Neuromotor Development and the Physiological Effects of Positioning in Very Low Birthweight Infants
Computing, Health and Science
Nursing and Public Health
Objective - To provide a comprehensive literature review of neuromotor development and related physiologic effects of positioning in very low birth weight infants. Data Sources - MEDLINE, CINHAL, Health Star, Current Contents, and the Australian Medical Index (1966–2000) databases were searched. Unpublished studies (e.g., dissertations, conference proceedings) and all relevant references listed in articles also were examined. Study Selection - One hundred and eighty theoretical writings, research studies, and clinical papers related to neuromotor development, the physiologic effects of positioning, and interventions to minimize or prevent short- and long-term effects of positioning in very low birth weight infants were reviewed. Data Extraction - Studies were assessed for scientific rigor, evidence of theoretical foundation, and clinical relevance. Comparisons were made across data sources to determine the most reliable, valid, and consistent findings. Data Synthesis - Three compelling results emerged: (a) The development of posture and mobility in newborn infants requires an optimal balance between active and passive muscle tone, (b) the prone position is physiologically more beneficial for the preterm infant than supine and lateral positions, and (c) the prone position can lead to short- and long-term postural and associated developmental problems. Conclusion - Use of empirically tested postural interventions appropriate for an infant's gestational age, health status, and overall organizational capacity is recommended.