Early intervention can improve coordination, strength of the legs, and object exploration
ALEXANDRIA, VA, September 29, 2009 — Preterm infants who
receive leg movement training display feet-reaching behaviors similar to
that of full-term infants, according to a randomized controlled trial reported in the October issue of Physical Therapy (PTJ), the scientific journal of the American
Physical Therapy Association (APTA). This finding supports feet-reaching
play as an early intervention strategy to encourage interaction with
physical objects in preterm infants who have movement problems within
the first months of postnatal life.
Previous studies have shown that full-term infants make contact with
toys using their feet before reaching with their hands. Studies also
have shown that movement training advances feet reaching in full-term
infants. Certain populations of preterm infants are known to be delayed
in hand reaching; however, no studies have looked at feet-reaching in
"The presence of feet reaching and a positive training effect in this
population would suggest a novel and easily implemented intervention
strategy to encourage early object interaction in infants with special
needs," said Jill C. Heathcock, PT, PhD, assistant professor in the
Division of Physical Therapy at Ohio State University, and lead author
of the study.
In this study, 27 preterm infants who were born at less than 33 weeks
of gestational age and weighed less than 5 lbs 8 oz received either
movement training or social training by their caregivers 5 days a week
for 8 weeks. Movement training consisted of three feet games: general
leg movement, moving the leg across the midline of the body, and
distinct leg movements, such as holding an infant's hip at 90 degrees
and encouraging knee motion to contact the toy with the foot. Caregivers
of infants in the social training group positioned their infant supine
on the floor and sat near the infant's feet. The caregiver interacted
with their infant visually and verbally, but did not touch or present
objects to their infant.
During the 8-week training period, all infants were tested and
videotaped for a total of five sessions. Infants were seated in a
custom-made chair with a strap placed around the chest, allowing for
free movement of the arms and legs. A toy was presented to the infant at
his or her midline at hip height for 30 seconds. After each trial, the
toy was removed from the infant's view and then repositioned in the
midline for the next trial.
Both groups of infants showed an equal number of foot-toy contacts
over each session. However, infants in the movement training group
out-performed infants in the social training group over time and during
the last session.
"Our results suggest that preterm infants display a new and
potentially important ability to contact objects with their feet before
their hands," said Heathcock. "This finding, coupled with a positive
effect of training, provides clinicians with a new intervention strategy
for encouraging object interaction within the first months of life in
infants at risk for long-term motor impairments."
The study was funded in part by Heathcock's awards from the
Foundation for Physical Therapy.
Physical therapists are highly-educated, licensed health
care professionals who can help patients reduce pain and improve or
restore mobility- in many cases without expensive surgery or the side
effects of prescription medications. APTA represents more than 72,000
physical therapists, physical therapist assistants, and students of
physical therapy nationwide. Its purpose is to improve the health and
quality of life of individuals through the advancement of physical
therapist practice, education, and research. In most states, patients
can make an appointment directly with a physical therapist, without a
physician referral. Learn more about conditions physical therapists can
treat and find a physical therapist in your area at www.moveforwardpt.com.