Research ArticlePrenatal vestibular stimulation as dance (VES-D) program: A mixed methods feasibility study
Introduction
Prenatal influences on human development have been studied across multiple disciplines including obstetrics, nursing, pediatrics, neurology, and psychology. Research designs examining proximal outcomes abound in the extant literature, where death and disease are plausible alternative outcomes (Conley, Strully, & Bennett, 2006; Jaakkola & Gissler, 2004; Khandaker, Zimbron, Lewis, & Jones, 2013). Distal outcomes are prevalent in studies examining the relationships between prenatal factors (e.g., stress, anxiety, and deprivation) and a child’s behavioral and academic performance (Almond, Mazumder, & Van Ewijk, 2011; Kingston & Tough, 2014; Shen et al., 2016). Noticeably, a gap exists in the inquiry of prenatal contributors to an infant’s nascent attention development, with methodological challenges contributing to this dearth. Recent findings in neurobiology and neurophysiology have implicated the vestibular system as a prominent but formerly overlooked influence on multiple cognitive processes, including memory, attention, and social cognition (Deroualle et al., 2015; Lopez, 2016; Palla & Lenggenhager, 2014). Because fetal vestibular activity is experienced abundantly in prenatal life—both passively by way of the mother’s movements and actively as fetal motoric patterns begin to organize—it is plausible that prenatal vestibular stimulation can yield proximal outcomes in newborn infants’ attentional capacities believed to underlie social cognition development.
Methods of vestibular stimulation used in clinical, therapeutic, and, more recently, neuroscientific contexts include caloric and galvanic stimulation of the vestibular organs in the ears as well as mechanical stimulators, such as rotating chairs and displacing platforms (Palla & Lenggenhager, 2014). Dance as a form of naturalistic vestibular conditioning has been studied as a contributor to improved balance, posture, and stability in groups of dancers compared to non-dancers (Oliveira-Barreto et al., 2017). Moreover, a retrospective study of mothers who had danced during pregnancy examined the sleeping behaviors and musical preferences of their children at infancy and again during middle childhood (Bellieni, Cordelli, Bagnoli, & Buonocore, 2004). To date, no research exists that uses dance as an independent variable from which to examine the relationship between prenatal vestibular stimulation and neonatal attention. The feasibility of designing a study that incorporates innovative methods in two sensitive environments—pregnancy and neonatal life—has not been established, suggesting there is a need to assess the acceptability and feasibility of noninvasive measures and procedures. Mixed-methods research designs are well-suited to explore the complex physical, social, and emotional contexts (Tashakkori & Teddlie, 2010) in which pregnant women find naturalistic dance-based prenatal vestibular stimulation safe, enjoyable, and beneficial to their well-being and that of their unborn children. The present study uses a mixed-methods design to examine the feasibility of undertaking a dance program for pregnant women and the feasibility of conducting out-of-hospital assessments of 9- to 11-day-old neonates using a non-invasive attention task.
Section snippets
Prenatal exercise and child outcomes
A small body of literature has addressed the possible impact of prenatal non-dance exercise on fetal and child neurocognitive development (Álvarez‐Bueno et al., 2017; Domingues et al., 2014; Labonte-Lemoyne, Curnier, & Ellemberg, 2017; Niño Cruz, Ramirez Varela, da Silva, Hallal, & Santos, 2018) as measured by IQ tests, language skills measures, developmental inventories, and fetal EEGs. In a literature review of empirical studies documenting the effects of exercise during pregnancy on various
Sample and setting
A purposive sample of five mothers and their five infants (N = 10) was recruited from a birthing center and a local university in the U.S. Southwest. The birthing center is staffed by certified nurse midwives who provide onsite prenatal healthcare and non-surgical birthing care. The researcher was allowed to approach birthing center patients with an information flyer and place recruitment flyers at the reception desk. Additionally, a recruitment email was sent out to the all graduate,
Demographics and pregnancy history
Table 1 summarizes the demographic characteristics and pregnancy history of the adult subsample (n1 = 5). All but one participant was over the age of 30 years at the start of the study (mean age = 31.2 years), indicating the sample was substantially older than the average age (26.3 years) of women who gave birth in the United States in 2014 (Matthews & Hamilton, 2016). All participants were in heterosexual marriages, and four participants were already parenting one biological child. The small
Discussion
The present paper describes the acceptability of a prenatal vestibular-stimulation-as-dance (VES-D) program on five pregnant women and the suitability and feasibility of a perceptual-based eye gaze task administered on five newborn infants in a home-based lab. The experience of participating in the dance-based sessions was reported as positive for the five adult participants and supported by high attendance rates and qualitative descriptions of perceived benefits to their own health as well as
Funding
This work was supported by the Mathes Family Scholarship Fund and the Delta Pilots Charitable Fund.
Declaration of Competing Interest
None.
Acknowledgements
Thank you to the mothers and infants who participated in this study. The author wishes to acknowledge the following individuals for their support with the research design and proof reading the manuscript: Dr. Jakob Vingren, Dr. Rebecca Glover, Dr. Cynthia Frosch, and Jon Greuel.
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