Tesis

Pengaruh Stimulasi Taktil Kinestetik terhadap Pertumbuhan, Neurobehaviour, Perkembangan Kognitif dan Bahasa pada Bayi Prematur : Suatu Studi Intervensi = Effect Tactile Kinesthetic Stimulation on Growth Neurobehaviour, Cognitive and Language Development of Preterm Neonates : an Intervention Study.

Latar belakang: Kelahiran bayi prematur merupakan salah satu masalah kesehatan utama yang masih dihadapi di banyak negara. Selain nutrisi, stimulasi taktil kinestetik (STK) dini dapat meningkatkan luaran pertumbuhan, neurobehaviour, perkembangan kognitif dan bahasa bayi prematur. Tujuan: Menilai pengaruh STK terhadap pertumbuhan, neurobehaviour, serta perkembangan kognitif dan bahasa bayi prematur. Metode: Studi intervensi bulan Agustus 2015 hingga Juli 2017 di Unit Neonatologi RSCM. Subjek penelitian adalah bayi prematur stabil, direkrut dengan randomisasi dibagi menjadi dua kelompok (a) perlakuan yang mendapat STK (b) kontrol hanya mendapat perawatan rutin. STK dilakukan tiga kali 15 menit setiap hari selama 10 hari, dengan moderate pressure pada posisi tengkurap (taktil), telentang (kinestetik), gerakan fleksi ekstensi tangan dan kaki. Semua bayi diukur kenaikan BB, PB, LK, neurobehaviour (skor Dubowitz) pada sebelum dan setelah intervensi, usia aterm, dan 3 bulan. Capute Scale dinilai usia 3 bulan. Hasil: Total 126 bayi (63 kelompok perlakuan dan 63 kelompok kontrol) didapatkan kenaikan BB, PB lebih baik pada bayi yang mendapat STK dibandingkan kontrol (p0,05). Perkembangan kognitif dan bahasa di antara kedua kelompok tidak berbeda signifikan (DQ-CLAMS, DQ-CAT, FSDQ, p>0,05). Simpulan: Stimulasi taktil kinestetik merupakan salah satu intervensi yang efektif untuk pertumbuhan bayi late preterm.
Kata kunci: bayi prematur, stimulasi taktil kinestetik, kenaikan BB, PB, neurobehaviour, perkembangan kognitif dan bahasa.


Background: Prematurity is one of the most common health problems in neonates. These neonates need tactile-kinesthetic stimulation (TKS) besides adequate nutrition at early age that hypothesized to have good outcome in growth, neurobehavioural, cognitive and language development later in life. Objective: To evaluate the effects of TKS on growth, neurobehaviour, cognitive and language development in preterm neonates. Method: An interventional study conducted during August 2015 to July 2017 in Neonatal Unit Cipto Mangunkusumo Hospital. Preterm neonates recruited by random sampling, divided into two groups; (a) intervention group who received TKS (b) control group who received routine hospital care only. TKS was provided three times 15 minute periods per day for 10 days to intervention group, with the massages consisting of moderate pressure strokes in supine-prone position and kinesthetic exercises consisting of flexion-extension of limbs. Changes in weight, length, head circumference and neurobehavior (Dubowitz Score) were assessed in both groups before, after the intervention period, term corrected age and 3 months chronological age. Cognitive and language skill were assessed with Capute scale at 3 months of chronological age. Results: There were 126 preterm neonates (63 in intervention group and 63 in control group). Over the 10 day TKS period, the intervention group gained significantly more weight and height increment compared to the control group (p0.05). There was no significant difference in cognitive and language between the intervention and control group (DQ-CLAMS, DQ-CAT, FSDQ, p>0.05). Conclusion: Tactile-kinesthetic stimulation can be an effective way to enhance growth in late preterm neonates.
Keywords: preterm neonates, tactile-kinesthetic stimulation, weight gain, length gain, neurobehaviour, cognitive and language