Assisted Physical Exercise for Preterm Neonates.

Metabolic bone disease (MBD) of prematurity, also known as osteopenia/ rickets of prematurity, is a major comorbidity in preterm, very low birth weight (VLBW) and chronically ill infants leading to deformities and even spontaneous fractures, if left untreated [1-3]. It is defined as reduced bone mineralization when compared to predicted level of bone mineral content of a fetus or neonate of similar gestational age or size along with biochemical markers and/or radiological findings [1]. The reported incidence varies from 16% in VLBW to 40% in extremely low birth weight (ELBW) neonates [2,3]. The key etiological factors remain inadequate calcium and phosphorous stores in the face of accelerated skeletal growth. Also, use of medications (steroids, caffeine), prolonged parenteral nutrition and immobilization in premature infants has shown to aggravate MBD [4,5]. MBD characteristically presents within 6-16 weeks after birth. Increased physical activity in preterm infants has shown to enhance bone mineralization along with better weight gain [4,6].