Feasibility of Early Intervention Through Home-Based and Parent-Delivered Infant Massage in Infants at High Risk for Cerebral Palsy

Valentina Menici, Camilla Antonelli, Elena Beani, Alessandra Mattiola, Matteo Giampietri, Giada Martini, Riccardo Rizzi, Alessandra Cecchi, Maria Luce Cioni, Giovanni Cioni, Giuseppina Sgandurra, Caretoy-R Consortium, Claudia Artese, Veronica Barzacchi, Marta Cervo, Carlo Dani, Paolo Dario, Marco Di Galante, Ugo Faraguna, Patrizio Fiorini, Viola Fortini, Simona Giustini, Clara Lunardi, Irene Mannari, Martina Maselli, Martina Orlando, Letizia Padrini, Filomena Paternoster, Valentina Menici, Camilla Antonelli, Elena Beani, Alessandra Mattiola, Matteo Giampietri, Giada Martini, Riccardo Rizzi, Alessandra Cecchi, Maria Luce Cioni, Giovanni Cioni, Giuseppina Sgandurra, Caretoy-R Consortium, Claudia Artese, Veronica Barzacchi, Marta Cervo, Carlo Dani, Paolo Dario, Marco Di Galante, Ugo Faraguna, Patrizio Fiorini, Viola Fortini, Simona Giustini, Clara Lunardi, Irene Mannari, Martina Maselli, Martina Orlando, Letizia Padrini, Filomena Paternoster

Abstract

Infant massage (IM) can be considered an early intervention program that leads to the environmental enrichment framework. The effectiveness of IM to promote neurodevelopment in preterm infants has been proved, but studies on infants with early brain damage are still lacking. The main aim of this study was to assess the feasibility, acceptability and usability of IM, carried out by parents at home, on infants at high risk for Cerebral Palsy. An IM daily diary and an ad hoc questionnaire, called Infant Massage Questionnaire Parent-Infant Experiences (IMQPE), were developed. IMQPE consisted of a total of 30 questions, divided into 5 areas. The parents were trained to carry out the IM with a home-based course, conducted by an expert therapist. The intensive IM program was set according to a defined daily length of at least 20 min, with a frequency of at least 5 days per week for a total of 8 weeks. Data collection consisted in the selection of the variables around the characteristics, both of the infants and the mothers, IM dosage and frequency, different body parts of the infants involved and IMQPE scores. Variable selection was carried out by minimizing the Bayesian Information Criteria (BIC) over all possible variable subsets. Nineteen high-risk infants, aged 4.83 ± 1.22 months, received IM at home for 8 weeks. The massage was given by the infants' mothers with a mean daily session dose of 27.79 ± 7.88 min and a total of 21.04 ± 8.49 h. 89.74% and 100% of mothers performed the IM for the minimum daily dosage and the frequency recommended, respectively. All the families filled in the IMQPE, with a Total mean score of 79.59% and of 82.22% in General Information on IM, 76.30% in Infant's intervention-related changes, 76.85% in IM Suitability, 79.07% in Infant's acceptance and 83.52% in Time required for the training. Different best predictors in mothers and in infants have been found. These data provide evidence of the feasibility of performing IM at home on infants at high risk for CP. Study registration: www.clinicaltrial.com (NCT03211533 and NCT03234959).

Keywords: cerebral palsy; early intervention; family-centered intervention; home-based intervention; infant massage.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Menici, Antonelli, Beani, Mattiola, Giampietri, Martini, Rizzi, Cecchi, Cioni, Cioni, Sgandurra and Caretoy-R Consortium.

Figures

Figure 1
Figure 1
Answers of IMQPE sections.
Figure 2
Figure 2
Total answers to the IMQPE.

