Journals / Turkish Journal of Kinesiology / 2026 / Volume: 12 Issue: 5

Transition to oral feeding through oromotor and developmental rehabilitation in a peg-fed, visually impaired preterm triplet infant: A case report

Neslihan Altuntas Yılmaz(Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Türkiye.)0000-0003-0116-9089
Pariya Pouriyamanesh(Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Necmettin Erbakan University, Konya, Türkiye.)0009-0005-3142-3510
Fatma Erdeo(Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Türkiye.)0000-0002-0266-229X
Pages
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Publication Date
2026-10-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings suggest that the combined rehabilitation program, integrating NMES with oromotor, sensory, and developmental interventions, may support the transition toward oral feeding in PEG-fed preterm infants with additional disabilities.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:His case report aimed to describe clinical outcomes following a combined rehabilitation program incorporating neuromuscular electrical stimulation (NMES), oromotor exercises, and developmental interventions in a PEG-fed, visually impaired preterm infant.
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Key Findings & Data:The infant was born at 32 weeks of gestation with a birth weight of 1500 g as one of triplets and had visual impairment due to retinopathy of prematurity.
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Conclusion & Impact:These findings suggest that the combined rehabilitation program, integrating NMES with oromotor, sensory, and developmental interventions, may support the transition toward oral feeding in PEG-fed preterm infants with additional disabilities.
🔬Design:Case Report
📍Scope:Comprehensive Sample
⚙️Variables:Deglutition disorders · electric stimulation therapy · feeding behavior

Abstract

His case report aimed to describe clinical outcomes following a combined rehabilitation program incorporating neuromuscular electrical stimulation (NMES), oromotor exercises, and developmental interventions in a PEG-fed, visually impaired preterm infant. The infant was born at 32 weeks of gestation with a birth weight of 1500 g as one of triplets and had visual impairment due to retinopathy of prematurity. Because oral feeding was not possible, nutrition was provided via percutaneous endoscopic gastrostomy (PEG). At baseline, Karaduman Chewing Performance Scale (KCPS) score was 4 and the Preterm Oral Feeding Readiness Assessment Scale (POFRAS) score was 19. The infant also exhibited low oral cavity tone, insufficient laryngeal elevation, and intolerance to oral feeding. Swallowing safety was assessed by an otorhinolaryngologist using fiberoptic endoscopic evaluation of swallowing (FEES); the Penetration–Aspiration Scale (PAS) score was 2, with no evidence of aspiration. The infant received a four-week combined rehabilitation program comprising 20 sessions (five sessions/week), including oromotor exercises, oral sensory stimulation, developmental physiotherapy, and NMES. Each session lasted approximately 60 minutes, including 40 minutes of NMES, and a home program was provided to the family. Following the intervention, the KCPS score improved from 4 to 3, while the POFRAS score increased from 19 to 31. Follow-up FEES performed by the otorhinolaryngologist showed that the PAS score remained at 2, with no evidence of aspiration. Oral cavity tone and laryngeal elevation improved, and tolerance to pacifier use and oral feeding increased. Oral feeding was initiated; however, PEG feeding was continued because oral intake remained insufficient to meet the infant's nutritional requirements. These findings suggest that the combined rehabilitation program, integrating NMES with oromotor, sensory, and developmental interventions, may support the transition toward oral feeding in PEG-fed preterm infants with additional disabilities.

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Cite This Article

Yılmaz, N. A., Pouriyamanesh, P., Erdeo, F. (2026). Transition to oral feeding through oromotor and developmental rehabilitation in a peg-fed, visually impaired preterm triplet infant: A case report. Turkish Journal of Kinesiology, Volume: 12 Issue: 5. https://doi.org/10.31459/turkjkin.1942570

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References (33)

