A Meta-Analysis of PRETERM INFANT MASSAGE: An Ancient Practice With Contemporary Applications
A Meta-Analysis of PRETERM INFANT MASSAGE: An Ancient Practice With Contemporary Applications
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DOI：
10.1097/nmc.0000000000000177
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发表时间：
2015-11-01
影响因子：
2.4
通讯作者：
Kahale, Lara
中科院分区：
文献类型：
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作者：
Badr, Lina Kurdahi;Abdallah, Bahia;Kahale, Lara
目的：评估按摩对早产儿短期和长期预后的影响。方法：使用PRISMA框架进行检索。纳入研究的有效性进行了评估，使用由科克伦协作，独立进行了两个审查员与第三个审查员，以解决difficulties.Results标准：34项研究符合纳入标准，3个是准实验，1个是试点研究，其余30个随机对照试验（RCT）。可用于荟萃分析并在三项以上研究中发现的结果表明，按摩使每日体重增加0.53 g（95% CI = 0.28-0.78），p < 0.0001，并使心理评分显著改善7.89分（95% CI = 0.96-14.82），p < 0.03。对住院时间、热量摄入或出院时体重无显著影响。由于测量单位不同或作者未提供平均值和标准差，未对其他结局进行分析。这些包括迷走神经活动和心率变异性（5项研究）、神经行为状态（7项研究）、疼痛反应（2项研究）、母体结局（2项研究）、母乳喂养（2项研究）和生理参数：骨形成（2项研究）、免疫标志物（1项研究）、脑成熟度（1项研究）和体温（1项研究）。研究的质量是可变的随机化和盲法的评估不清楚的34项study.Conclusions中的18个方法：按摩治疗可以是一个舒适的措施，为婴儿在新生儿重症监护室，以改善体重增加，提高智力发育。然而，高异质性，一些研究的质量差，按摩和发育结果之间缺乏科学关联，排除了明确的建议，并强调需要进一步的RCT来促进现有的知识体系。
Objective:To evaluate the efficacy of massage on the short- and long-term outcomes of preterm infants.Methods:A search was conducted using the PRISMA framework. Validity of included studies was assessed using criteria defined by the Cochrane Collaboration that was carried out independently by two reviewers with a third reviewer to resolve differences.Results:Thirty-four studies met the inclusion criteria, 3 were quasi-experimental, 1 was a pilot study, and the remaining 30 were randomized controlled trials (RCTs). The outcomes that could be used in the meta-analysis and found in more than three studies noted that massage improved daily weight gain by 0.53 g (95% CI = 0.28-0.78), p < 0.0001, and resulted in a significant improvement in mental scores by 7.89 points (95% CI = 0.96-14.82), p < 0.03. There were no significant effects on length of hospital stay, caloric intake, or weight at discharge. Other outcomes were not analyzed either because the units of measurement varied or because means and standard deviations were not provided by the authors. These included vagal activity and heart rate variability (5 studies), neurobehavioral states (7 studies), pain responses (2 studies), maternal outcomes (2 studies), breastfeeding (2 studies), and physiologic parameters: bone formation (2 studies), immunologic markers (1 study), brain maturity (1 study), and temperature (1 study). The quality of the studies was variable with methods of randomization and blinding of assessment unclear in 18 of the 34 studies.Conclusions:Massage therapy could be a comforting measure for infants in the NICU to improve weight gain and enhance mental development. However, the high heterogeneity, the weak quality in some studies, and the lack of a scientific association between massage and developmental outcomes preclude making definite recommendations and highlight the need for further RCTs to contribute to the existing body of knowledge.