References

    1. Vickers A, Ohlsson A, Lacy JB, Horsley A. Massage for promoting growth and development of preterm and/or low birth-weight infants. Cochrane Database Syst Rev. (2004) 2004:CD000390. 10.1002/14651858.CD000390.pub2
    1. Bennett C, Underdown A, Barlow J. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane Database Syst Rev. (2013) 2013:CD005038. 10.1002/14651858.CD005038.pub3
    1. Cioni G, D'Acunto G, Guzzetta A. Perinatal brain damage in children. Neuroplasticity, early intervention, and molecular mechanisms of recovery. Prog Brain Res. (2011) 189:139–54. 10.1016/B978-0-444-53884-0.00022-1
    1. Wang L, He JL, Zhang XH. The efficacy of massage on preterm infants: a meta-analysis. Am J Perinatol. (2013) 30:731–8. 10.1055/s-0032-1332801
    1. Badr LK, Abdallah B, Kahale L. A meta-analysis of preterm infant massage: an ancient practice with contemporary applications. MCN Am J Matern Nurs. (2015) 40:344–58. 10.1097/NMC.0000000000000177
    1. Lu LC, Lan SH, Hsieh YP, Lin LY, Chen JC, Lan SJ. Massage therapy for weight gain in preterm neonates: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract. (2020) 39:101168. 10.1016/j.ctcp.2020.101168
    1. Juneau AL, Aita M, Héon M. Review and critical analysis of massage studies for term and preterm infants. Neonatal Netw. (2015) 34:165–77. 10.1891/0730-0832.34.3.165
    1. Álvarez MJ, Fernández D, Gómez-Salgado J, Rodríguez-González D, Rosón M, Lapeña S. The effects of massage therapy in hospitalized preterm neonates: a systematic review. Int J Nurs Stud. (2017) 69:119–36. 10.1016/j.ijnurstu.2017.02.009
    1. Guzzetta A, D'acunto MG, Carotenuto M, Berardi N, Bancale A, Biagioni E, et al. . The effects of preterm infant massage on brain electrical activity. Dev Med Child Neurol. (2011) 53:46–51. 10.1111/j.1469-8749.2011.04065.x
    1. Guzzetta A, Baldini S, Bancale A, Baroncelli L, Ciucci F, Ghirri P, et al. . Massage accelerates brain development and the maturation of visual function. J Neurosci. (2009) 29:6042–51. 10.1523/JNEUROSCI.5548-08.2009
    1. Livingston K, Beider S, Kant AJ, Gallardo CC, Joseph MH, Gold JI. Touch and massage for medically fragile infants. Evid Based Complement Altern Med. (2009) 6:473–82. 10.1093/ecam/nem076
    1. Ang JY, Lua JL, Mathur A, Thomas R, Asmar BI, Savasan S, et al. . A randomized placebo-controlled trial of massage therapy on the immune system of preterm infants. Pediatrics. (2012) 130:e1549–5. 10.1542/peds.2012-0196
    1. Diego MA, Field T, Hernandez-Reif M, Deeds O, Ascencio A, Begert G. Preterm infant massage elicits consistent increases in vagal activity and gastric motility that are associated with greater weight gain. Acta Paediatr Int J Paediatr. (2007) 96:1588–91. 10.1111/j.1651-2227.2007.00476.x
    1. Ferreira AM, Bergamasco NHP. Behavioral analysis of preterm neonates included in a tactile and kinesthetic stimulation program during hospitalization. Rev Bras Fisioter. (2010) 14:141–8. 10.1590/S1413-35552010005000002
    1. Field T, Diego M, Hernandez-Reif M, Dieter JNI, Kumar AM, Schanberg S, et al. . Insulin and insulin-like growth factor-1 increased in preterm neonates following massage therapy. J Dev Behav Pediatr. (2008) 29:463–6. 10.1097/DBP.0b013e3181856d3b
    1. Haley S, Beachy J, Ivaska KK, Slater H, Smith S, Moyer-Mileur LJ. Tactile/kinesthetic stimulation (TKS) increases tibial speed of sound and urinary osteocalcin (U-MidOC and unOC) in premature infants (29-32weeks PMA). Bone. (2012) 51:661–6. 10.1016/j.bone.2012.07.016
    1. Hernandez-Reif M, Diego M, Field T. Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behav Dev. (2007) 30:557–61. 10.1016/j.infbeh.2007.04.002
