The Societal Importance of Embracing Counterintuitive Thought in Science: Assisted Exercise in Preterm Infants for Long-term Health Outcomes.

For research to lead to progressive change, scientists and society must embrace what may seem counterintuitive. While there is often resistance to changing views of what we presume to already understand, we must be open to evolving knowledge and evidence. Our research is examining the effect of a novel intervention designed to increase physical activity of premature babies in their first year of life on: (1) body composition, (2) associated biochemical and cellular mechanisms of growth and inflammation, and (3) quality of maternal care. This study is novel because it is counterintuitive to prevailing knowledge of the care and treatment of infants born prematurely. Traditionally, we swaddle infants and restrict their movement in order to minimize energy expenditure. We are proposing the opposite: to increase energy expenditure in a systematic, controlled way in order to increase muscle mass and bone density, with the ultimate goal of preventing diseases associated with lack of muscle mass or bone density. Our research actively engages the mothers in the study by learning about their perceptions and their experiences of doing the exercise with their infants because the mothers, too, are aware of the prevailing views that are counter to what they are being asked to do. The mothers have taught us, however, that they are willing to participate in this exercise study, while paradoxically also viewing their infants as "fragile" and are fearful of hurting their infants. Our thesis in this research-based paper is that science and society must work in tandem to be effective.

[1]  Neil Marlow,et al.  Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies) , 2012, BMJ : British Medical Journal.

[2]  Kimberley D. Lakes,et al.  Enhancing the Construct and Content Validity of Rating Scales for Clinical Research: Using Qualitative Methods to Develop a Rating Scale to Assess Parental Perceptions of Their Role in Promoting Infant Exercise. , 2012, The International journal of educational and psychological assessment.

[3]  Kimberley D. Lakes,et al.  Maternal perceptions of infant exercise in the neonatal intensive care unit. , 2009, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[4]  Anne Greenough,et al.  Long-Term Pulmonary Outcome in the Preterm Infant , 2008, Neonatology.

[5]  P. Casey Growth of low birth weight preterm children. , 2008, Seminars in Perinatology.

[6]  Frank R Greer,et al.  Long-term Adverse Outcomes of Low Birth Weight, Increased Somatic Growth Rates, and Alterations of Body Composition in the Premature Infant: Review of the Evidence , 2007, Journal of pediatric gastroenterology and nutrition.

[7]  Assuring Healthy Outcomes,et al.  Preterm Birth : Causes , Consequences , and Prevention , 2005 .

[8]  A. Singhal Early nutrition and long-term cardiovascular health. , 2006, Nutrition reviews.

[9]  D. Nemet,et al.  Osteopenia of prematurity - the role of exercise in prevention and treatment. , 2005, Pediatric endocrinology reviews : PER.

[10]  H. Hoffman,et al.  Infant sleep position and risk for sudden infant death syndrome: report of meeting held January 13 and 14, 1994, National Institutes of Health, Bethesda, MD. , 1994, Pediatrics.

[11]  V. Langer Minimal handling protocol for the intensive care nursery. , 1990, Neonatal network : NN.

[12]  J. Lucey,et al.  Excessive handling as a cause of hypoxemia. , 1980, Pediatrics.

[13]  J. Kitterman,et al.  Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. , 1971, The New England journal of medicine.

[14]  V. Harrison,et al.  The significance of grunting in hyaline membrane disease. , 1968, Pediatrics.

[15]  T. Kuhn,et al.  The Structure of Scientific Revolutions. , 1964 .

[16]  Bernard Shaw,et al.  The Doctor's Dilemma. , 2003, International journal of epidemiology.