title: Oral and nonoral sensorimotor interventions facilitate suck-swallow-respiration functions and their coordination in preterm infants.
abstract: BACKGROUND
  Preterm infants are at high risk of encountering oral feeding difficulties. Early sensorimotor interventions may improve oral feeding skills in preterm infants.
  
  
  OBJECTIVE
  To further explore the effects of an oral (O), tactile/kinesthetic (T/K), and combined (O+T/K) sensorimotor intervention on preterm infants' nutritive sucking, swallowing and their coordination with respiration.
  
  
  METHODS
  Seventy-five infants (29 [0.3, standard error of mean, SEM] weeks gestation, 49 males/26 females) were randomly assigned to an O group involving sensorimotor input to the oral structures; a T/K group involving sensorimotor input to the trunk and limbs; a combined (O+T/K) group; and a control group.
  
  
  METHODS
  Stage of sucking, suction and expression amplitudes (mmHg), suck-swallow ratio, stability of suck-swallow interval, and swallow-respiration patterns.
  
  
  RESULTS
  The O group had significantly more advanced sucking stages, and greater suction and expression amplitudes than controls [p≤0.035, effect size (ES) >0.6]. The suck-swallow ratio and stability of suck-swallow intervals did not significantly differ among groups (p≥0.181, ES≤0.3). The three interventions led to fewer swallows bracketed by prolonged respiratory pauses compared to controls (pause-swallow-pause, p≤0.044, ES≥0.7). The T/K and combined (O+T/K) groups had greater occurrence of swallows bracketed by expiration than the control and O groups (expiration-swallow-expiration, p≤0.039, ES≥0.3).
  
  
  CONCLUSIONS
  The O intervention enhanced specific components of nutritive sucking. All three interventions resulted in improved swallow-respiration coordination. Sensorimotor interventions have distributed beneficial effects that go beyond the specific target of input.
authors.affiliation: School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada. sandra.fucile@mail.mcgill.ca
authors.forename: Sandra
authors.initials: S
authors.lastname: Fucile
authors.forename: David H
authors.initials: DH
authors.lastname: McFarland
authors.forename: Erika G
authors.initials: EG
authors.lastname: Gisel
authors.forename: Chantal
authors.initials: C
authors.lastname: Lau
mesh_terms: D001903:Bottle Feeding; D002675:Child, Preschool; D003679:Deglutition / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology* / Q000523:psychology; D008297:Male; D008405:Massage / Q000379:methods*; D009055:Mouth; D010812:Physical Stimulation; D011446:Prospective Studies; D011597:Psychomotor Performance; D012119:Respiration; D013391:Sucking Behavior / Q000502:physiology*