OMT to Improve Feeding After Hypothermia

NCT ID: NCT03380013

Last Updated: 2019-05-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-24

Study Completion Date

2019-04-30

Brief Summary

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The goal of this study is to determine if infants with neonatal encephalopathy will achieve full oral feeds faster after therapeutic hypothermia has completed if they are treated with osteopathic manipulative treatment. The treated infants will be compared to matched historical controls.

Detailed Description

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Infants affected by neonatal encephalopathy (NE) have been shown to have better survival rates and improved long term neurodevelopment following treatment with therapeutic hypothermia. However, a barrier to hospital discharge for these infants is a successful transition from gavage to either breast or bottle feeding.

Often, the factor delaying hospital discharge is slow transition to full oral feeds. Osteopathic manipulative treatment (OMT) helps to effectively stabilize and regulate the autonomic nervous system as well as the cranial nerves important in the sucking and latching reflexes, which may in turn help to ease the transition to full oral feeding. We hypothesize that infants who receive OMT will accelerate the transition to full oral feeds, thus decreasing their overall length of hospitalization compared to historical matched controls.

Conditions

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Neonatal Encephalopathy Feeding; Difficult, Newborn

Keywords

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hypothermia treatment OMT in infants

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Infants recruited for this study are treated with OMT upon completion of hypothermia. They are compared 1:3 with matched historical controls.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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OMT group

Osteopathic Manipulative Therapy (OMT); two treatments between day 4 and 7 of life

Group Type EXPERIMENTAL

Osteopathic Manipulative Treatment (OMT)

Intervention Type PROCEDURE

Each neonate will have a structural exam completed assessing each body region (head, cervical, thoracic, lumbar, sacral, pelvic, rib cage, and abdominal regions) for underlying somatic dysfunctions prior to each treatment. The specific OMT techniques used will be left to the discretion of the treating physician and will not be based on a predetermined protocol. Treatment techniques will consist of myofascial release, balanced ligamentous tension, balanced membranous tension, and osteopathy in the cranial field. Total treatment time will be 15 minutes. The features of the osteopathic structural exam which will be recorded on paper by the treating physician at the time of the evaluation. The paper will be marked only with the research identifier.

Interventions

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Osteopathic Manipulative Treatment (OMT)

Each neonate will have a structural exam completed assessing each body region (head, cervical, thoracic, lumbar, sacral, pelvic, rib cage, and abdominal regions) for underlying somatic dysfunctions prior to each treatment. The specific OMT techniques used will be left to the discretion of the treating physician and will not be based on a predetermined protocol. Treatment techniques will consist of myofascial release, balanced ligamentous tension, balanced membranous tension, and osteopathy in the cranial field. Total treatment time will be 15 minutes. The features of the osteopathic structural exam which will be recorded on paper by the treating physician at the time of the evaluation. The paper will be marked only with the research identifier.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Neonate \> 37 weeks gestational age at birth
* Neonate been diagnosed with neonatal encephalopathy or hypoxic ischemic encephalopathy and treated with therapeutic hypothermia
* Neonate with mild to moderate encephalopathy
* EEG without seizure activity
* Brain MRI without basal ganglia injury

Exclusion Criteria

* Neonate \< 37 weeks gestational age at birth
* Neonate with severe encephalopathy (as defined by Sarnat)
* EEG demonstrated seizure activity or evidence of status epilepticus during therapeutic hypothermia treatment
* Brain MRI demonstrating moderate or severe basal ganglia injury
* Neonate affected by neonatal abstinence syndrome (NAS)
* Neonate affected by intrauterine growth restriction (IUGR)
* Neonate born with major congenital anomalies (i.e., cleft palate)
* Prenatal history of maternal insulin dependent gestational or type 1 diabetes
* Moribund status (i.e., infants unlikely to benefit from or are not responsive to aggressive life support)
Minimum Eligible Age

37 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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MaineHealth

OTHER

Sponsor Role lead

Responsible Party

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Alexa Craig

Neonatal and Pediatric Neurologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alexa Craig, MD

Role: PRINCIPAL_INVESTIGATOR

MaineHealth

Locations

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Maine Medical Center

Portland, Maine, United States

Site Status

Countries

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United States

References

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Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013 Jan 31;2013(1):CD003311. doi: 10.1002/14651858.CD003311.pub3.

Reference Type BACKGROUND
PMID: 23440789 (View on PubMed)

Henley CE, Ivins D, Mills M, Wen FK, Benjamin BA. Osteopathic manipulative treatment and its relationship to autonomic nervous system activity as demonstrated by heart rate variability: a repeated measures study. Osteopath Med Prim Care. 2008 Jun 5;2:7. doi: 10.1186/1750-4732-2-7.

Reference Type BACKGROUND
PMID: 18534024 (View on PubMed)

Inder TE. Pediatrics: predicting outcomes after perinatal brain injury. Nat Rev Neurol. 2011 Sep 13;7(10):544-5. doi: 10.1038/nrneurol.2011.142. No abstract available.

Reference Type BACKGROUND
PMID: 21912407 (View on PubMed)

Frymann V. Relation of disturbances of craniosacral mechanisms to symptomatology of the newborn: study of 1,250 infants. J Am Osteopath Assoc. 1966 Jun;65(10):1059-75. No abstract available.

Reference Type BACKGROUND
PMID: 5178520 (View on PubMed)

Cerritelli F, Pizzolorusso G, Ciardelli F, La Mola E, Cozzolino V, Renzetti C, D'Incecco C, Fusilli P, Sabatino G, Barlafante G. Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: a randomized controlled trial. BMC Pediatr. 2013 Apr 26;13:65. doi: 10.1186/1471-2431-13-65.

Reference Type BACKGROUND
PMID: 23622070 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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IRB 1134889-1

Identifier Type: -

Identifier Source: org_study_id