The effectiveness of the early habilitation complex in premature infants according to N.A. Bernstein’s concept

Abstract

BACKGROUND: Currently, the incidence of developmental disorders and the level of disability in premature infants, especially those born with a low and extremely low body weight, remain high, that determines the relevance of habilitation methods.

AIM: to develop and evaluate the effectiveness of the early habilitation complex in premature infants with a perinatal brain damage when transferring to the stage III of rehabilitation.

MATERIALS AND METHODS: The study included 86 patients born with a very low and extremely low body weight, who had a hypoxic-ischemic or hemorrhagic brain damage and were observed at the Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan during the first three years of life. A comparative analysis of the development and functional outcomes of the disease was carried out for children of two groups. The first group, when transferred to the stage III of rehabilitation, was assigned a complex of early sensorimotor habilitation, developed on the basis of N.A. Bernstein’s concept to be carried out at home for three months after an appropriate training. The second group was not prescribed such a complex.

RESULTS: The effect of the early sensorimotor rehabilitation complex on the functional (motor, speech and cognitive) outcomes in prematurely born patients was evaluated and described. In the first group with an assigned complex of sensorimotor exercises, despite the absence of a significant effect by the age of 6 months, it was found by the age of one and a half years, that the average indices of the development of large (p=0.022) and fine motor skills (p=0.023), expressive speech (p=0.006) and cognitive functions (p=0.040) were higher, while, by the age of three years, the differences in speech (p=0.001) and cognitive (p=0.001) outcomes retained their statistical significance compared to the development indicators in children who did not receive the same early habilitation complex.

CONCLUSION: It was found that premature infants who received the early habilitation complex had better speech and cognitive outcomes by the age of three, compared to patients who did not receive the complex. The significance of the positive influence on the ontogenesis of motor skills persists during the second year of life.

Keywords

premature infants / rehabilitation / child development

References

[1] Shumilov PV, Mazmanyan PA, Sarkisyan EA, Nikogosyan KV. Features of psychomotor development of premature newborns with very low and extremely low birth weight by the two-year adjusted age. Russ Bulletin Perinatology Pediatrics. 2022;67(3):54–60. (In Russ). doi: 10.21508/1027-4065-2022-67-3-54-60

[2] Шумилов П.В., Мазманян П.А., Саркисян Е.А., Никогосян К.В. Особенности психомоторного развития недоношенных новорожденных с очень низкой и экстремально низкой массой тела при рождении к двухлетнему скорригированному возрасту // Российский вестник перинатологии и педиатрии. 2022. Т. 67, № 3. С. 54–60. doi: 10.21508/1027-4065-2022-67-3-54-60

[3] Jarjour IT. Neurodevelopmental outcome after extreme prematurity: A review of the literature. Pediatric Neurilogy. 2015;52(2):143–152. doi: 10.1016/j.pediatrneurol.2014.10.027

[4] Jarjour I.T. Neurodevelopmental outcome after extreme prematurity: A review of the literature // Pediatric Neurilogy. 2015. Vol. 52, N 2. Р. 143–152. doi: 10.1016/j.pediatrneurol.2014.10.027

[5] Woolard A, Coleman T, Johnsone K, et al. Parent-infant interaction quality is related to preterm status and sensory processing. Infant Behavior Development. 2022;(68):101746. doi: 10.1016/j.infbeh.2022.101746

[6] Woolard A., Coleman T., Johnsone K., et al. Parent-infant interaction quality is related to preterm status and sensory processing // Infant Behavior Development. 2022. N 68. Р. 101746. doi: 10.1016/j.infbeh.2022.101746

[7] Johnston MV. Plasticity in the developing brain: Implications for rehabilitation. Developmental Dis Res Rev. 2009;15(2):94–101. doi: 10.1002/ddrr.64

[8] Johnston M.V. Plasticity in the developing brain: Implications for rehabilitation // Developmental Dis Res Rev. 2009. Vol. 15, N 2. Р. 94–101. doi: 10.1002/ddrr.64

[9] Mobbsab C, Spittlecd A, Johnstona L. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial. Early Human Development. 2022;(166):105551. doi: 10.1016/j.earlhumdev.2022.105551

[10] Mobbsab C., Spittlecd A., Johnstona L. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial // Early Human Development. 2022. N 166. Р. 105551. doi: 10.1016/j.earlhumdev.2022.105551

[11] Bernstein NA. On the construction of movements. Moscow: Medgiz; 1947. 250 р. (In Russ).

[12] Бернштейн Н.А. О построении движений. Москва: Медгиз, 1947. 250 с.

[13] Skvortsov IA. Illustrated neurology of development. Moscow: MEDpress-inform; 2014. 352 p. (In Russ).

