EFFECTS OF FACILITATED TUCKING DURING ROUTINE CAREGIVING ACTIVITIES: A CASE SERIES ON PRETERM INFANT PAIN EXPRESSION

The purpose of this case series was to compare infants’ behavioral and physiologic responses to caregiving procedures performed with and without a facilitated tuck intervention provided by a neonatal physical therapist. Three stable, hospitalized infants, between 26 and 29 weeks post-menstrual age (mean = 28.5 weeks) on the day of observation, were assessed during routine caregiving activities. In the experimental condition, the physical therapist first supported each neonate with a facilitated tuck for two minutes. The nurse then performed routine caregiving activities while the physical therapist maintained the facilitated tuck position. The infant was further supported in the facilitated tuck position for an additional two minutes after the caregiving activities were completed. During the control condition, the nurse alone provided care to the infant without facilitated tucking. Infants supported by facilitated tucking during routine nursing caregiving activities demonstrated a mean N-PASS score of 3.3, compared to a mean of 4.6 when not tucked. Additionally, during the recovery phase, infants supported with a facilitated tuck demonstrated a mean N-PASS score of 3.1, compared to a mean of 4.3 when not supported with a facilitated tuck. Infants demonstrated a lower stress response when supported with a facilitated tuck prior to, throughout, and post nursing caregiving activities. Physical therapists skilled in neonatal handling techniques can support a reduced stress response in infants less than 30 weeks post-menstrual age by supporting them throughout routine caregiving activities and during their transition back to a restful state.