Skip to main content

Daily physical activity in low-risk extremely low birth weight preterm infants: positive impact on bone mineral density and anthropometric measurements

Abstract

The aim of this study was to evaluate the changes in bone mineral density and anthropometric indices of extremely low birth weight (ELBW) preterm infants undergoing daily physical activity. Twenty-eight low-risk ELBW preterm infants (intervention group = 14, control group = 14) with a birth weight of under 1000 g and gestational age of 26–32 weeks were recruited. Preterm infants in the control group were provided with standard nursing care, whereas those in the intervention group received a daily physical activity programme in addition to standard nursing care during the study. Before and after the study, anthropometric indices and tibial speed of sound (SOS) values were measured. In this study, the tibial SOS values were found to be increased in the intervention group (+111.14 m/s) (p = 0.001) and decreased in the control group (−58.21 m/s) (p = 0.030). The increase in percentage of body weight, height, and tibial length of infants in the intervention group was significantly higher than in the control group (respectively; p = 0.002, p = 0,015, p < 0.001). A daily physical activity programme increased body weight, height, tibial length, and SOS values of the tibia in ELBW preterm infants.

This is a preview of subscription content, access via your institution.

References

  1. Wen SW, Smith G, Yang Q, Walker M (2004) Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med 9:429–435

    Article  PubMed  Google Scholar 

  2. Fanaroff AA (2002) Neonatal mortality and morbidity. In: Rudolph CD, Rudolph AM, Hostetter MK, Lister G, Siegel NJ (eds) Rudolph’s pediatrics. The McGraw-Hill Companies, USA, pp 56–61

    Google Scholar 

  3. Schmücker G, Brisch KH, Köhntop B, Betzler S, Österle M, Pohlandt F, Pokorny D, Laucht M, Kächele H, Buchheim A (2005) The influence of prematurity, maternal anxiety, and infants’ neurobiological risk on mother–infant interactions. Infant Ment Health J 26:423–441

    Article  Google Scholar 

  4. Ward RM, Beachy JC (2003) Neonatal complications following preterm birth. BJOG 110:8–16

    Article  PubMed  Google Scholar 

  5. Wilson-Costello D, Friedman H, Minich N, Siner B, Taylor G, Schluchter M, Hack M (2007) Improved neurodevelopmental outcomes for extremely low birth weight infants in 2000–2002. Pediatrics 119:37–45

    Article  PubMed  Google Scholar 

  6. Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark A, Bauer CR, Donovan EF, Korones SB, Laptook AR, Lemons JA, Oh W, Papile LA, Shankaran S, Stevenson DK, Tyson JE, Poole WK (2007) Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 196:141–148

    Article  Google Scholar 

  7. Lorenz JM, Wooliever DE, Jetton JR, Paneth N (1998) A quantitative review of mortality and developmental disability in extremely premature newborns. Arch Pediatr Adolesc Med 152:425–435

    Article  CAS  PubMed  Google Scholar 

  8. Blaymore-Bier J, Pezzullo J, Kim E, Oh W, Garcia-Coll C, Vohr BR (1994) Outcome of extremely low-birth-weight infants: 1980–1990. Acta Paediatr 83:1244–1248

    Article  CAS  PubMed  Google Scholar 

  9. Aly H, Moustafa MF, Hassanein SM, Massaro AN, Amer HA, Patel K (2004) Physical activity combined with massage improves bone mineralization in premature infants: a randomized trial. J Perinatol 24:305–309

    Article  PubMed  Google Scholar 

  10. Mitchell SM, Rogers SP, Hicks PD, Hawthorne KM, Parker, Abrams SA (2009) High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support. BMC Pediatr 9:1–7

    Article  Google Scholar 

  11. Eliakim A, Nemet D (2005) Osteopenia of prematurity––the role of exercise in prevention and treatment. Pediatr Endocrinol Rev 2:675–682

    PubMed  Google Scholar 

  12. Moyer-Mileur LJ, Brunstetter V, McNaught TP, Gill G, Chan GM (2000) Daily physical activity program increases bone mineralization and growth in preterm very low birth weight infants. Pediatrics 106:1088–1092

    Article  CAS  PubMed  Google Scholar 

  13. Chen HL, Lee CL, Tseng HI, Yang SN, Yang RC, Jao HC (2010) Assisted exercise improves bone strength in very low birth weight infants by bone quantitative ultrasound. J Paediatr Child Health 46:653–659

    Article  PubMed  Google Scholar 

  14. Horsman A, Ryan SW, Congdon PJ, Truscott JG, James JR (1989) Osteopenia in extremely low birthweight infants. Arch Dis Child 64:485–488

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Mori R, Yamakura S, Tanaka H, Tamai H, Funato M, Seino Y (1998) Bone status assessment in preterm and term infants by dual-energy X-ray absorptiometry. J Bone Miner Metab 16:100–105

    Article  Google Scholar 

  16. Nemet D, Dolfin T, Wolach B, Eliakim A (2001) Quantitative ultrasound measurements of bone speed of sound in premature infants. Eur J Pediatr 160:736–740

    Article  CAS  PubMed  Google Scholar 

  17. Lam HS, So KW, Ng PC (2007) Osteopenia in neonates: a review. J Paediatr 12:118–124

    Google Scholar 

  18. Smurthwaite D, Wright NB, Russell S, Emmerson AJ, Mughal MZ (2009) How common are rib fractures in exremely low birth weight preterm infants? Arch Dis Child Fetal Neonatal Ed 94:F138–F139