[14] Скворцов И.А. Иллюстрированная неврология развития. Mосква: МЕДпресс-информ, 2014. 352 с.

[15] Aukhadeev EI, Bodrova RA, Nefedieva DL, Komarnitsky VS. Restoration of impaired motor and speech functions based on the concept of N.A. Bernstein «On the construction of movements». Kazan: MedDok; 2021. 116 р (In Russ).

[16] Аухадеев Э.И., Бодрова Р.А., Нефедьева Д.Л., Комарницкий В.С. Восстановление нарушенных двигательных и речевых функций на основе концепции Н.А. Бернштейна «О построении движений». Казань: МедДоК, 2021. 116 с.

[17] Bure NP, Bochkarev IA, Suslova GA, et al. The use of the «dry immersion» method for premature infants and infants at the inpatient stage of medical rehabilitation. Children’s medicine of the North-West. 2018;7(1):52–53. (In Russ).

[18] Бурэ Н.П., Бочкарев И.А., Суслова Г.А., и др. Использование метода «сухой иммерсии» для недоношенных и детей грудного возраста на стационарном этапе медицинской реабилитации // Детская медицина Северо-Запада. 2018. Т. 7, № 1. С. 52–53.

[19] Skvortsov IA. Development of the nervous system in children in normal and pathological conditions. Moscow: MEDpress-inform; 2003. 368 p. (In Russ).

[20] Скворцов И.А. Развитие нервной системы у детей в норме и патологии. Mосква: МЕДпресс-информ, 2003. 368 с.

[21] Ionio C, Riboni E, Confalonieri E, et al. Paths of cognitive and language development in healthy preterm infants. Infant Behavir Development. 2016;(44):199–207. doi: 10.1016/j.infbeh.2016.07.004

[22] Ionio C., Riboni E., Confalonieri E., et al. Paths of cognitive and language development in healthy preterm infants // Infant Behavir Development. 2016. N 44. Р. 199–207. doi: 10.1016/j.infbeh.2016.07.004

[23] Rampon C, Jiang CH, Dong H, et al. Effects of environmental enrichment on gene expression in the brain. Proceedings National Acad Sci. 2000;97(23):12880–12884. doi: 10.1073/pnas.97.23.12880

[24] Rampon C., Jiang C.H., Dong H., et al. Effects of environmental enrichment on gene expression in the brain // Proceedings National Acad Sci. 2000. Vol. 97, N 23. Р. 12880–12884. doi: 10.1073/pnas.97.23.12880

[25] Pepino V, Mezzacappa MA. Application of tactile/kinesthetic stimulation in premature infants: A systematic rewiew. J Pediatria. 2015;91(3):213–233. doi: 10.1016/j.jped.2014.10.005

[26] Pepino V., Mezzacappa M.A. Application of tactile/kinesthetic stimulation in premature infants: A systematic rewiew // J Pediatria. 2015. Vol. 91, N 3. Р. 213–233. doi: 10.1016/j.jped.2014.10.005

[27] Leib S, Benfield G, Guidubaldi J. Effect of early intervention and stimulation on preterm infants. Pediatrics. 1980;66(1):83–90.

[28] Leib S., Benfield G., Guidubaldi J. Effect of early intervention and stimulation on preterm infants // Pediatrics. 1980. Vol. 66, N 1. Р. 83–90.

[29] Hayes JS. Premature infant development. The relationship of neonatal stimulation, birth condition and home environment. Pediatric Nursing. 1980;6(6):33–36.

[30] Hayes J.S. Premature infant development. The relationship of neonatal stimulation, birth condition and home environment // Pediatric Nursing. 1980. Vol. 6, N 6. Р. 33–36.

[31] Liljin ET, Doskin VA. Children’s rehabilitation. Moscow: Litterra; 2011. 640 p. (In Russ).

[32] Лильин Е.Т., Доскин В.А. Детская реабилитология. Москва: Литтерра, 2011. 640 с.

[33] Saito Y, Fukuhara R, Aoyama S, Toshima T. Frontal brain activation in premature infants response to auditory stimuli on neonatal intensive care unit. Early Human Development. 2009;85(5):471–474. doi: 10.1016/j.earlhumdev.2009.04.004

[34] Saito Y., Fukuhara R., Aoyama S., Toshima T. Frontal brain activation in premature infants response to auditory stimuli on neonatal intensive care unit // Early Human Development. 2009. Vol. 85, N 5. Р. 471–474. doi: 10.1016/j.earlhumdev.2009.04.004

[35] Picciolini O, Porro M, Meazza A, et al. Early exposure to maternal voice: Effects on preterm infants development. Early Human Development. 2014;90(6):287–292. doi: 10.1016/j.earlhumdev.2014.03.003

