Date of Award

2013

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not neonatal massage leads to reduced stress behavior in medically stable preterm infants in the NICU.

STUDY DESIGN: Review of three English language primary studies published in 1996, 2005 and 2007.

DATA SOURCES: Three randomized control trials comparing stress behavior in preterm infants receiving massage to a control group that did not receive massage were found using PubMed and Medline databases.

OUTCOMES MEASURED: Researcher recorded stress behavior as behavioral distress activity and motor activity via direct observations and a time sampling method. Motor activities were coded as single limb, multiple limbs, gross body movements, head turns, and startles. Behavioral distress activity included mouthing/ yawning movements, facial grimaces, and clenched fists.

RESULTS: All three studies showed some statically significant data between experimental and control groups. Hernandez-Reif et al showed statistically significant decrease in both motor activity and behavioral distress in the experimental group. Lee et al showed inconclusive evidence with no
statistical difference between control and experimental groups for behavioral distress, and a significant increase in motor activity. Harrison et al was also inconclusive showing no significant difference in motor activity or behavioral distress between the first and last day of intervention, but did show a statically significant decrease in both motor activity and behavioral distress during the massage as compared to baseline or post-massage.

CONCLUSIONS: Although additional studies on larger samples and over extended periods of time are necessary, the findings of these three RCTs were inconclusive but suggest that there may be some benefit, but no harm in neonatal massage. All three studies showed some statically significant data between experimental and control groups which supports the hypothesis that
neonatal massage reduced stress behavior in preterm infants in the NICU.

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