Some evidence suggests that physical activity programs might promote short-term weight gain and bone mineralization in preterm infants .
Current evidence does not support the routine use of physical activity programs in preterm infants .
BACKGROUND Lack of physical stimulation may contribute to metabolic bone disease of preterm infants , result ing in poor bone mineralization and growth .
Physical activity programs combined with adequate nutrition might help to promote bone mineralization and growth .
OBJECTIVES The primary objective was to assess whether physical activity programs in preterm infants  improve bone mineralization and growth and reduce the risk of fracture .
Subgroup analysis : • Given that the smallest infants are most vulnerable for developing osteopenia ( Bishop 1999 ) , a subgroup analysis was planned for infants with birth weight < 1000 g.•  Calcium and phosphorus intake may affect an infant 's ability to increase bone mineral content ( Kuschel 2004 ) .
Tactile/kinesthetic stimulation (TKS) increases tibial speed of sound and urinary osteocalcin (U-MidOC and unOC) in premature infants (29-32weeks PMA).
Preterm delivery ( < 37 weeks post-menstrual age ) is associated with suboptimal bone mass . We hypothesized that tactile/kinesthetic stimulation ( TKS ) , a form of infant massage that incorporates kinesthetic movement , would increase bone strength and markers of bone accretion in preterm infants . Preterm , AGA infants ( 29 - 32 weeks ) were r and omly assigned to TKS ( N=20 ) or Control ( N=20 ) . Twice daily TKS was provided 6 days per week for 2 weeks . Control infants received the same care without TKS treatment . Treatment was masked to parents , health care providers , and study personnel . Baseline and week two measures were collected for tibial speed of sound ( tSOS , m/sec ) , a surrogate for bone strength , by quantitative ultrasound ( Sunlight8000 ) and urine markers of bone metabolism , pyridinium crosslinks and osteocalcin ( U-MidOC and unOC ) . Infant characteristics at birth and study entry as well as energy/nutrient intake were similar between TKS and Control . TKS intervention attenuated the decrease in tSOS observed in Control infants ( p<0.05 ) . Urinary pyridinium crosslinks decreased over time in both TKS and CTL ( p<0.005 ) . TKS infants experienced greater increases in urinary osteocalcin ( U-MidOC , p<0.001 and unOC , p<0.05 ) . We conclude that TKS improves bone strength  in premature infants by attenuating the decrease that normally follows preterm birth . Further , biomarkers of bone metabolism suggest a modification in bone turnover in TKS infants in favor of bone accretion . Taken together , we speculate that TKS improves bone mineralization
Some evidence suggests that physical activity programs might promote short-term weight gain and bone mineralization in preterm infants .
Current evidence does not support the routine use of physical activity programs in preterm infants .
BACKGROUND Lack of physical stimulation may contribute to metabolic bone disease of preterm infants , result ing in poor bone mineralization and growth .
Physical activity programs combined with adequate nutrition might help to promote bone mineralization and growth .
OBJECTIVES The primary objective was to assess whether physical activity programs in preterm infants  improve bone mineralization and growth and reduce the risk of fracture .
Subgroup analysis : • Given that the smallest infants are most vulnerable for developing osteopenia ( Bishop 1999 ) , a subgroup analysis was planned for infants with birth weight < 1000 g.•  Calcium and phosphorus intake may affect an infant 's ability to increase bone mineral content ( Kuschel 2004 ) .