Impact of a novel relaxation method of touch on neonatal neurobehavioral development among very preterm infants
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Infants born very preterm (< 30 weeks estimated gestational age [EGA]) annually and are at greatest risk to develop significant neurodevelopmental abnormalities. These neurodevelopmental abnormalities are the result of complex conditions involving the interaction between multiple biological, genetic, and environmental risks. In an effort to manipulate and support the extra-uterine environment, infant massage has been aimed at decreasing stress and optimizing the infant's sensory experience. However, the majority of existing infant massage studies has varying protocols, are limited to healthy or convalescing preterm infants greater than 32 weeks postmenstrual age (PMA), and are seldom contingent on infant behavioral cues. The M Technique is a gentle, structured, comforting touch method aimed at limiting stress and anxiety in fragile intensive care patients who are unable to tolerate conventional massage. Little is known about the effects of this technique on infants born very preterm. Therefore, the purpose of this matched case-control pilot study was to systematically test the cumulative effect of the M Technique on infant neurodevelopment, growth velocity, and physiologic and behavioral state in hospitalized very preterm infants in a Midwestern academic level IV neonatal intensive care unit (NICU). Results indicate that very preterm infants who received the M Technique over a 5-week period did not differ significantly in neurobehavioral developmental and growth velocity compared to control infants. However, very preterm infants who received the M Technique had improved physiologic stability and more quiet sleep states from baseline to 10 minutes post the M Technique intervention over all three time points, suggesting improved physiologic stability and more quiet sleep state over time. Research regarding the type, timing, and duration of comforting touch in infants born very preterm starting at 30 weeks' PMA is lacking. Preliminary findings from this study support an infant-driven (e.g., where the protocol is based on each infant response or cues) M Technique intervention to promote comfort and relaxation in highrisk infants born very preterm. A longitudinal research design with a larger sample size is needed to confirm and expand on the effects and potential mechanisms of the M Technique on neurobehavior and growth velocity.
Table of Contents
Introduction -- Integrative review -- Theoretical framework and methods -- Feasibility study -- Results -- Discussion -- Appendix A. IRB authorization agreement between UMKC and WUSTL -- Appendix B. Informed consent -- Appendix C. Infant demographics -- Appendix D. NICU Network Neurobehavioral Scale (NNNS) -- Appendix E. Anderson Behavioral State Scale (ABSS) -- Appendix F. SLCH research grant award letter -- Appendix G. NANN small grant award letter