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 ) .
Evidence for exercise-induced bone formation in premature infants.
We assessed the effect of a four weeks exercise training intervention on bone turnover markers in premature infants . Twenty-four very low birth weight premature infants were matched for gestational age , birth weight , gender , as well as for corrected age and weight at initiation of the study . Then the subjects were r and omly divided into an exercise ( n = 12 ) and a control group ( n = 12 ) . Exercise consisted of passive range of motion exercise with gentle compression of both the upper and lower extremities lasting 5 - 10 minutes each day , 5 days per week for 4 weeks . This protocol has been shown to increase bone mineral density in premature infants . Bone formation was assessed by measurements of circulating bone specific alkaline phosphatase ( BSAP ) and the C-terminal procollagen peptide ( PICP ) . Bone resorption was determined by serum measurements of C- terminal cross-links telopeptide of type-I collagen ( ICTP ) . Training led to a significant ( P < 0.05 ) increase in weight gain ( 767 + /- 49 versus 586 + /- 24 gr in trained and control premature infants , respectively ) ; and to a significant increase in BSAP ( 37.2 + /- 14.6 versus 4.1 + /- 8.4 % in trained and control premature infants , respectively ) . PICP increased also following exercise ( 34.6 + /- 18.9 versus 5.4 + /- 9.1 % in trained and control subjects , respectively ) , however , this increase was not statistically significant . Exercise led to a significant decrease in ICTP ( -24.7 + /- 3.1 versus -5.5 + /- 5.4 % in trained and control subjects , respectively ) . A relatively brief exercise intervention was associated with a biochemical evidence of bone formation in very low birth weight premature infants
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 ) .