Feasibility of a Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (Dance PREEMIE)
Introduction
Children born extremely preterm (EP: <28 weeks gestation) and/or extremely low birthweight (ELBW: <1000 g birthweight) are at greater risk of motor impairment, including cerebral palsy (CP) [1] and non-CP motor impairment [2], than children born at term. Children with motor impairment engage in lower levels of physical activity (PA) and have lower self-efficacy for participating in PA [3]. Furthermore, preschool age children born EP/ELBW, including children with and without motor impairment, have lower PA levels than children born at term [4,5]. This is of concern, as participation in PA may provide opportunity to learn and improve motor skills, develop social and cognitive skills, and improve physical fitness [6].
Participation is a complex construct. Defined by Imms et al. as ‘involvement in a life situation’ [7], it concerns an individual's attendance and involvement in activities that are socially or culturally meaningful [8], which can include participation in sports teams, exercise classes, or playing at the park with family and friends. While participation can include a variety of meaningful activities, this paper focuses specifically on participation in PA. Interventions aiming to improve participation for children with motor impairment are considered a priority [9] and need to directly target the element of participation, as there is little evidence to suggest that improvement in motor skills leads to improved participation [10]. Although there is a growing body of literature exploring interventions aiming to promote PA participation for individuals with motor impairment, [[11], [12], [13], [14], [15]] there is little evidence to support PA participation interventions for children at preschool age or specifically for children born EP/ELBW [16].
Dance is a commonly available PA for preschool age children. It is repetitive and progressive, and has been found to facilitate motor learning and mastery of motor skills for children with disabilities [[17], [18], [19]]. Furthermore, preschool dance classes are non-competitive and aim to be engaging and enjoyable, and are therefore likely salient, for children. Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age (Dance PREEMIE) is an intervention aiming to promote PA participation [20]. As this is a novel intervention design, a feasibility study is prudent before progressing to a larger efficacy trial [21]. This study therefore aims to evaluate the feasibility of Dance PREEMIE in the setting of metropolitan Melbourne, Australia.
Section snippets
Study design
A case series design was used to assess the feasibility of Dance PREEMIE (Trial registration number: ACTRN12619001266156) [20]. Ethical approval was obtained from the Royal Children's Hospital and Royal Women's Hospital Human Research and Ethics Committees.
Intervention description
The protocol for Dance PREEMIE is published [20]. In summary, Dance PREEMIE aimed to promote PA participation for preschool age children born EP/ELBW with motor impairment through facilitating participation in community dance classes; thereby
Recruitment and participant characteristics (Table 1 and Fig. 2)
Ten children were recruited into Dance PREEMIE; nine children were EP and ELBW, while one child was only ELBW. Medical approval was required for one child. The recruitment strategy was effective at identifying children at risk of motor impairment; seven children scored ≤16th percentile on the MABC-2, while three children did not complete the assessment for behavioural reasons, of which one child had a diagnosis of developmental delay. Dance teachers were recruited for all participating
Discussion
This study explored the feasibility of a novel community-based participation intervention for children with motor impairment; Dance PREEMIE. The findings of this study indicate that it is feasible to recruit and involve both dance teachers and preschool age children in an 8-week community-based dance intervention, with positive goal-based outcomes for participating children. The opportunity to participate in a dance intervention appeared attractive to families; most families offered information
Funding statement
This work is supported by grants from the Physiotherapy Research Foundation, Australia (Project grant S18-021), the National Health and Medical Research Council of Australia (Centre of Research Excellence #1060733 and #1153176; Career Development Fellowship #1159533 to AJS), the Medical Research Future Fund of Australia (Career Development Fellowship to JLYC #1141354) and the Victorian Government's Operational Infrastructure Support Program. KLC's PhD candidature is supported by The Australian
CRediT authorship contribution statement
Kate Cameron conceptualised, designed and coordinated the study, analysed the data, drafted the initial manuscript, and reviewed and revised the manuscript. Prof Alicia Spittle, Prof Jeanie Cheong, Prof Jennifer McGinley, Dr. Kim Allison and Dr. Natalie Fini conceptualised and designed the study, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Declaration of competing interest
The authors report no conflict of interest.
Acknowledgements
Thank you to the Dance PREEMIE families and dance teachers for your enthusiastic participation. Thank you to the Victorian Infant Collaborative Study team, research nurses Merilyn Bear, Emma McInnes and Marion McDonald, and to the physiotherapists who completed the assessments; Dr. Tara FitzGerald, Dr. Amanda Kwong and Dr. Rachel Kennedy.
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