Effect of Auditory and Tactile-kinesthetic Stimulation on Preterm Neonates
Condition: Prematurity
MeSH terms: Premature Birth
Study type: Interventional

Summary: 
      The study was conducted at a level II special care nursery of the Moi Teaching & Referral
      Hospital, an academic hospital in the Western region of Kenya. A sample of 108 preterm
      neonates who met eligibility criteria were studied (36 in auditory group, 36 in
      tactile-kinesthetic stimulation group, and 36 in control group). Auditory group listened to
      recorded maternal voice while tactile-kinesthetic group received massage and joint
      movements.The interventions were provided for 15 minutes, 3 times a day for 10 days while
      outcome measures were observed for 21 days. The neonates in the control group received
      standard neonatal care and were observed for outcome measures as those in the intervention
      groups.
    

Detailed description: 
      The study was aimed to determine the effect of auditory stimulation using recorded maternal
      voice and tactile-kinesthetic stimulation on physiological parameters, physical growth and
      behavioral development of preterm neonates. Three groups were involved; auditory stimulation,
      tactile-kinesthetic stimulation and control.

      A quasi-experimental design was used to recruit 108 study subjects (36 in each group). A
      trained researcher conducted the stimulation in the intervention groups and two research
      assistants did the data entry. The research assistants were blinded to aim of study, group
      assignments, and interventions received by preterm neonates.

      Preterm neonates baseline characteristics and clinical data were obtained at initial contact.

      Physiological parameters (heart rate, oxygen saturation and body temperature) were monitored
      using a cardio-respiratory monitor (CODEC patient monitor CMS6000). Respiratory rate was
      measured by counting breaths per minute by the research assistant. The parameters were
      monitored and recorded before, during and after stimulation in the intervention groups. The
      control group had the measurement recorded in the morning, afternoon and evening.

      Physical growth was assessed using weight measurement. Neonates are weighed daily in the
      nursery and data on weight was entered by research assistants on alternate days.

      Neonatal behavioral assessment scale (NBAS) was used to assess behavior at initial contact,
      day 10, 17 and 24.
    

Intervention name(s): Tactile-kinesthetic stimulation; Recorded maternal voice
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Tactile-kinesthetic stimulation involved three sessions per day; morning, afternoon, and evening for 10 days starting day 3 of life (initial contact). The stimulation included three phases; Phase 1: With neonates in prone position, moderate pressure was used to provide 12 strokes with palms of the hands, each stroke lasting 5 seconds. The strokes were provided in each area as follows: head, neck, shoulders and back.
Phase 2: In supine position, twelve moderate pressure strokes with palms of the hands, 5 seconds each, were provided in each area as follows:forehead,cheeks,chest, abdomen, upper limbs (each separately), lower limbs, palms and soles.
Phase 3: Kinesthetic stimulation was done for 5 minutes. The intervention comprised five passive flexion and extension movements of each large joint.; Following informed written consent from mothers,maternal voice was recorded (5 minutes talking to her baby and 10 minutes singing) using Philips Electronics, SA2RGA04KS, Netherlands. Recorded voice was played back inside the incubator or cot via micro audio system, which has been validated for safety and feasibility in previous studies (Doheny et al., 2012. Preterm neonate lay in supine/lateral position and recorded maternal voice was played for 15 minutes three times a day (morning, afternoon, evening) starting on day 3 of life up to day 12 of life (10 days).
Allocation: Non-Randomized
Intervention model: Sequential Assignment
Intervention model description: Quasi-experimental design
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Maternal voice and tactile-kinesthetic stimulation