THE EFFECT OF TACTILE-KINESTHETIC STIMULATION ON WEIGHT AND LENGTH OF HOSPITAL STAYS IN PRETERM NEONATES: A RANDOMIZED CLINICAL TRIAL

Abstract

Background: Preterm birth is a major cause of neonatal mortality and long-term neurodevelopmental impairment, while the stressful NICU environment negatively affects preterm neonates' growth, weight gain, and length of hospital stay (LOS). Although Tactile-Kinesthetic Stimulation (TKS) is an evidence-based, non-pharmacological intervention that may reduce these adverse effects, further high-quality evidence is needed to establish its effectiveness in improving growth and clinical outcomes among preterm neonates.

Purpose: This study evaluated the clinical efficacy of the TKS protocol on weight trajectories and the LOS among preterm neonates.

Design and Method: A parallel-group, randomized clinical trial design was utilized at the NICU of King Abdullah University Hospital in northern Jordan. A total of 69 stable preterm neonates (gestational age 34–37 weeks, birth weight 1500–2500 grams) were randomized to either the TKS group (n = 34) or the control group (n = 35). The study group received routine NICU care combined with a standardized 15-minute, skin-to-skin TKS protocol administered twice daily for 5 consecutive days, consisting of prone tactile stroking and supine passive range-of-motion exercises. The control group received only routine nursing care. Primary outcomes included daily weight, discharge weight, and LOS. Data analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.0.

Result: Independent samples t-tests revealed no statistically significant differences in raw mean absolute weights between the TKS and control groups at baseline (1986 ± 220 grams vs1972 ± 257 grams), post-intervention day five (2061 ± 224 grams vs 1983 ± 258 grams), or medical discharge (2117 ± 217 grams vs 2120 ± 223 grams). Daily weight velocity also lacked significant variations (9.46 ± 5.17 grams/day for the TKS group vs10.88 ± 24.9 grams/day for the control group, p = 0.219). Interestingly, the percentage of weight gain from day 5 to discharge was significantly higher in the control group than in the TKS group (5.5% ± 4.1% vs 2.31% ± 0.71%, p = 0.031). Preterm neonates in the TKS group experienced an average hospitalization duration of 14 ± 3 days compared to 12 ± 3 days in the control group, which was not statistically significant (p = 0.143). Linear regression modelling confirmed that TKS exposure did not serve as a statistically meaningful independent predictor of absolute discharge weight or length of hospital stay.

Conclusion: Although the TKS protocol did not achieve a statistically significant independent reduction in absolute discharge weights or hospital length of stay within this specific sample, it established positive directional trends in neonatal weight trajectories.

Practical Implication: TKS is a safe, non-invasive, and cost-effective intervention that can be integrated into routine neonatal nursing care to support early physiological stability in preterm neonates. Future large-scale, multicenter RCTs with long-term follow-up are needed to confirm its effectiveness and determine the optimal intervention dosage.