Effect of a Novel Postural Support Device Versus Conventional Swaddling on Postural Development in Preterm Neonates Over One Week: A Quasi-Experimental Trial.

BACKGROUND

Preterm neonates are at high risk of postural asymmetries and developmental delays due to the abrupt transition from the protected intrauterine environment to the gravity-dominated neonatal intensive care unit (NICU). Therapeutic positioning is crucial for supporting early musculoskeletal and neuromotor development.

OBJECTIVE

This study aimed to evaluate the effect of a novel postural support device, in combination with physiotherapy, on the postural development of preterm neonates in the NICU using the Infant Positioning Assessment Tool (IPAT).

METHODS

A quasi-experimental trial with alternate group assignment was conducted with 146 preterm neonates (73 intervention and 73 control) admitted to a tertiary hospital NICU. Both groups received physiotherapy, but the intervention group was positioned using the newly developed postural support device, while controls received conventional swaddling. Postural alignment across multiple body segments was assessed weekly using IPAT.

RESULTS

At baseline, no significant differences were observed between groups in demographic or clinical variables (p > 0.05). By the first week, the intervention group demonstrated significantly higher IPAT scores for shoulders (p < 0.001), hips/pelvis (p < 0.001), knees/ankles/feet (p < 0.001), and overall posture (p < 0.001) compared to controls. Improvements in head, neck, and hand positioning were also observed, with the intervention group showing early correction of baseline deficits.

CONCLUSION

The novel postural support device, when combined with physiotherapy, significantly enhanced postural symmetry and flexion in preterm neonates compared to conventional swaddling. These findings highlight the importance of structured, developmentally supportive positioning in optimizing early neuromotor outcomes for preterm infants in the NICU.