Neuromotor development and the physiologic effects of positioning in very low birth weight infants.
OBJECTIVE
To provide a comprehensive literature review of neuromotor development and related physiologic effects of positioning in very low birth weight infants.


METHODS
MEDLINE, CINHAL, Health Star, Current Contents, and the Australian Medical Index (1966-2000) databases were searched. Unpublished studies (e.g., dissertations, conference proceedings) and all relevant references listed in articles also were examined.


METHODS
One hundred and eighty theoretical writings, research studies, and clinical papers related to neuromotor development, the physiologic effects of positioning, and interventions to minimize or prevent short- and long-term effects of positioning in very low birth weight infants were reviewed.


METHODS
Studies were assessed for scientific rigor, evidence of theoretical foundation, and clinical relevance. Comparisons were made across data sources to determine the most reliable, valid, and consistent findings.


RESULTS
Three compelling results emerged: (a) The development of posture and mobility in newborn infants requires an optimal balance between active and passive muscle tone, (b) the prone position is physiologically more beneficial for the preterm infant than supine and lateral positions, and (c) the prone position can lead to short- and long-term postural and associated developmental problems.


CONCLUSIONS
Use of empirically tested postural interventions appropriate for an infant's gestational age, health status, and overall organizational capacity is recommended.
Monterosso
Leanne
L
School of Nursing and Public Health, Edith Cowan University, Churchlands, Western Australia. l.monterosso@ecu.edu.au
Kristjanson
Linda
L
Cole
Joan
J
D002657:Child Development / Q000502:physiology*; D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D017283:Neonatal Nursing / Q000379:methods*; D009482:Neurophysiology; D010043:Outcome and Process Assessment, Health Care; D016684:Prone Position / Q000502:physiology*; D016683:Supine Position / Q000502:physiology