    1. Massaro AN, Hammad TA, Jazzo B, Aly H. Massage with kinesthetic stimulation improves weight gain in preterm infants. J Perinatol. (2009) 29:352–7. 10.1038/jp.2008.230
    1. Moyer-Mileur LJ, Haley S, Slater H, Beachy J, Smith SL. Massage improves growth quality by decreasing body fat deposition in male preterm infants. J Pediatr. (2013) 162:490–5. 10.1016/j.jpeds.2012.08.033
    1. Smith SL, Lux R, Haley S, Slater H, Beechy J, Moyer-Mileur LJ. The effect of massage on heart rate variability in preterm infants. J Perinatol. (2013) 33:59–64. 10.1038/jp.2012.47
    1. Diego MA, Field T, Hernandez-Reif M. Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J Pediatr. (2005) 147:50–55. 10.1016/j.jpeds.2005.02.023
    1. Akhavan Karbasi S, Golestan M, Fallah R, Golshan M, Dehghan Z. Effect of body massage on increase of low birth weight neonates growth parameters: a randomized clinical trial. Iran J Reprod Med. (2013) 11:583–8.
    1. Procianoy RS, Mendes EW, Silveira RC. Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants. Early Hum Dev. (2010) 86:7–11. 10.1016/j.earlhumdev.2009.12.001
    1. Kumar J, Upadhyay A, Dwivedi AK, Gothwal S, Jaiswal V, Aggarwal S. Effect of oil massage on growth in preterm neonates less than 1800 g: a randomized control trial. Indian J Pediatr. (2013) 80:465–9. 10.1007/s12098-012-0869-7
    1. Arora J, Kumar A, Ramji S. Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates. Indian Pediatr. (2005) 42:1092–100.
    1. Ferber SG, Feldman R, Kohelet D, Kuint J, Dollberg S, Arbel E, et al. . Massage therapy facilitates mother-infant interaction in premature infants. Infant Behav Dev. (2005) 67:37–45. 10.1016/j.infbeh.2004.07.004
    1. Teti DM, Black MM, Viscardi R, Glass P, O'Connell MA, Baker L, et al. . Intervention with African American premature infants. J Early Interv. (2009) 31:146–66. 10.1177/1053815109331864
    1. Abdallah B, Badr LK, Hawwari M. The efficacy of massage on short and long term outcomes in preterm infants. Infant Behav Dev. (2013) 36:662–9. 10.1016/j.infbeh.2013.06.009
    1. Afand N, Keshavarz M, Fatemi NS, Montazeri A. Effects of infant massage on state anxiety in mothers of preterm infants prior to hospital discharge. J Clin Nurs. (2017) 26:1887–92. 10.1111/jocn.13498
    1. Feijó L, Hernandez-Reif M, Field T, Burns W, Valley-Gray S, Simco E. Mothers' depressed mood and anxiety levels are reduced after massaging their preterm infants. Infant Behav Dev. (2006) 29:476–80. 10.1016/j.infbeh.2006.02.003
    1. Onozawa K, Glover V, Adams D, Modi N, Kumar RC. Infant massage improves mother-infant interaction for mothers with postnatal depression. J Affect Disord. (2001) 63:201–7. 10.1016/S0165-0327(00)00198-1
    1. O'Higgins M, James Roberts I, Glover V. Postnatal depression and mother and infant outcomes after infant massage. J Affect Disord. (2008) 109:189–92. 10.1016/j.jad.2007.10.027
    1. Glover V, Onozawa K, Hodgkinson A. Benefits of infant massage for mothers with postnatal depression. Semin Neonatol. (2002) 7:495–500. 10.1053/siny.2002.0154
    1. Oskoui M, Coutinho F, Dykeman J, Jette N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. (2013) 55:509–19. 10.1111/dmcn.12080
    1. Cioni G, Inguaggiato E, Sgandurra G. Early intervention in neurodevelopmental disorders: underlying neural mechanisms. Dev Med Child Neurol. (2016) 58:61–6. 10.1111/dmcn.13050
    1. Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, et al. . State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep. (2020) 20:3. 10.1007/s11910-020-1022-z
