TITLE:
PreEMPT (Preterm Infant Early Intervention for Movement and Participation Trial): The Feasibility of a Novel, Participation-Focused Early Physiotherapy Intervention Supported by Telehealth in Regional Australia—A Protocol
AUTHORS:
Chelsea A. Mobbs, Alicia J. Spittle, Leanne M. Johnston
KEYWORDS:
Early Intervention, Preterm Infants, Participation, Physiotherapy
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.4,
December
23,
2020
ABSTRACT: Background: Early intervention is beneficial for improving
preterm infant motor and cognitive outcomes in early childhood; however, little
is known about whether early intervention can influence a preterm infant’s
participation. Additionally, many studies investigating the impact of early
intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside in
regional areas underrepresented in the literature to date. Consequentially,
it is not yet known whether there are service delivery models, such as using
telehealth as an adjunct to face-to-face intervention, that might cater to the
needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement
and Participation Trial) is a novel early physiotherapy intervention that has
been designed to use a participation goal-directed intervention approach via a
mixture of face-to-face clinic sessions and telehealth sessions to improve the
motor and participation outcomes of preterm born infants. Methods: This
study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT
to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional
Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks
gestational age) will be recruited prior to
term corrected age from the special care nursery of a regional hospital.
Following informed consent and baseline assessments, infants will be randomly
allocated to receive either PreEMPT, a novel participation-focused early
physiotherapy intervention delivered weekly for 14 forty-five-minute sessions
alternating face-to-face sessions with telehealth into the infant’s home, or
UPC, two - three physiotherapy sessions
in the 4-month intervention period. Outcome measures relating to infant
neuromotor development, motor performance, general development, and parental
mental health and well-being will be assessed at 4-, 6- and 8-months corrected
age. Feasibility will be evaluated by acceptability (parental satisfaction),
demand and practicality (recruitment rate and telehealth session
implementation), implementation (attendance at assessment and treatment
sessions), and limited efficacy testing (comparing outcomes listed above for
infants in PreEMPT and UPC). Discussion: This study will be the first of
its kind to use the participation of preterm infants in meaningful life
situations as the foundation for intervention delivered via alternating
face-to-face clinic sessions with telehealth into the home. The feasibility of
this approach will be evaluated and used to inform future iterations of
research about PreEMPT’s efficacy for improving preterm infant motor and
participation outcomes.