title: Oral and non-oral sensorimotor interventions enhance oral feeding performance in preterm infants.
abstract: OBJECTIVE
  The aim of this study was to determine whether oral, tactile/kinaesthetic (T/K), or combined (oral+T/K) interventions enhance oral feeding performance and whether combined interventions have an additive/synergistic effect.
  
  
  METHODS
  Seventy-five preterm infants (mean gestational age 29 wk; standard error of the mean [SEM] 0.3 wk; mean birthweight 1340.3g; SEM 52.5 g; 49 males and 26 females) were randomly assigned to one of three intervention groups or a control group. The oral group received sensorimotor input to the oral structures, the T/K group received sensorimotor input to the trunk and limbs, and the combined group received both. The outcomes were time from introduction of nipple feeding to independent oral feeding (d), proficiency (intake in the first 5 min, %), volume transfer (%), rate of transfer (mL/min), volume loss (%), and length of hospital stay (d).
  
  
  RESULTS
  Infants in the three intervention groups achieved independent oral feeding 9-10 days earlier than those in the control group (p<0.001; effect size 1.9-2.1). Proficiency (p ≤ 0.002; effect size 0.7-1.4) at the time of one to two and three to five oral feedings per day, volume transfer (p ≤ 0.001; effect size 0.8-1.1) at one to two, three to five, and six to eight oral feedings per day, and overall rate of transfer (p ≤ 0.018; effect size 0.8-1.1) were greater, and overall volume losses were less (p ≤ 0.007; effect size 0.9-1.1), than in the control group (p ≤ 0.042). The combined group attained independent oral feeding at a significantly younger postmenstrual age than controls (p=0.020) and had clinically greater proficiency than the T/K group (p=0.020; effect size 0.7) and oral group (p=0.109; effect size 0.5). Length of hospital stay was not significantly different between groups (p=0.792; effect size 0.02-0.3).
  
  
  CONCLUSIONS
  Oral and T/K interventions accelerated the transition from introduction to independent oral feeding and enhanced oral feeding skills. T/K has beneficial effects beyond the specific targeted system. The combined sensorimotor intervention led to an additive/synergistic effect for proficiency, further benefiting this population.
authors.affiliation:  School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada. School of Speech Therapy and Audiology, University of Montreal, Montreal, QC, Canada. Department of Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Fucile
authors.affiliation:  School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada. School of Speech Therapy and Audiology, University of Montreal, Montreal, QC, Canada. Department of Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Erika G
authors.initials: EG
authors.lastname: Gisel
authors.affiliation:  School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada. School of Speech Therapy and Audiology, University of Montreal, Montreal, QC, Canada. Department of Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: McFarland
authors.affiliation:  School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada. School of Speech Therapy and Audiology, University of Montreal, Montreal, QC, Canada. Department of Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Chantal
authors.initials: C
authors.lastname: Lau
mesh_terms: D000367:Age Factors; D005247:Feeding Behavior; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008405:Massage / Q000379:methods*; D009055:Mouth; D010812:Physical Stimulation / Q000379:methods*; D047928:Premature Birth / Q000503:physiopathology* / Q000534:rehabilitation*; D011597:Psychomotor Performance; D018709:Statistics, Nonparametric; D013391:Sucking Behavior