Conclusion: Based on the findings of this research and the meetings held with experts in this field, we could organize early rehabilitation interventions for motor skills of preterm infants in 4 groups: 1) multimodal and multisensory interventions, 2) neurodevelopmental interventions, 3) parents-administered interventions, and 4) supporting play exploration and early developmental intervention to categorize. In this way, all types of therapeutic interventions in improving the motor skills of infants were identified. Most studies included interventions performed quickly and reported short-term effects on motor improvement. Only the supportive play exploration intervention continued after discharge, bridging the gap between early neonatal intensive care unit and home interventions. It reported improved motor development in the short- and long-term periods (6 and 12 months). |