Motor co-ordination and postural stability of extremely low birth weight preschool children following physiotherapy intervention: a randomised controlled trial

Question: What is the effect of small group physiotherapy intervention compared to usual advice on motor co-ordination and postural stability in able-bodied preschool children with a history of extreme prematurity or extremely low birth weight? Design: Randomised Controlled Trial with concealed allocation and assessor blinding. Participants: 44 four-year-old children born < 1,000g and/or < 28 weeks gestational age, and managed at the Mater Mothers’ Hospital, Brisbane and who: scored 9-12 on the Neurosensory Motor Developmental Assessment and > 70 on the Stanford-Binet test of IQ at four years corrected age; had not startedpreparatory school; had no major impairments.Intervention: The intervention group completed six one-hour weekly structured sessions addressing co-ordination, postural control, individual movement difficulties, and a goal-focused home program. The control group received ‘usual care’ and a booklet of general age-appropriate activities.Outcome Measures: Movement Assessment Battery for Children-2, single leg stand, lateral reach and standing long jump. All children were assessed pre- commencement of the intervention and then within one month of program completion.Results: 42 of 44 children completed assessments. There were no significant differences between groups on any measure at baseline. Pre-post intervention analysis shows significant gains on more measures within the interventiongroup than the control group, but no significant pre-post changes between groups.Conclusion: Advice coupled with parental compliance appears to be beneficial in four-year-old children with a history of preterm birth/extremely low birth weight, although for optimal outcomes, intervention is recommended.Key Practice Points:• Able-bodied preschool children born extremely preterm/with extremely low birth weight have mild motor problems and reduced postural stability.• Small group physiotherapy intervention is recommended to optimise the physical performance of this population before school.• Important to investigate if long-term benefits of intervention in this population.