Article

The aim of this study was to determine whether oral, tactile/kinaesthetic
(T/K), or combined (oral+T/K) interventions enhance oral feeding performance and
whether combined interventions have an additive/synergistic effect. METHOD:
Seventy-five preterm infants (mean gestational age 29 wk; standard error of the
mean [SEM] 0.3 wk; mean birthweight 1340.3g; SEM 52.5 g; 49 males and 26 females)
were randomly assigned to one of three intervention groups or a control group.
The oral group received sensorimotor input to the oral structures, the T/K group
received sensorimotor input to the trunk and limbs, and the combined group
received both. The outcomes were time from introduction of nipple feeding to
independent oral feeding (d), proficiency (intake in the first 5 min, %), volume
transfer (%), rate of transfer (mL/min), volume loss (%), and length of hospital
stay (d). RESULTS: Infants in the three intervention groups achieved independent
oral feeding 9-10 days earlier than those in the control group (p<0.001; effect
size 1.9-2.1). Proficiency (p </= 0.002; effect size 0.7-1.4) at the time of one
to two and three to five oral feedings per day, volume transfer (p </= 0.001;
effect size 0.8-1.1) at one to two, three to five, and six to eight oral feedings
per day, and overall rate of transfer (p </= 0.018; effect size 0.8-1.1) were
greater, and overall volume losses were less (p </= 0.007; effect size 0.9-1.1),
than in the control group (p </= 0.042). The combined group attained independent
oral feeding at a significantly younger postmenstrual age than controls (p=0.020)
and had clinically greater proficiency than the T/K group (p=0.020; effect size
0.7) and oral group (p=0.109; effect size 0.5). Length of hospital stay was not
significantly different between groups (p=0.792; effect size 0.02-0.3).
INTERPRETATION: Oral and T/K interventions accelerated the transition from
introduction to independent oral feeding and enhanced oral feeding skills. T/K
has beneficial effects beyond the specific targeted system. The combined
sensorimotor intervention led to an additive/synergistic effect for proficiency,
further benefiting this population.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS