A Cochrane review [Abstract] 1 included 11 studies with a total of 324 preterm infants (gestational age 26 to 34 weeks).
Four trials demonstrated moderate short-term benefits of physical activity on bone mineralization at completion of the physical activity program; data was not pooled for meta-analyses due to methodological differences. The only trial assessing long-term effects on bone mineralization showed no effect of physical activity administered during initial hospitalization on bone mineralization at 12 months corrected age. Meta-analysis from four trials demonstrated a positive effect of physical activity on daily weight gain (WMD 2.21 g/kg/d, 95% CI 1.23, 3.19). Data from four trials showed a positive effect on linear growth (WMD 0.12 cm/week, 95% CI 0.01 to 0.24) but not on head growth (WMD -0.03 cm/week, 95% CI -0.14 to 0.08) during the study period. The I2 statistic suggested heterogeneity on the analysis of linear growth (p < 0.001, I2 = 92%). None of the trials assessed fractures or other outcomes relevant to this review.
Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment) and by imprecise results (few patients and wide confidence intervals).
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