# NEO rehab program for premature infants at risk for cerebral palsy

> **NIH NIH R03** · UNIVERSITY OF VIRGINIA · 2020 · $161,500

## Abstract

Abstract
Cerebral Palsy (CP) is the most common motor disability in children born preterm. CP can cause profound
disability, lifelong need for extensive care and result in significant economic burden. Ideally infants at risk for
CP should be identified while still in the neonatal intensive care unit (NICU), at a stage of rapid brain
development where intervention may have an impact on synaptic pruning and brain rewiring. The general
movement assessment (GMA) tool has been shown to reliably identify infants at high risk for CP and can be
implemented shortly after birth making it an ideal screening tool for preterm infants. This tool provides a unique
opportunity to greatly decrease the age of CP diagnosis, an essential step for the implementation of earlier,
potentially course-modifying interventions. Previous studies indicate that intervention focusing on
environmental enrichment, emotional connection between mother and infant can positively impact the
neurodevelopmental outcomes of infants born preterm. However, whether this type of interventions can
improve the motor outcomes of infants at risk for CP remains unknown. To address this gap in knowledge, we
have developed a NICU-based multimodal rehabilitation program (NEO rehab) to support neuromuscular
development in preterm infants at high risk for CP (as determined by the GMA). This multimodal program, is
composed of 6 evidence-based interventions (vocal soothing, scent exchange, comforting touch, kangaroo
care, infant massage and physical therapy) administered in a GA appropriate fashion by a parent. We
hypothesize that this innovative NEO rehab program will positively impact short-term motor outcomes in
preterm infants at risk for CP. At risk infants (≤32 week’s gestation and/or ≤1500 grams birthweight) will be
eligible for a pilot randomized controlled trial (RCT) comparing the effects of the NEO rehab program versus
usual care on short term motor outcomes (general movements (GMs), cranial nerves, posture, movements,
tone, and reflexes). The effects of the NEO rehab program the primary outcome will be measured using the
GMA, the Test of Infant Motor Performance (TIMP) and the Hammersmith Infant Neurological Examination
(HINE) instruments at NICU discharge and at 3 months corrected GA. In addition, the acceptability, feasibility
and fidelity of the Neo Rehab program will be determined by performing direct observation, weekly interviews
and activity log reviews. This study addresses one of the priorities of the National Center for Medical
Rehabilitation Research to explore “multimodal rehabilitation approaches that promote plasticity and
sensorimotor function”. Results from this study will provide the preliminary evidence necessary to design and
implement a large, multi-center RCT to test the efficacy of NICU-based rehabilitation programs to improve the
motor outcomes of infants born preterm.

## Key facts

- **NIH application ID:** 9906927
- **Project number:** 5R03HD097727-02
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Lisa Letzkus
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $161,500
- **Award type:** 5
- **Project period:** 2019-04-04 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9906927

## Citation

> US National Institutes of Health, RePORTER application 9906927, NEO rehab program for premature infants at risk for cerebral palsy (5R03HD097727-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9906927. Licensed CC0.

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