[36] Picciolini O., Porro M., Meazza A., et al. Early exposure to maternal voice: Effects on preterm infants development // Early Human Development. 2014. Vol. 90, N 6. Р. 287–292. doi: 10.1016/j.earlhumdev.2014.03.003

[37] Pascoe M, Bissessur D, Mayers P. Mothers perceptions of their premature infants communication: A description of two cases. Health SA Gesondheid. 2016;(21):143–154. doi: 10.1016/j.hsag.2015.10.002

[38] Pascoe M., Bissessur D., Mayers P. Mothers perceptions of their premature infants communication: A description of two cases // Health SA Gesondheid. 2016. N 21. Р. 143–154. doi: 10.1016/j.hsag.2015.10.002

[39] Lekskulchai R, Cole J. Effect of a developmental program on motor performance in infants born preterm. Austral J Physiotherapy. 2001;47(3):169–176. doi: 10.1016/s0004-9514(14)60264-6

[40] Lekskulchai R., Cole J. Effect of a developmental program on motor performance in infants born preterm // Austral J Physiotherapy. 2001. Vol. 47, N 3. Р. 169–176. doi: 10.1016/s0004-9514(14)60264-6

[41] Dusing SC, Tracker LR, Galloway JC. Infant born preterm have delayed development of adaptive postural control in the first 5 months of life. Infant Behavior Development. 2016;(44):49–58. doi: 10.1016/j.infbeh.2016.05.002

[42] Dusing S.C., Tracker L.R., Galloway J.C. Infant born preterm have delayed development of adaptive postural control in the first 5 months of life // Infant Behavior Development. 2016. N 44. Р. 49–58. doi: 10.1016/j.infbeh.2016.05.002

[43] King C, Norton D. Does therapeutic positioning of preterm infants impact upon optimal health outcomes? A literature review. J Neonatal Nursing. 2017;23(5):1–5. doi: 10.1016/j.jnn.2017.03.004

[44] King C., Norton D. Does therapeutic positioning of preterm infants impact upon optimal health outcomes? A literature review // J Neonatal Nursing. 2017. Vol. 23, N 5. Р. 1–5. doi: 10.1016/j.jnn.2017.03.004

[45] Khan MA, Prikuls VF, Mikitchenko NA, et al. Physical rehabilitation of children with perinatal lesions of the central nervous system. Physiotherapist. 2021;(3):29–39. (In Russ). doi: 10.33920/med-14-2106-04

[46] Хан М.А., Прикулс В.Ф., Микитченко Н.А., и др. Физическая реабилитация детей с перинатальным поражением центральной нервной системы // Физиотерапевт. 2021. № 3. С. 29–39. doi: 10.33920/med-14-2106-04

[47] Khan MA, Petrova MS, Degtyareva MG, et al. Modern technologies of physical rehabilitation of children with perinatal lesions of the central nervous system. Bulletin Res Med. 2021;20(4):57–64. (In Russ). doi: 10.38025/2078-1962-2021-20-4-57-64

[48] Хан М.А., Петрова М.С., Дегтярева М.Г., и др. Современные технологии физической реабилитация детей с перинатальным поражением центральной нервной системы // Вестник восстановительной медицины. 2021. Т. 20, № 4. С. 57–64. doi: 10.38025/2078-1962-2021-20-4-57-64

[49] Piaget J. Pathology of intelligence. Saint Petersburg: Peter; 2003. 192 p. (In Russ).

[50] Пиаже Ж. Патология интеллекта. Санкт-Петербург: Питер, 2003. 192 с.

[51] Mikitchenko NA, Degtyareva MG, Ivanova II, et al. Voita-therapy in the medical rehabilitation of children with the consequences of perinatal lesions of the central nervous system. Bulletin Res Med. 2022;21(4): 51–59. (In Russ). doi: 10.38025/2078-1962-2022-21-4-51-59

[52] Микитченко Н.А., Дегтярева М.Г., Иванова И.И., и др. Войта-терапия в медицинской реабилитации детей с последствиями перинатальных поражений центральной нервной системы // Вестник восстановительной медицины. 2022. Т. 21. № 4. С. 51–59. doi: 10.38025/2078-1962-2022-21-4-51-59

[53] Krysanova AS. Voita-therapy and neuro-developmental therapy in children with childhood postural asymmetry: A randomized controlled study. Universe Brain. 2020;2(4):37–41. (In Russ).

[54] Крысанова А.С. Войта-терапия и нейроразвивающая терапия у детей с детской постуральной асимметрией: рандомизированное контролируемое исследование // Вселенная мозга. 2020. Т. 2, № 4 С. 37–41.

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