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The goal of this clinical trial is to learn about the effects of Neonatal Touch and Massage Therapy on premature babies.
The main questions it aims to answer are:
Participants assigned to the treatment group will receive Neonatal Touch and Massage Therapy while admitted to the NICU. Researchers will compare their outcomes to a control group, receiving standard NICU care, to see if there are any differences in the length of hospital stay, weight gain, pain scores, neurodevelopmental outcomes, and incidence of other common conditions associated with prematurity.
The purpose of this study is to determine the effects of Neonatal Touch and Massage Therapy on premature infants in the NICU. Babies enrolled in this study will be randomly assigned to receive Neonatal Touch and Massage or standard NICU care. Babies in the therapy group will be given Neonatal Touch or Massage therapy by certified providers 3 days per week for 5 to 15 minutes. Therapy will be done for a minimum of 4 weeks. The investigators will assess pain and stress responses before and after treatment. The investigators will also review participant's medical records to collect information about weight gain, length of hospitalization, and general health status. After a participant is discharged home, information will be collected about participant's developmental assessments at regularly scheduled NICU follow-up clinic appointments. There are no significant risks with this therapy. Potential benefits of therapy include increased weight gain, shorter hospitalization, decreased pain and stress, and improved developmental outcomes. Information gained from this study could also help future babies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | This group will receive structured neonatal touch or massage therapy from a certified NICU provider. Therapy will given 3 days a week for 5 to 15 minutes for a minimum of 4 weeks. We will also be collecting data to assess pain and stress responses during the period immediately before, during, and shortly after the therapy. This includes assessment of crying/irritability, behavior state, facial expression, extremities tone, and vital signs (heart rate, breathing rate, and oxygen levels). |
|
| Control | No Intervention | This group will receive standard NICU care, no different than if they were not enrolled in the study. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neonatal Touch and Massage Therapy | Other | Structured touch and massage therapy performed by certified providers. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Length of stay | Total length of hospitalization, from NICU admission to discharge home in days | Day of birth to discharge home, up to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Weight gain | Assessment of daily weight in grams | Through study intervention, an average of 4 weeks |
| Linear growth | Assessment of weekly length in centimeters |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Johana Diaz, MD | University of Maryland, Baltimore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Maryland Medical Center | Baltimore | Maryland | 21201 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19484828 | Background | Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, Bellieni CV; Pain Study Group of the Italian Society of Neonatology. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009 Jun;98(6):932-9. doi: 10.1111/j.1651-2227.2009.01291.x. | |
| Background | Leslie Altimier, RN, MSN, DNPc, NEA-BC, Raylene M. Phillips, MD, MA, IBCLC, FAAP. The Neonatal Integrative Developmental Care Model: Seven Neuroprotective Core Measures for Family-Centered Developmental Care. Newborn & Infant Nursing Reviews 13 (2013) 9-22. | ||
| 21045616 |
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There is no plan to make individual participant data available to other researchers.
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| ID | Term |
|---|---|
| D047928 | Premature Birth |
| ID | Term |
|---|---|
| D007752 | Obstetric Labor, Premature |
| D007744 | Obstetric Labor Complications |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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| ID | Term |
|---|---|
| D008405 | Massage |
| ID | Term |
|---|---|
| D064746 | Therapy, Soft Tissue |
| D026201 | Musculoskeletal Manipulations |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
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Randomized controlled trial
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Assessors evaluating neurodevelopmental outcomes will be masked from knowing which intervention was assigned to individual participants.
| Through study intervention, an average of 4 weeks |
| Head growth | Assessment of weekly head circumference in centimeters | Through study intervention, an average of 4 weeks |
| Neurodevelopmental Outcomes | Prior to NICU discharge or transfer each subject will undergo a Neonatal Neurobehavioral Scale (NNNS-II) assessment by a certified examiner. This is a comprehensive evaluation of neurological integrity and behavioral function including reflexes, motor development, and active and passive tone. NNNS profiles have been demonstrated to be predictive of short term cognitive, motor, and behavioral outcomes after NICU discharge. Standardized neurodevelopmental assessments will also be completed at regularly scheduled NICU follow-up clinic visits | Within in 1 week of NICU discharge or transfer until up to 3 years of age |
