Zhongguo quanke yixue (Jan 2023)
A Randomized Controlled Study of Multisensory Interventions in Promoting Brain Function Development in Premature Infants
Abstract
Background The prevalence of neurodevelopmental disorders in premature infants is high, and there is an urgent need to improve neurodevelopmental outcomes of them. There are few reports on amplitude-integrated electroencephalography (aEEG) -assessed effect of multisensory (MS) interventions on brain function of premature infants by aEEG. Objective To evaluate the effect of MS interventions on improving brain function of premature infants. Methods A single-center, randomized controlled trial was conducted. One hundred and twenty-six premature infants who were admitted to Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University from October 2020 to September 2021 were selected and randomly divided into control group (n=63) and intervention group (n=63) by random numbers according Excel. Both groups received routine treatment and nursing care, the intervention group additionally received MS interventions developed by our team (including auditory, tactile, visual and vestibular interventions) , twice a day, 15 minutes each time. The time of intervention lasted for at least 7 days for both groups. Before and 7 days after the intervention, the lower boundary voltage, bandwidth, and aEEG score during the quiet sleep (QS) period and active sleep (AS) period, average time and total time of QS period were monitored by AEEG. The Neonatal Behavioral Neurological Assessment (NBNA) was used to evaluate the neurobehavior. The Gesell Developmental Schedules (GDS) was used to evaluate the development quotient at the corrected age of one month. Results 119 premature infants completed the study, including 59 cases in the control group and 60 cases in the intervention group. Seven days after intervention, intervention group had higher lower boundary voltage〔 (5.47±0.92) μV vs (5.10±0.87) μV〕and narrower bandwidth〔 (18.90±1.90) μV vs (19.78±2.50) μV〕 during QS period than the control group (P<0.05) . Moreover, intervention group also demonstrated higher lower boundary voltage〔 (7.63±0.97) μV vs (7.21±1.00) μV〕 and narrower bandwidth〔 (13.93±2.61) μV vs (14.94±2.58) μV〕 during AS period (P<0.05) . After 7 days of intervention, intervention group had higher total score of aEEG 〔 (10.45±2.18) vs (9.53±1.91) 〕, and higher item score of sleep-awakening cycle〔 (4.17±0.85) vs (3.80±0.85) 〕, and broadband score 〔 (2.90±0.75) vs (2.59±0.72) 〕 than control group (P<0.05) . However, there was no significant difference in item continuity and lower boundary score between two groups in aEEG score (P>0.05) . Moreover, intervention group had longer average time of QS period 〔 (25.67±6.95) min vs (23.29±4.87) min〕 and longer total time of QS period 〔 (62.80±18.89) min vs (55.27±20.65) min〕 than control group (P< 0.05) . Intervention group also had higher total score of NBNA 〔 (34.82±2.97) vs (33.12±3.49) 〕 (P< 0.05) . At the corrected age of one month, intervention group had higher developmental quotient scores in terms of gross motor 〔 (52.83±10.93) vs (48.83±10.11) 〕, fine motor〔 (51.67±11.05) vs (47.71±9.15) 〕, adaptive development 〔 (55.28±11.65) vs (50.31±10.14) 〕, language 〔 (53.40±11.29) vs (49.41±9.82) 〕 and personal-social〔 (53.57±10.57) vs (49.51±9.35) 〕 than the control group (P<0.05) . Conclusion MS intervention could facilitate the rise of lower boundary voltage, narrow the bandwidth and improve aEEG scores of preterm infants in QS period and AS period, thus promoting the maturation of aEEG background activity and improving brain development. MS intervention could also prolong the time of QS period and promote the development of brain function, improve the total scores of NBNA and GDS, suggesting that the intervention could improve neurobehavioral development of preterm infants.
Keywords