    1. Sgandurra G, Beani E, Giampietri M, Rizzi R, Cioni G, CareToy-R Consortium. Early intervention at home in infants with congenital brain lesion with CareToy revised: a RCT protocol. BMC Pediatr. (2018) 18:295. 10.1186/s12887-018-1264-y
    1. Beani E, Menici V, Cecchi A, Cioni ML, Giampietri M, Rizzi R, et al. . Feasibility analysis of caretoy-revised early intervention in infants at high risk for cerebral palsy. Front Neurol. (2020) 11:601137. 10.3389/fneur.2020.601137
    1. Heineman KR, Middelburg KJ, Bos AF, Eidhof L, La Bastide-Van Gemert S, Van Den Heuvel ER, et al. . Reliability and concurrent validity of the infant motor profile. Dev Med Child Neurol. (2013) 55:539–545. 10.1111/dmcn.12100
    1. Heineman KR, Bos AF, Hadders-Algra M. The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy. Dev Med Child Neurol. (2008) 50:275–82. 10.1111/j.1469-8749.2008.02035.x
    1. Heineman KR, Bos AF, Hadders-Algra M. Infant Motor Profile and cerebral palsy: promising associations. Dev Med Child Neurol. (2011) 53:40–5. 10.1111/j.1469-8749.2011.04063.x
    1. Rizzi R, Menici V, Cioni ML, Cecchi A, Barzacchi V, Beani E, et al. . Concurrent and predictive validity of the infant motor profile in infants at risk of neurodevelopmental disorders. BMC Pediatr. (2021) 21:68. 10.1186/s12887-021-02522-5
    1. Wang HH, Liao HF, Hsieh CL. Reliability, sensitivity to change, and responsiveness of the peabody developmental motor scales-second edition for children with cerebral palsy. Phys Ther. (2006) 86:1351–9. 10.2522/ptj.20050259
    1. Provost B, Heimerl S, McClain C, Kim NH, Lopez BR, Kodituwakku P. Concurrent validity of the Bayley scales of infant development II motor scale and the Peabody developmental motor Scales-2 in children with developmental delays. Pediatr Phys Ther. (2004) 16:149–56. 10.1097/01.PEP.0000136005.41585.FE
    1. Bayley N. editor. Bayley Scales of Infant and Toddler Development® Technical Manual. 3rd ed. San Antonio, TX: Pearson: (2005).
    1. Greenr J. The organisation of attachment relationships: maturation, culture and context. J Child Psychol Psychiatry. (2002) 43:551. 10.1111/1469-7610.t01-12-00044
    1. Biringen Z. The Universal Language of Love: Assessing Relationships Through the Science of Emotional Availability. EA Press: (2009).
    1. Teller DY, McDonald MA, Preston K, Sebris SL, Dobson V. Assessment of visual acuity in infants and children: the acuity card procedure. Dev Med Child Neurol. (1986) 28:779–89. 10.1111/j.1469-8749.1986.tb03932.x
    1. So K, Adamson TM, Horne RSC. The use of actigraphy for assessment of the development of sleep/wake patterns in infants during the first 12 months of life. J Sleep Res. (2007) 16:181–7 10.1111/j.1365-2869.2007.00582.x
    1. Greenspan SI. editor. Greenspan Social-Emotional Growth Chart: A Screening Questionnaire for Infants and Young Children . San Antonio, TX: Harcourt Assessment: (2004).
    1. Abidin RR. editor. Parenting Stress Index . Odessa, FL: Psychological Assessment Resources: (1995).
    1. Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res. (2011) 45:626–9. 10.1016/j.jpsychires.2010.10.008
    1. Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios LP, et al. . A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. (2010) 10:1. 10.1186/1471-2288-10-1
    1. Verhelst H, Vander Linden C, Vingerhoets G, Caeyenberghs K. How to train an Injured Brain? A pilot feasibility study of a home-based computerized cognitive training. Games Health J. (2017) 6:28–38. 10.1089/g4h.2016.0043
