Physical Therapy for Better Bones

Physical Therapy for Better Bones

VignochiCM, Miura E, and Canani LH. Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study. J Perinatol (Sept 2008); 28:624–631. Full Text | PDF

Objective: To study the effect of physical therapy on bone mineralization, weight gain and growth in preterm infants.

Method: After fulfilling the inclusion criteria, preterm infants were matched for gestational age and birth weight and then randomly assigned to the physiotherapy group (PG, n=15) and control group (CG, n=14). The PG received motor physical therapy for 15 min daily, 5 times per week until hospital discharge. Bone mineralization was measured by total body dual energy X-ray beam absorptiometry (DEXA) at the onset and end of the study. Statistical analysis was realized by ANCOVA and linear correlation tests.

Result: The physical therapy group (PG) presented greater body weight gain per day (27.42.4 vs 21.014.4 g, P<0.001) and length (1.30.3 vs 0.80.2 cm week^-1, P<0.001) than did the control group (CG). Body composition values verified by DEXA were greater for the PG. The mean gain in bone mineral content (BMC) (mg) was greater in the PG (434247.5 vs -8.911.4, P<0.001), as was the mean bone mineral density (BMD) gain (mg cm^-2) (8.45.6 vs -3.15.5, P<0.001). The gain in bone area (BA,cm²) was 10.35 in the PG vs 1.5 2 in the CG (P<0.001). The gain in lean mass (LM) (g) in the PG was also greater than in the CG (271.121.4 vs 109.11.0, P<0.009). The fat mass (g) was similar between the groups (P=0.432).

Conclusion: These results showed that physiotherapy in preterm infants produced greater gains in growth, body weight, BMC, BMD, BA and LM.

Comments: This is a small but well-designed study from Brasil that demonstrates a significant benefit to physical therapy in improving growth and bone mineralization in premature babies. Babies 26-34 weeks were included in the study, and the physical therapy was begun at around 2-3 weeks of age. “Rickets of prematurity” is a significant problem in our NICUs, and nutritional interventions alone are not sufficient to prevent it. More attention needs to be paid to the role of physical therapy in optimizing bone mineralization in preterm babies. ABK

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