PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial. (March 2022)

• Record Type: Journal Article
• Authors: Mobbs, Chelsea; Spittle, Alicia; Johnston, Leanne
• Is Part Of: Early human development. Volume 166(2022)
• Publication Date: 2022-03
• Subjects: Preterm infants -- Participation -- Early intervention; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2022.105551
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Purpose: Investigate feasibility of PreEMPT: a novel participation-focused, early physiotherapy intervention for preterm infants in regional Australia. Materials and methods: Participants were infants born <35 weeks, residing in regional Australia. Sixteen infants were recruited then randomised to usual physiotherapy care (UPC: n = 8) or PreEMPT (n = 8). PreEMPT involved 14-weeks of alternating clinic- or telehealth-based, participation-focused intervention. Feasibility was evaluated by: demand, practicality, acceptability, implementation and limited efficacy testing for infants (motor, participation) and parents (mental well-being, self-efficacy). Results: Demand was lower than expected (45% recruitment rate). For practicality, attrition was high in the PreEMPT group (mean assessment attendance 3.8/5 sessions, range 2–5) compared to UPC (4.8/5 sessions, range 4–5). In addition, mean PreEMPT treatment dose received was approximately half intended (overall: 7.3/14 sessions, range 0–12; equivalent for face-to-face: 3.9/7, range 0–6, versus telehealth 3.4/7, range 0–6). The most common reason cited for treatment non-attendance was maternal mental health (22 sessions). Treatment acceptability for parents was high, with PreEMPT parents reporting they were offered choices in sessions ( p = .02), and increased their knowledge ( p = .01) and confidence ( p = .009). There was a large effect size in favour of PreEMPT for increased parental self-efficacy ( p = .021, ES = 1.34). Conclusion: Early post-discharge physiotherapy for preterm infants in regional Australia is beneficial according to families but logistically challenging. Highlights: PreEMPT is beneficial according to parents of preterm infants Participation outcomes for preterm infants is under researched; this paper offers insight on how this important outcome could be evaluated Provides future researchers an example on how to determine the feasibility of an early intervention trial for preterm infants