Physical Therapy to Prevent Osteopenia in Preterm Infants

NCT ID: NCT04356807

Last Updated: 2025-04-25

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

101 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2020-07-31

Brief Summary

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To determine whether reflex locomotion therapy is effective for the prevention of osteopenia in preterm infants and compare its effectiveness over other physiotherapeutic methods like passive joint mobilizations and massage

Detailed Description

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Premature infants have smaller and low bone mineralization compared with term infants bones, since 80% of calcium uptake occurs at the end of pregnancy. Passive Physiotherapy has been effective in the treatment of osteopenia. Active mobilizations implemented by the baby itself, may be more effective than passive, as they cause muscle contraction from the Central Nervous System (CNS). Reflex locomotion therapy (RLT), stimulates CNS causing muscle contraction so it may be effective in the treatment of osteopenia in premature.

Objectives: To determine whether RLT is effective for the prevention of osteopenia in preterm infants and compare its effectiveness over other physiotherapeutic methods.

Methodology: Our study is a multicentre randomized clinical trial, with 90 children less than 34 weeks of gestational age, divided into three treatment groups, one will receive RLT, another will be treated with passive joint mobilizations with articular pressure; and last one will be done massage techniques. The treatment will last for one month, for the three groups. We intend to measure changes in mineralization, bone formation, and bone resorption, and anthropometry.

Conditions

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Metabolic Bone Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
Care Provider and Outcomes Assessor are masked to the objectives of the study

Study Groups

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Reflex Locomotion Therapy

during 15 minutes once a day five days a week

Group Type EXPERIMENTAL

Reflex Locomotion Therapy

Intervention Type PROCEDURE

The exercises corresponding to the motor complexes of the 1st phase of the rolling reflex and the original creeping reflex were performed, dedicating one minute to each side and performing two repetitions in each session.

Passive Joint Mobilizations

during 15 minutes once a day five days a week

Group Type EXPERIMENTAL

Passive Joint Mobilizations

Intervention Type PROCEDURE

Passive Joint Mobilizations with articular pressure described by Moyer-Mileur, et al. 1995 and modified by Vignochi, et al. 2008

Massage

during 15 minutes once a day five days a week

Group Type PLACEBO_COMPARATOR

Massage

Intervention Type PROCEDURE

Soft massage with soft pressures in limbs, tactile stimulation and no motion.

Interventions

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Reflex Locomotion Therapy

The exercises corresponding to the motor complexes of the 1st phase of the rolling reflex and the original creeping reflex were performed, dedicating one minute to each side and performing two repetitions in each session.

Intervention Type PROCEDURE

Passive Joint Mobilizations

Passive Joint Mobilizations with articular pressure described by Moyer-Mileur, et al. 1995 and modified by Vignochi, et al. 2008

Intervention Type PROCEDURE

Massage

Soft massage with soft pressures in limbs, tactile stimulation and no motion.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Preterm infants
* 26 to 34 weeks of gestational age
* Admitted in neonates
* Hemodynamically stable
* Complete enteral nutrition
* Parents or guardians signed an informed consent authorizing the participation of the baby in this study.

Exclusion Criteria

* Neurological disorders
* Mechanical ventilation

* Bronchopulmonary dysplasia
* Congenital malformations
* Metabolic diseases
* Genetic diseases
* Intraventricular hemorrhage III-IV,
* Diuretic medication or corticosteroids
* Bone fractures at the time of inclusion.
Maximum Eligible Age

34 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Galaad Torró Ferrero

OTHER

Sponsor Role lead

Responsible Party

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Galaad Torró Ferrero

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Galaad Torró-Ferrero, MSc

Role: PRINCIPAL_INVESTIGATOR

Universidad de Murcia

Locations

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Hospital General Universitario de Elche

Elche, Alicante, Spain

Site Status

Hospital Torrecárdenas de Almería

Almería, , Spain

Site Status

Hospital Clínico Universitario Virgen de la Arrixaca

Murcia, , Spain

Site Status

Countries

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Spain

References

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Vignochi CM, Miura E, Canani LH. Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study. J Perinatol. 2008 Sep;28(9):624-31. doi: 10.1038/jp.2008.60. Epub 2008 Jul 17.

Reference Type BACKGROUND
PMID: 18633420 (View on PubMed)

Vignochi CM, Silveira RC, Miura E, Canani LH, Procianoy RS. Physical therapy reduces bone resorption and increases bone formation in preterm infants. Am J Perinatol. 2012 Sep;29(8):573-8. doi: 10.1055/s-0032-1310520. Epub 2012 Jul 6.

Reference Type BACKGROUND
PMID: 22773291 (View on PubMed)

Moyer-Mileur L, Luetkemeier M, Boomer L, Chan GM. Effect of physical activity on bone mineralization in premature infants. J Pediatr. 1995 Oct;127(4):620-5. doi: 10.1016/s0022-3476(95)70127-3.

Reference Type BACKGROUND
PMID: 7562289 (View on PubMed)

Shaw SC, Sankar MJ, Thukral A, Natarajan CK, Deorari AK, Paul VK, Agarwal R. Assisted Physical Exercise for Improving Bone Strength in Preterm Infants Less than 35 Weeks Gestation: A Randomized Controlled Trial. Indian Pediatr. 2018 Feb 15;55(2):115-120. Epub 2017 Dec 14.

Reference Type BACKGROUND
PMID: 29242413 (View on PubMed)

Giannantonio C, Papacci P, Ciarniello R, Tesfagabir MG, Purcaro V, Cota F, Semeraro CM, Romagnoli C. Chest physiotherapy in preterm infants with lung diseases. Ital J Pediatr. 2010 Sep 26;36:65. doi: 10.1186/1824-7288-36-65.

Reference Type BACKGROUND
PMID: 20868518 (View on PubMed)

El-shaarawy MK, Rahman SAA, Fakher M, El A, Salah WM. Effect of rolling on oxygen saturation and incubation period in preterm neonates with respiratory distress syndrome. Int J Dev Res. 2017;07(01):11319-11323.

Reference Type BACKGROUND

Sanz-Esteban I, Calvo-Lobo C, Rios-Lago M, Alvarez-Linera J, Munoz-Garcia D, Rodriguez-Sanz D. Mapping the human brain during a specific Vojta's tactile input: the ipsilateral putamen's role. Medicine (Baltimore). 2018 Mar;97(13):e0253. doi: 10.1097/MD.0000000000010253.

Reference Type BACKGROUND
PMID: 29595683 (View on PubMed)

Torro-Ferrero G, Fernandez-Rego FJ, Aguera-Arenas JJ, Gomez-Conesa A. Effect of physiotherapy on the promotion of bone mineralization in preterm infants: a randomized controlled trial. Sci Rep. 2022 Jul 8;12(1):11680. doi: 10.1038/s41598-022-15810-6.

Reference Type DERIVED
PMID: 35804078 (View on PubMed)

Torro-Ferrero G, Fernandez-Rego FJ, Jimenez-Liria MR, Aguera-Arenas JJ, Pinero-Penalver J, Sanchez-Joya MDM, Fernandez-Berenguer MJ, Rodriguez-Perez M, Gomez-Conesa A. Effect of physical therapy on bone remodelling in preterm infants: a multicenter randomized controlled clinical trial. BMC Pediatr. 2022 Jun 24;22(1):362. doi: 10.1186/s12887-022-03402-2.

Reference Type DERIVED
PMID: 35739544 (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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Fisio-Osteopenia

Identifier Type: -

Identifier Source: org_study_id

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