681 - Long-term Effect of Parent-administrated Early Physiotherapy in Infants Born Very Preterm.

Publication Number: 681.5859

Henriette Paulsen, Norwegian University of Science and Technology, Tolvsrød, Vestfold, Norway; Tordis Ustad, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway; Kristina Anna Djupvik Aakvik, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway; Vibeke Smith Aulie, Oslo University Hospital, Oslo, Oslo, Norway; Silje Dahl Benum, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway; Marit Sørvoll, UiT The Artic University of Norway, Tromsdalen, Troms, Norway; Gunn Kristin Øberg, UiT, The arctic university of Norway, Tromsø, Troms, Norway; Hanne Jørgensen, St.Olavs hospital, TRONDHEIM, Sor-Trondelag, Norway; Kari Anne I. Evensen, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway

Background: Infants born very preterm (≤32 weeks gestation) face a significant risk of motor impairments. However, the long-term effects of early intervention on improving motor outcomes are not documented. In a follow-up of a randomised controlled trial, we assessed the long-term impact of parent-administrated early physiotherapy in children born very preterm.

Objective: Our study aimed to compare motor outcomes in children born very preterm with children born at term.

Design/Methods: At 7-10 years, we assessed 92 children born very preterm, of which 43 had been randomised to early parent-administered physiotherapy intervention and 49 to standard care. A control group of 83 term-born children were recruited at the same time. The children were assessed by physiotherapists who were blinded to group status, using the Movement Assessment Battery for Children (MABC-2) and the High-level Mobility Assessment Tool - Revised (HiMAT-R). Differences in mean scores for both tests and odds for scoring ≤ 5th and 15th percentile on the MABC-2 were examined and adjusted for age and sex.

Results: The MABC-2 total score was -0.6 (95%CI: -1.9 to 0.6), points lower in the early intervention than in the standard care group. Compared with the term control group, the MABC-2 total score was -1.9 (95%CI: -3.1 to -0.8) points lower in the early intervention group and -1.3 (95%CI: -2.4 to -0.3) points lower in the standard care group.
The HiMAT total score was -0.5 (95%CI: -2.0 to 1.2), points lower in the early intervention than in the standard care group. Compared with the term control group, the HiMAT total score was -2.5 (95% CI: -3.9 to -1.1) points lower in the early intervention group and -2.0 (95%CI: -2.0 to -0.6) points lower in the standard care group.
Compared with the term control group, the odds ratio for MABC-2 total score ≤15th percentile was 4.2 (95%CI:1.5 to 11.7) for children that received early intervention and 2.1 (95%CI:0.7 to 6.3) for children that received standard care. The odds ratios for MABC-2 total scores ≤5th percentile were 4.2 (95%CI: 0.7 to 23.7) and 4.6 (95%CI: 0.9 to 24.7), respectively.

Conclusion(s): Early parent-administered physiotherapy showed no lasting effect on motor outcomes by the age of 7-10 years. Children born very preterm exhibited poorer motor outcomes compared with children born at term, highlighting a critical area of concern for their development.

Mean differences in Movement Assessment Battery for Children-2 scores at 7-10 years, adjusted for age and sex
Intervention=children born preterm randomised to early parent-administrated physiotherapy intervention, Standard care=children born preterm randomised to standard care