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Exploring Objects With Feet Advances Movement in Infants Born Preterm: A Randomized Controlled Trial

J.C. Heathcock, PT, PhD, is Assistant Professor, Division of Physical Therapy, Ohio State University, 453 W 10th Ave, Columbus, Ohio 43210 (USA).
J.C. Galloway, PT, PhD, is Associate Professor, Department of Physical Therapy, University of Delaware, Newark, Delaware.

Address all correspondence to Dr Heathcock at: jill.heathcock{at}osumc.edu

Background: Previous work has shown that full-term infants who were healthy contacted a toy with their feet several weeks before they did so with their hands and that movement training advanced feet reaching. Certain populations of preterm infants are delayed in hand reaching; however, feet reaching has not been investigated in any preterm population.

Objective: The primary purpose of this study was to determine whether preterm infants born at less than 33 weeks of gestational age contacted a toy with their feet at 2 months of corrected age, before doing so with their hands, and whether movement training advanced feet reaching.

Design: This study was a randomized controlled trial.

Methods: Twenty-six infants born preterm were randomly assigned to receive daily movement training or daily social training. During the 8-week training period, the infants were videotaped in a testing session every other week from 2 to 4 months of age.

Results: Both groups contacted the toy with their feet at 2 months of age during the first testing session prior to training, at an age when no infants consistently contacted the toy with their hands. After 8 weeks of training, the movement training group displayed a greater number and longer duration of foot-toy contacts compared with the social training group.

Conclusions: These results suggest that movement experiences advance feet reaching as they do for hand reaching. For clinicians, feet-oriented play may provide an early intervention strategy to encourage object interaction for movement impairments within the first months of postnatal life. Future studies can build on these results to test the long-term benefit of encouraging early purposeful leg movements.

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