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Research Article  |   May 2003
Comparison of Motor Self-Regulatory and Stress Behaviors of Preterm Infants Across Body Positions
Author Affiliations
  • Isabelle Roy Grenier, MS, OTR/L, is Staff Therapist, Easter Seals of New Hampshire, Manchester, New Hampshire. At the time of this study, she was Degree Candidate, Advanced Master's Degree Program, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts. Mailing address: 132 Winter Hill Road, Goffstown, New Hampshire, 03045; iroyOT@aol.com
  • Rosemarie Bigsby, ScD, BCP, OTR/L, FAOTA, is Clinical Assistant Professor, Department of Pediatrics, Brown Medical School, and Coordinator of NICU Services, Infant Development Center, Women and Infants Hospital, Providence, Rhode Island
  • Elsie R. Vergara, ScD, OTR, FAOTA, is Associate Professor, Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts
  • Barry M. Lester, PhD, is Professor, Department of Psychiatry and Department of Pediatrics, Brown Medical School, and Director, Infant Development Center, Women and Infants Hospital and Bradley Hospital, Providence, Rhode Island
Article Information
Pediatric Evaluation and Intervention / Infant and Childhood Occupation
Research Article   |   May 2003
Comparison of Motor Self-Regulatory and Stress Behaviors of Preterm Infants Across Body Positions
American Journal of Occupational Therapy, May/June 2003, Vol. 57, 289-297. doi:10.5014/ajot.57.3.289
American Journal of Occupational Therapy, May/June 2003, Vol. 57, 289-297. doi:10.5014/ajot.57.3.289
Abstract

Occupational therapists working with infants in neonatal intensive care units (NICUs) make positioning recommendations to optimize self-regulation, with little published data supporting this practice. In this retrospective descriptive study, 15 hospitalized preterm infants (Mgestational age = 32 weeks) were videotaped during noncaregiving periods in order to record the frequency of specific behaviors in relation to six infant positions (prone nested, prone un-nested, side-lying nested, side-lying un-nested, supine nested, and supine un-nested). Behaviors coded were those that suggest infant stress or motor efforts at self-regulation, as defined for the original study. Mixed effects regressions and post-hoc Tukey Honestly Significant Difference tests were used to analyze the data, after the calculation of a ratio of the number of behaviors in each position. Higher ratio values reflect a greater occurrence of behaviors.

The number of motor self-regulatory and stress behaviors were related to infant position, with the highest ratios of behaviors observed in side-lying un-nested and the lowest in prone nested. Behavior ratios did not differ between prone un-nested and prone nested, nor between supine un-nested and supine nested. More self-regulatory and stress behaviors were related to longer periods of fussing and crying. Longer periods of light sleep were related to fewer stress behaviors.

Infants performed the fewest stress behaviors in prone nested, prone un-nested, or side-lying nested. These positions may benefit infants in the NICU by reducing the need for motor-based self-regulatory behaviors and potentially conserving energy for growth.