Abstract
Studies have previously demonstrated that brief (4 weeks) passive range-of-motion exercise is beneficial for bone development in very low birth weight (VLBW) preterm infants. However, the optimal duration of exercise for bone development in preterm infants is yet unknown. The aim of the present study was to examine the effect of 8 weeks of assisted exercise on bone strength and metabolism in VLBW premature infants. Sixteen infants (mean ± standard error of the mean birth weight 1,009 ± 55 g and gestational age 27.3 ± 0.3 weeks) were randomly assigned into exercise (n = 8) and control (n = 8) groups. The intervention started at the first week of life and involved 8 weeks of daily passive extension and flexion range-of-motion exercise of the upper and lower extremities. Biochemical markers of bone turnover were measured at enrollment and after 8 weeks. Bone strength was measured weekly by quantitative ultrasound measurement of tibial bone speed of sound (SOS). Bone SOS decreased significantly in the control group (−108.1 ± 33.7 m/second, P < 0.0001) during the study period, while remaining stable in the exercise group (11.3 ± 22.8 m/second). The main beneficial effect of exercise occurred in the first 4 weeks of the intervention. There were no significant differences in the bone turnover marker changes between the groups. There is a significant postnatal decrease in bone SOS in VLBW preterm infants. Eight weeks of assisted range-of-motion exercise attenuates the decrease in bone strength and may decrease the risk of osteopenia in premature infants.
Similar content being viewed by others
References
Forbes GB, (1976) Calcium accumulation by the human fetus. Pediatrics 57:976–977
Ziegler EE, O’Donnell AM, Nelson SE, Fomon SJ (1976) Body composition of the reference fetus. Growth 40:329–341
Kulkarni PB, Hall RT, Rhodes PG, Sheehan MB, Callenbach JC, Germann DR, Abramson SJ (1980) Rickets in very low-birth-weight infants. J Pediatr 96:249–252
James JR, Condon PJ, Truscott J, Horsman A, Arthur R (1986) Osteopenia of prematurity. Arch Dis Child 61:871–876
Eliakim A, Dolfin T, Weiss E, Shainkin-Kestenbaum R, Lis M, Nemet D (2002) The effects of exercise on body weight and circulating leptin in premature infants. J Perinatol 22:550–554
Nemet D, Dolfin T, Litmanovitz I, Shainkin-Kestenbaum R, Lis M, Eliakim A (2002) Evidence for exercise-induced bone formation in premature infants. Int J Sports Med 23:82–85
Moyer-Mileur L, 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
Moyer-Mileur L, Luetkemeler M, Boomer L, Chan GM (1995) Effect of physical activity on bone mineralization in premature infants. J Pediatr 127:620–625
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
Delmas PD (1995) Biochemical markers of bone turnover. Acta Orthop Scand 266(suppl):176–182
Kent NG (1997) Markers of bone turnover. J Int Fed Clin Chem 9:31–35
Tomlinson C, McDevitt H, Ahmed SF, White MP (2006) Longitudinal changes in bone health as assessed by the speed of sound in very low birth weight preterm infants. J Pediatr 148:450–455
Miller ME (2003) The bone disease of preterm birth: a biomechanical perspective. Pediatr Res 53:10–15
Littner Y, Mandel D, Mimouni FB, Dollberg S (2003) Bone ultrasound velocity curves of newly born term and preterm infants. J Pediatr Endocrinol Metab 16:43–72
Nemet D, Dolfin T, Wolach B, Eliakim A (2001) Quantitative ultrasound measurements of bone speed of sound in premature infants. Eur J Pediatr 160:737–740
Foldes AJ, Rimon A, Keinan DD, Popovtzer MM (1995) Quantitative ultrasound of the tibia: a novel approach for assessment of bone status. Bone 17:363–367
Prevrhal S, Fuerst T, Fan B, Njeh C, Hans D, Uffmann M, Srivastav S, Genant HK (2001) Quantitative ultrasound of the tibia depends on both cortical density and thickness. Osteoporos Int 12:28–34
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
Shiff Y, Eliakim A, Sheinkin-Kestenbaum R, Arnon S, Lis M, Dolfin T (2001) Measurements of bone turnover markers in premature infants. J Pediatr Endocrinol Metab 14:389–395
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Litmanovitz, I., Dolfin, T., Arnon, S. et al. Assisted Exercise and Bone Strength in Preterm Infants. Calcif Tissue Int 80, 39–43 (2007). https://doi.org/10.1007/s00223-006-0149-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00223-006-0149-5