| Pain scores | Neonatal Pain, Agitation, and Sedation Scale (N-PASS) scores, a validated assessment tool using a combination of physiologic and behavioral indices, will documented before and after therapy to evaluate pain and stress responses. The scale has a minimum value of -10 and maximum value of +10, with a higher score indicating more pain. | 1 hour before intervention and up to 3 hours post-intervention |
| Background |
| Pickler RH, McGrath JM, Reyna BA, McCain N, Lewis M, Cone S, Wetzel P, Best A. A model of neurodevelopmental risk and protection for preterm infants. J Perinat Neonatal Nurs. 2010 Oct-Dec;24(4):356-65. doi: 10.1097/JPN.0b013e3181fb1e70. |
| 26223408 | Background | Cruz MD, Fernandes AM, Oliveira CR. Epidemiology of painful procedures performed in neonates: A systematic review of observational studies. Eur J Pain. 2016 Apr;20(4):489-98. doi: 10.1002/ejp.757. Epub 2015 Jul 29. |
| 27568006 | Result | Lai MM, D'Acunto G, Guzzetta A, Boyd RN, Rose SE, Fripp J, Finnigan S, Ngenda N, Love P, Whittingham K, Pannek K, Ware RS, Colditz PB. PREMM: preterm early massage by the mother: protocol of a randomised controlled trial of massage therapy in very preterm infants. BMC Pediatr. 2016 Aug 27;16(1):146. doi: 10.1186/s12887-016-0678-7. |
| 32117835 | Result | Williams MD, Lascelles BDX. Early Neonatal Pain-A Review of Clinical and Experimental Implications on Painful Conditions Later in Life. Front Pediatr. 2020 Feb 7;8:30. doi: 10.3389/fped.2020.00030. eCollection 2020. |
| 26302088 | Result | Badr LK, Abdallah B, Kahale L. A Meta-Analysis of Preterm Infant Massage: An Ancient Practice With Contemporary Applications. MCN Am J Matern Child Nurs. 2015 Nov-Dec;40(6):344-58. doi: 10.1097/NMC.0000000000000177. |
| 35681968 | Result | Mrljak R, Arnsteg Danielsson A, Hedov G, Garmy P. Effects of Infant Massage: A Systematic Review. Int J Environ Res Public Health. 2022 May 24;19(11):6378. doi: 10.3390/ijerph19116378. |
| 28368368 | Result | Niemi AK. Review of Randomized Controlled Trials of Massage in Preterm Infants. Children (Basel). 2017 Apr 3;4(4):21. doi: 10.3390/children4040021. |
| 20732945 | Result | Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, Hale EC, Newman NS, Schibler K, Carlo WA, Kennedy KA, Poindexter BB, Finer NN, Ehrenkranz RA, Duara S, Sanchez PJ, O'Shea TM, Goldberg RN, Van Meurs KP, Faix RG, Phelps DL, Frantz ID 3rd, Watterberg KL, Saha S, Das A, Higgins RD; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010 Sep;126(3):443-56. doi: 10.1542/peds.2009-2959. Epub 2010 Aug 23. |
| 28235686 | Result | Alvarez MJ, Fernandez D, Gomez-Salgado J, Rodriguez-Gonzalez D, Roson M, Lapena S. The effects of massage therapy in hospitalized preterm neonates: A systematic review. Int J Nurs Stud. 2017 Apr;69:119-136. doi: 10.1016/j.ijnurstu.2017.02.009. Epub 2017 Feb 14. |
| 35849396 | Result | McGowan EC, Hofheimer JA, O'Shea TM, Kilbride H, Carter BS, Check J, Helderman J, Neal CR, Pastyrnak S, Smith LM, Camerota M, Dansereau LM, Della Grotta SA, Lester BM. Analysis of Neonatal Neurobehavior and Developmental Outcomes Among Preterm Infants. JAMA Netw Open. 2022 Jul 1;5(7):e2222249. doi: 10.1001/jamanetworkopen.2022.22249. |
| 25635585 | Result | Santos J, Pearce SE, Stroustrup A. Impact of hospital-based environmental exposures on neurodevelopmental outcomes of preterm infants. Curr Opin Pediatr. 2015 Apr;27(2):254-60. doi: 10.1097/MOP.0000000000000190. |
| 20137814 | Result | Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: a review. Infant Behav Dev. 2010 Apr;33(2):115-24. doi: 10.1016/j.infbeh.2009.12.004. |
| 11247199 | Result | Agarwal KN, Gupta A, Pushkarna R, Bhargava SK, Faridi MM, Prabhu MK. Effects of massage & use of oil on growth, blood flow & sleep pattern in infants. Indian J Med Res. 2000 Dec;112:212-7. |
| 16340050 | Result | Arora J, Kumar A, Ramji S. Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates. Indian Pediatr. 2005 Nov;42(11):1092-100. |
| 23830725 | Result | Fallah R, Akhavan Karbasi S, Golestan M, Fromandi M. Sunflower oil versus no oil moderate pressure massage leads to greater increases in weight in preterm neonates who are low birth weight. Early Hum Dev. 2013 Sep;89(9):769-72. doi: 10.1016/j.earlhumdev.2013.06.002. Epub 2013 Jul 5. |
| 25725185 | Result | Saeadi R, Ghorbani Z, Shapouri Moghaddam A. The effect of massage with medium-chain triglyceride oil on weight gain in premature neonates. Acta Med Iran. 2015;53(2):134-8. |
| 23322391 | Result | Wang L, He JL, Zhang XH. The efficacy of massage on preterm infants: a meta-analysis. Am J Perinatol. 2013 Oct;30(9):731-8. doi: 10.1055/s-0032-1332801. Epub 2013 Jan 15. |
| 15106151 | Result | Vickers A, Ohlsson A, Lacy JB, Horsley A. Massage for promoting growth and development of preterm and/or low birth-weight infants. Cochrane Database Syst Rev. 2004;2004(2):CD000390. doi: 10.1002/14651858.CD000390.pub2. |
| 20022717 | Result | Procianoy RS, Mendes EW, Silveira RC. Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants. Early Hum Dev. 2010 Jan;86(1):7-11. doi: 10.1016/j.earlhumdev.2009.12.001. Epub 2009 Dec 22. |
| 33974990 | Result | Fitri SYR, Nasution SK, Nurhidayah I, Maryam NNA. Massage therapy as a non-pharmacological analgesia for procedural pain in neonates: A scoping review. Complement Ther Med. 2021 Jun;59:102735. doi: 10.1016/j.ctim.2021.102735. Epub 2021 May 8. |
| 33542780 | Result | Bernstein K, Karkhaneh M, Zorzela L, Jou H, Vohra S. Massage therapy for paediatric procedural pain: A rapid review. Paediatr Child Health. 2019 Nov 1;26(1):e57-e66. doi: 10.1093/pch/pxz133. eCollection 2021 Feb. |
| 18165830 | Result | Hummel P, Puchalski M, Creech SD, Weiss MG. Clinical reliability and validity of the N-PASS: neonatal pain, agitation and sedation scale with prolonged pain. J Perinatol. 2008 Jan;28(1):55-60. doi: 10.1038/sj.jp.7211861. Epub 2007 Oct 25. |
| D000091642 | Urogenital Diseases |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |