Randomised clinical trial of group-based physiotherapy in extremely low birthweight children with minimal/mild motor impairment: a preliminary study

Aim: Extremely low birthweight infants often present with mild neurodevelopmental impairments in gross motor function and postural stability in early childhood. The aim of the study was to undertake a randomised controlled trial to determine the short- and longer-term effects of group-based physiotherapy compared to standard care on performance in extremely low birthweight children with minimal/mild impairment. Methods: Fifty children aged 4 years, born <28 weeks gestation and/or birthweight <1000 g with minimal/mild motor impairment were enrolled in a randomised controlled trial and randomly allocated to 6 weeks of group-based intervention (n = 24) or standard care (n = 26). The intervention consisted of a combination of traditional physiotherapy and task-oriented approaches of approximately 1 h in duration and varied according to each child's strengths and weaknesses. Baseline, post intervention and 1 year post baseline assessments included Movement Assessment Battery for Children-2 (MABC-2), single leg stance, lateral reach and long jump. Results: Forty-eight (96%) children completed the study, which demonstrated no significant differences between the intervention and standard care groups on any of the assessments. Both groups improved initially from baseline to initial reassessment on the MABC-2 (P < 0.001). For both groups, however, MABC-2 manual dexterity, aiming/catching and total score declined from baseline to 1 year follow-up. However, for both groups, single leg stance and limb strength were significantly improved from baseline to 1 year follow-up. Conclusions: There were no differences in outcomes between groups. Both approaches may contribute to improved short-term performance and longer-term improvements on functional skills in extremely preterm children.