Effects on Motor Development of Kicking and Stepping Exercise in Preterm Infants with Periventricular Brain Injury: A Pilot Study

Background: Preterm infants with periventricular brain injury (PBI) have a high incidence of atypical development and leg movements. Objective: Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age (CA) in children with PBI improves motor function at 12 months CA when compared with control subjects. Method: In a multi-center pilot study for a controlled clinical trial sixteen infants with PBI were randomly assigned to home exercise consisting of kicking and treadmill stepping or a notraining control condition. Development was assessed at 2, 4, 6, 10, and 12 months CA with the Alberta Infant Motor Scale (AIMS). At 12 months children were classified as normal, delayed, or with cerebral palsy (CP). Results: At 12 months CA 3 of 7 (43%) of the exercise group children walked alone or with one hand held versus 1 of 9 (11%) in the control group (p=.262), but no significant differences in AIMS scores were found at any age. Half of the subjects had CP or delay; the outcomes of these infants was not improved by exercise. Compliance with the home program was lower than requested and may have affected results. Conclusion: Although not statistically significant with a small sample size, self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI, but improvements of the protocol to increase and document compliance are needed before a larger study is implemented.