    1. Orsmond GI, Cohn ES. The distinctive features of a feasibility study: objectives and guiding questions. OTJR Occup Particip Heal. (2015) 35:169–77. 10.1177/1539449215578649
    1. Davis FD. A Technology Acceptance Model for Empirically Testing New End- User Information Systems: Theory and Results . Massachusetts Institute of Technology. (2019). Available online at: (accessed September 11, 2019).
    1. Dillon AP, Morris MG. User acceptance of new information technology: theories and models. Ann Rev Inform Sci Technol. (1996) 31:3–32.
    1. Wixon D, Wilson C. The usability engineering framework for product design and evaluation. In: Helander MG. Landauer TK, Prabhu PV, editors. Handbook of Human-Computer Interaction, 2nd ed. New York, NY: North Holland: (1997). p. 653–88.
    1. Abran A, Khelifi A, Suryn W, Seffah A. Usability meanings and interpretations in ISO standards. Softw Qual J. (2003) 11:325–38. 10.1023/A:1025869312943
    1. Jokela T, Iivari N, Matero J, Karukka M. The standard of user-centered design and the standard definition of usability: analyzing ISO 13407 against ISO 9241-11. CLIHC. (2003) 53–60. 10.1145/944519.944525
    1. Dirks T, Hadders-Algra M. The role of the family in intervention of infants at high risk of cerebral palsy: a systematic analysis. Dev Med Child Neurol. (2011) 53:62–7. 10.1111/j.1469-8749.2011.04067.x
    1. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez, et al. . Early, accurate diagnosis and early intervention in cerebral palsy. JAMA Pediatr. (2017) 2086:1–11. 10.1001/jamapediatrics.2017.1689
    1. Spittle AJ, Morgan C, Olsen JE, Novak I, Cheong JLY. early diagnosis and treatment of cerebral palsy in children with a history of preterm birth. Clin Perinatol. (2018) 45:409–20. 10.1016/j.clp.2018.05.011
    1. Treyvaud K, Inder TE, Lee KJ, Northam EA, Doyle LW, Anderson PJ. Can the home environment promote resilience for children born very preterm in the context of social and medical risk? J Exp Child Psychol. (2012) 112:326–37. 10.1016/j.jecp.2012.02.009
    1. Lai MM, D'Acunto G, Guzzetta A, Boyd RN, Rose SE, Fripp J, et al. . PREMM: preterm early massage by the mother: protocol of a randomised controlled trial of massage therapy in very preterm infants. BMC Pediatr. (2016) 16:146. 10.1186/s12887-016-0678-7
    1. Spittle A, Treyvaud K. The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm. Semin Perinatol. (2016) 40:542–8. 10.1053/j.semperi.2016.09.006
    1. Midtsund A, Litland A, Hjälmhult E. Mothers' experiences learning and performing infant massage-a qualitative study. J Clin Nurs. (2019) 28:489–98. 10.1111/jocn.14634
    1. Beani E, Menici V, Ferrari A, Cioni G, Sgandurra G. Feasibility of a home-based action observation training for children with unilateral cerebral palsy: an explorative study. Front Neurol. (2020) 11:16. 10.3389/fneur.2020.00016
    1. Corti C, Poggi G, Romaniello R, Strazzer S, Urgesi C, Borgatti R, et al. . Feasibility of a home-based computerized cognitive training for pediatric patients with congenital or acquired brain damage: an explorative study. PLoS ONE. (2018) 13:e0199001. 10.1371/journal.pone.0199001
    1. Guttmann K, Flibotte J, DeMauro SB. Parental perspectives on diagnosis and prognosis of neonatal intensive care unit graduates with cerebral palsy. J Pediatr. (2018) 203:156–62. 10.1016/j.jpeds.2018.07.089
    1. Dagenais L, Hall N, Majnemer A, Birnbaum R, Dumas F, Gosselin J, et al. . Communicating a diagnosis of cerebral palsy: caregiver satisfaction and stress. Pediatr Neurol. (2006) 35:408–14. 10.1016/j.pediatrneurol.2006.07.006

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever