Physical activity programmes for promoting bone mineralisation and growth in preterm infants

Sirée Kaempfen; Chris Cooper; Sven Schulzke; supported by Cochrane Neonatal

doi:10.1002/14651858.cd005387.pub4

September 16, 2026Cochrane library

Physical activity programmes for promoting bone mineralisation and growth in preterm infants

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Key Points

To evaluate whether physical activity programmes improve bone mineralisation and growth and reduce the risk of fractures in preterm infants.
Searched CENTRAL, MEDLINE, Embase, and trial registries through October 2025 for randomised and quasi-randomised controlled trials.
Included 15 trials enrolling 434 preterm infants (gestational age 26 to 34 weeks) comparing daily range-of-motion exercises (extension and flexion) lasting 3.5 to 8 weeks against routine care or tactile stimulation.
Synthesised outcomes using fixed-effect meta-analysis with mean differences (MD), risk ratios (RR), and GRADE certainty assessments.
Physical activity may increase whole-body bone mineral density (MD 0.11, 95% CI 0.07 to 0.15; I² = 0%; 2 studies, 65 participants; low-certainty evidence) and daily body weight gain (MD 2.98 g/kg/day, 95% CI 2.31 to 3.65; I² = 83%; 14 studies, 418 participants; low-certainty evidence).
Evidence is very uncertain regarding whole-body bone mineral content increase (MD 5.58 g, 95% CI -0.88 to 12.04; I² = 95%; 2 studies, 65 participants) and fracture risk (RR 0.33, 95% CI 0.01 to 7.68; 3 studies, 102 participants; two studies with zero events in both arms).
Physical activity programmes may result in little to no difference in body length gain during the intervention period (MD 0.05 cm/week, 95% CI -0.02 to 0.13; I² = 66%; 11 studies, 355 participants; low-certainty evidence).

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Implication

Systematic review reveals physical activity may improve bone mineral density and weight gain in preterm infants, indicating potential benefits despite low-certainty evidence.

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Kaempfen et al. (2026) studied this question.

synapsesocial.com/papers/6aabb7b85f706d05830e6fd9 https://doi.org/10.1002/14651858.cd005387.pub4

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Physical activity programmes for promoting bone mineralisation and growth in preterm infants

Key Points

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Implication

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Physical activity programmes for promoting bone mineralisation and growth in preterm infants

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Implication

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Cite This Study

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