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Improving the quality of life for preterm children is a global health priority, given their vulnerability to neurocognitive impairments and adverse health consequences. Lack of posthospital care further exacerbates these risks, necessitating effective interventions during the neonatal period. This protocol for a pilot study aims to investigate the effects of touch interventions, including physiotherapy and osteopathic manipulative treatment, on brain activity in moderately preterm infants using brain functional MRI (fMRI), computerised EEG and metabolomics.
A 3-arm randomised sham-controlled trial will be conducted with 15 infants per experimental group. The study will include stable preterm infants born between 32.0 and 33.6 weeks of gestational age who do not require any intensive care treatments.
The study aims to assess the impact of touch interventions on brain activity and metabolic sequelae. Using fMRI will primarily examine the pre-post changes between groups in blood oxygenation level dependent levels among different brain areas, specifically the anterior insula and the medial prefrontal cortex. Secondarily, we will explore the preterm brain’s neural effects on EEG slow delta wave band. Metabolomics will provide data on the effects among the three groups on metabolic changes associated with touch interventions.
Ethical approval has been obtained from the Ethics Committee of the local health agency in Milan (CET 449-2024). Understanding the effects of touch interventions on brain activity in moderately preterm infants, without needs of intensive care, can contribute to improving their clinical outcomes and promoting their growth, development and social behaviour. Findings from this pilot study will pave the way for future research, enabling the development of evidence-based interventions to enhance preterm infants’ well-being and long-term outcomes.
Stroke represents the second leading cause of death worldwide after cardiovascular disease and the first cause of disability in adults. Only 25% of stroke survivors fully recover, 75% survive with some form of disability, and half of them lose self-sufficiency, negatively impacting their quality of life. This study aims to understand the experiences of stroke survivors and caregivers of training needs and support during the transitional care phase from hospital to home; it also investigates the experience of health care professionals (HCPs) of providing support and training to the dyad during this phase.
Meta-synthesis was conducted following a critical-interpretative approach. The SPIDER method was used for sample selection, and the PRISMA research question was adopted for article selection. The search for studies on CINAHL, Pubmed, Scopus, ERIC, PsycInfo and OVID was conducted until August 2024.
Of the 1123 articles found, 32 met the inclusion criteria and were included in the meta-synthesis. Text analysis revealed two main thematic areas: (1) the training need is a new awareness in the transition of care from hospital to home and (2) moulding oneself to new life. The first theme had six subthemes: need for information and training, uncertainty, involvement, evaluation of training needs, individual discharge planning and physical-psychological problems. The second theme included three subthemes: different role perception, support after discharge and adaptation to change.
Knowing the training and support needs in the stroke survivor caregiver dyad guides HCPs to structure tailored discharge plans. Multi-method and multidisciplinary training and support interventions such as health coaching, weekend passes and early supported discharge are satisfactory outcomes for the triad involved in the transition of care, as continuous feedback on the needs of the new reality at home fortifies the relationship between the dyad and HCPs. A transitional care pathway based on the dynamic needs of the triad can improve the quality of care in the community.
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