    Article  CAS  PubMed  Google Scholar 

  19. Moyer-Mileur L, Luetkemeier M, Boomer L, Chan GM (1995) Effect of physical activity on bone mineralization in premature infants. J Pediatr 127:620–625

    Article  CAS  PubMed  Google Scholar 

  20. Specker BL, Beck A, Kalkwarf H, Ho M (1997) Randomized trial of varying mineral intake on total body bone mineral accretion during the first year of life. Pediatrics 99:1–7

    Article  Google Scholar 

  21. Wauben IP, Atkinson SA, Grad TL, Shah JK, Paes B (1998) Moderate nutrient supplementation of mother’s milk for preterm infants supports adequate bone mass and short-term growth: a randomized controlled trial. Am J Clin Nutr 67:465–472

    CAS  PubMed  Google Scholar 

  22. Bozzetti V, Tagliabue P (2009) Metabolic bone disease in preterm newborn: an update on nutritional issues. Ital J Pediatr 35:1–8

    Article  Google Scholar 

  23. Trotter A, Bokelmann B, Sorgo W, Bechinger-Kornhuber D, Heinemann H, Schmücker G, Oesterle M, Köhntop B, Brisch KH, Pohlandt F (2001) Follow-up examination at the age of 15 months of extremely preterm infants after postnatal estradiol and progesterone replacement. J Clin Endocrinol Met 86:601–603

    Article  CAS  Google Scholar 

  24. Trotter A, Maier L, Pohlandt F (2001) Management of the extremely preterm infant: is the replacement of estradiol and progesterone beneficial? Pediatr Drugs 3:629–637

    Article  CAS  Google Scholar 

  25. Litmanovitz I, Dolfin T, Friedland O, Arnon S, Regev R, Shainkin-Kestenbaum R, Lis M, Eliakim A (2003) Early physical activity intervention prevents decrease of bone strength in very low birth weight infants. Pediatrics 112:15–19

    Article  PubMed  Google Scholar 

  26. Litmanovitz I, Dolfin T, Arnon S, Regev RH, Nemet D, Eliakim A (2007) Assisted exercise and bone strength in preterm infants. Calcif Tissue Int 80:39–43

    Article  CAS  PubMed  Google Scholar 

  27. Tosun Ö, Bayat M, Güneş T, Erdem E (2011) Daily physical activity in low-risk pre-term infants: positive impact on bone strength and mid-upper arm circumference. Ann Hum Biol 38:635–639

    Article  PubMed  Google Scholar 

  28. Baptista F, Barrigas C, Vieira F, Santa-Clara H, Homens PM, Fragoso I, Teixeira PJ, Sardinha LB (2012) The role of lean body mass and physical activity in bone health in children. J Bone Miner Metab 30:100–108

    Article  PubMed  Google Scholar 

  29. Johnson TS, Engstrom JL (2002) State of the science in measurement of infants size at birth. Newborn Infant Nurs Rev 2:150–158

    Article  Google Scholar 

  30. Sunlight Omnisense PremierTM Users’s Guide. Sunlight Medical Ltd, Tel Aviv, Israel

  31. Gursoy T, Yurdakok M, Hayran M, Korkmaz A, Yigit S, Tekinalp G (2008) Bone speed of sound curves of twin and singleton neonates. J Pediatr Endocrinol Metab 21:1065–1071

    Article  PubMed  Google Scholar 

  32. Rubin LP (2012) Disorders of calcium and phosphorus metabolism. In: Gleason CA, Devaskar SU (eds) Avery’s diseases of the newborn, 9th edn. Saunders, Philadelphia, pp 1346–1365

    Google Scholar 

  33. Sharp M (2007) Bone disease of prematurity. Early Hum Dev 83:653–658

    Article  CAS  PubMed  Google Scholar 

  34. So KW, Ng PC (2005) Treatment and prevention of neonatal osteopenia. Curr Paediatr 15:106–113

    Article  Google Scholar 

  35. Rigo J, Curtis M (2006) Disorders of calcium, phosphorus, and magnesium metabolism. In: Martin RJ, Fanaroff AA, Walsh MC (eds) Fanaroff and Martin’s neonatal perinatal medicine, 8th edn. Mosby Elsevier, Philadelphia, pp 1491–1523

    Google Scholar 

  36. Vignochi CM, Miura E, Canani LH (2008) Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study. J Perinatol 28:624–631

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Assoc. Prof. Ahmet Ozturk and Assist. Prof. Ferhan Elmali (Erciyes University, School of Medicine, Department of Biostatistics) for statistical analyses.

Conflict of interest

All authors have no conflicts of interest

Author information

Affiliations

Authors

Corresponding author

Correspondence to Emine Erdem.

About this article

Verify currency and authenticity via CrossMark

Cite this article

Erdem, E., Tosun, Ö., Bayat, M. et al. Daily physical activity in low-risk extremely low birth weight preterm infants: positive impact on bone mineral density and anthropometric measurements. J Bone Miner Metab 33, 329–334 (2015). https://doi.org/10.1007/s00774-014-0594-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00774-014-0594-6

Keywords

  • Anthropometry
  • Bone mineral density
  • Physical activity
  • Preterm infants
  • Quantitative ultrasound