| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 107 === Background: The very low birth weight(VLBW) infants with some neonatal complication, like brain injury and bronchopulmonary dyspalsia, lead to some poor outcomes, such as global development delay, delay walking and uncoordinated stepping pattern. Although treadmill training was widely used to improve stepping performance and walking ability, the evidence of the training in preterm infants still limited.
Purpose: To investigate the effects of treadmill training on stepping, walking, and development in high risk preterm infant.
Study design: Clinical control trail.
Subject: Inclusion criteria included (1)preterm, (2)birth weight<1500g, (3)severe brain injury or bronchopulmonary dyspalsia. Exclusion criteria included (1)congenital abnormality, (2) unable to tolerate treadmill training.
Method: Subjects were assigned in to experimental group (EG, who received home visit once a month and treadmill training at home as early intervention) and control group(CG, who received home visit once a month only). The intervention began form 4 months corrected age to 18 months corrected age (or walking attainment). The dose of treadmill training program was 5 days per week and 10 minutes per day.
Outcome measure: Assessment took place at 4, 8, 12, 18, 24months of corrected age and 3 years old. If the subject was under 18 months of corrected age or unable to walk independently, than the assessment included stepping performance and development outcome. If the subject was above 18 months of corrected age or able to walk independently, than the assessment included gait and development outcome. Age of walking onset was recorded when the infant could walk for 5 successive steps without support in 3 consecutive days. Stepping performance included alternating steps frequency, inter-joint coordination and inter-limb coordination. Gait data included walking speed, stride length and percentage of swing time. Developmental outcome was measured by Comprehensive Developmental Inventory for Infant and Toddlers.
Results: There were 24 subjects in this study (EG=10,CG=14).The age of walking attainment of EG(56 weeks) seemed to be earlier than CG(61 weeks). The hip-knee correlation of EG was higher than CG at 4 months of corrected age, but no between group difference at 8 months of corrected age. The knee-ankle correlation and swing phase asymmetric ratio of EG were lower than CG at 12 months of corrected age. There were no significant difference between groups at development outcomes.
Conclusion: Although there was a small sample size and low compliance of treadmill training program in this study, the finding indicates that treadmill training could improve the coordination of stepping and age of walking attainment. Future study is needed to include a large sample and ensure the compliance of the trainer.
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