Effect of a NICU to Home Physical Therapy Intervention on White Matter Trajectories, Motor Skills, and Problem-Solving Skills of Infants Born Very Preterm: A Case Series

Christiana Dodd Butera; Claire Rhee; Claire E Kelly; Thijs Dhollander; Deanne K Thompson; Jessica Wisnowski; Rebecca M Molinini; Barbara Sargent; Natasha Lepore; Greg Vorona; Dave Bessom; Mary S Shall; Jennifer Burnsed; Richard D Stevenson; Shaaron Brown; Amy Harper; Karen D Hendricks-Muñoz; Stacey C Dusing

doi:10.3390/jpm12122024

Effect of a NICU to Home Physical Therapy Intervention on White Matter Trajectories, Motor Skills, and Problem-Solving Skills of Infants Born Very Preterm: A Case Series

J Pers Med. 2022 Dec 7;12(12):2024. doi: 10.3390/jpm12122024.

Authors

Christiana Dodd Butera¹, Claire Rhee¹, Claire E Kelly^{2

3}, Thijs Dhollander⁴, Deanne K Thompson^{2

5}, Jessica Wisnowski⁶, Rebecca M Molinini⁷, Barbara Sargent¹, Natasha Lepore^{8

9}, Greg Vorona¹⁰, Dave Bessom¹¹, Mary S Shall⁷, Jennifer Burnsed¹², Richard D Stevenson¹³, Shaaron Brown⁷, Amy Harper¹⁴, Karen D Hendricks-Muñoz¹⁵, Stacey C Dusing^{1

7}

Affiliations

¹ Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA.
² Victorian Infant Brain Studies and Developmental Imaging, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia.
³ Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC 3000, Australia.
⁴ Developmental Imaging, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia.
⁵ Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia.
⁶ Departments of Radiology and Pediatrics (Neonatology), Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.
⁷ Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23284, USA.
⁸ CIBORG Laboratory, Department of Radiology, University of Southern California, Los Angeles, CA 90089, USA.
⁹ Departments of Pediatrics and Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA.
¹⁰ Department of Radiology, Virginia Commonwealth University, Richmond, VA 23284, USA.
¹¹ Department of Radiology, Children's Hospital of Richmond at VCU, Richmond, VA 23284, USA.
¹² Division of Neonatology, Departments of Pediatrics and Neurology, University of Virginia, Charlottesville, VA 22903, USA.
¹³ Division of Neurodevelopmental and Behavioral Pediatrics, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22903, USA.
¹⁴ Department of Neurology, Virginia Commonwealth University, Richmond, VA 23284, USA.
¹⁵ Department of Pediatrics, Virginia Commonwealth University School of Medicine, Children's Hospital of Richmond at VCU, Richmond, VA 23284, USA.

Abstract

Infants born very preterm (VPT; ≤29 weeks of gestation) are at high risk of developmental disabilities and abnormalities in neural white matter characteristics. Early physical therapy interventions such as Supporting Play Exploration and Early Development Intervention (SPEEDI2) are associated with improvements in developmental outcomes. Six VPT infants were enrolled in a randomised clinical trial of SPEEDI2 during the transition from the neonatal intensive care unit to home over four time points. Magnetic resonance imaging scans and fixel-based analysis were performed, and fibre density (FD), fibre cross-section (FC), and fibre density and cross-section values (FDC) were computed. Changes in white matter microstructure and macrostructure were positively correlated with cognitive, motor, and motor-based problem solving over time on developmental assessments. In all infants, the greatest increase in FD, FC, and FDC occurred between Visit 1 and 2 (mean chronological age: 2.68-6.22 months), suggesting that this is a potential window of time to optimally support adaptive development. Results warrant further studies with larger groups to formally compare the impact of intervention and disparity on neurodevelopmental outcomes in infants born VPT.

Keywords: corticospinal tract; early intervention; fixel-based analysis; preterm infants.

Publication types

Case Reports

Abstract

Publication types

Grants and funding