  1. Benfer, K., Weir, K., Bell, K., Ware, R., Davies, P., & Boyd, R. (2017). Oropharyngeal dysphagia and cerebral palsy. Pediatrics, 140(6). doi: 10.1542/peds.2017-0731.
  2. Boiron, M., Nobrega, L. D., Roux, S., Henrot, A., & Saliba, E. (2007). Effects of oral stimulation and oral support on non-nutritive sucking and feeding performance in preterm infants. Dev Med Child Neurol, 49(6), 439-444. doi:10.1111/j.1469-8749.2007.00439.x.
  3. Butler, P. B., Saavedra, S., Sofranac, M., Jarvis, S. E., & Woollacott, M. H. (2010). Refinement, reliability, and validity of the segmental assessment of trunk control. Pediatr Phys Ther, 22(3), 246–257. doi: 10.1097/PEP.0b013e3181e69490.
  4. Çamur, Z., & Çetinkaya, B. (2021). The validity and reliability study of the Turkish version of the Preterm Oral Feeding Readiness Assessment Scale (T-POFRAS). J Pediatr Res, 8(3), 225–232. doi: 10.4274/jpr.galenos.2020.35682
  5. Cemali, M., Cemali, Ö., Günal, A., & Pekçetin, S. (2023). Relationship between sensory processing skills and feeding behaviors in children aged 3–6 years with cerebral palsy with cerebral visual impairment. Children, 10(7), 1188. doi: 10.3390/children10071188
  6. Cemali, Ö., Yurteri Tiryaki, A., Cemali, M., & Torpil, B. (2026). Effects of feeding behavior training on sensory processing and developmental areas in children with cerebral visual impairment: A randomized controlled study. Ital J Pediatr, 52(1), 42. doi: 10.1186/s13052-026-02213-w
  7. Comuk Balci, C., N., Takci, S., & Seren, H. C. (2023). Improving feeding skills and transition to breastfeeding in early preterm infants: a randomized controlled trial of oromotor intervention. Front Pediatr, 11, 1252254. doi: 10.3389/fped.2023.1252254.
  8. Cook, C., Busch, D., Ward, I., & Lequerica, A. (2023). The impact of thermal-tactile stimulation on dysphagia in patients with acquired brain injury. Arch Phys Med Rehabil, 104(3), e56. doi: 10.1016/j.apmr.2022.12.163
  9. Dodrill, P. & Gosa, M. (2015). Pediatric dysphagia: physiology, assessment, and management. Ann Nutr Metab, 66, 24-31. doi: 10.1159/000381372
  10. El-Kassas, O., Amer, A., Abdel-Hady, H., & Abou-Elsaad, T. (2024). The transition from tube feeding to oral feeding algorithm in preterm infants: Case-control study. BMC Pediatr, 24(1), 453. doi: 10.1186/s12887-024-04909-6
  11. Engle, W. A., Tomashek, K. M., & Wallman, C. (2007). "Late-preterm" infants: A population at risk. Pediatrics, 120(6), 1390–1401. doi: 10.1542/peds.2007-2952
  12. Fleischman, A. R., Oinuma, M., & Clark, S. L. (2010). Rethinking the definition of "term pregnancy". Obstet Gynecol, 116(1), 136–139. doi: 10.1097/AOG.0b013e3181e24f28
  13. Fucile, S., Gisel, E. G., Mcfarland, D. H. & Lau, C. (2011). Oral and non-oral sensorimotor interventions enhance oral feeding performance in preterm infants. Dev Med Child Neurol, 53(9), 829-835. doi: 10.1111/j.1469-8749.2011.04023.x
  14. Girgin, G., Gözen, D., Uslubaş, M., & Bilgin, H. (2021). Home-based oral motor interventions in preterm infants: Family compliance and feeding outcomes. Turk J Pediatr, 63(4), 564–573. doi: 10.24953/turkjped.2021.04.008
  15. Goday, P. S., Huh, S. Y., Silverman, A., Lukens, C. T., Dodrill, P., Cohen, S. S., Delaney, A. L., Feuling, M. B., Noel, R. J., Gisel, E., Kenzer, A., Kessler, D. B., Kraus de Camargo, O., Browne, J., & Phalen, J. A. (2019). Pediatric feeding disorder: consensus definition and conceptual framework. J Pediatr Gastroenterol Nutr, 68(1), 124-129. doi:10.1097/MPG.0000000000002188
  16. Goldstein, A., High, M., Lynch, E., Fawcett, A., & Sobotka, S. A. (2025). Pediatric gastrostomy feeding tube weaning strategies: A scoping review. J Pediatr Gastroenterol Nutr, 81(2), 387–403. doi: 10.1002/jpn3.70078
  17. Gosa, M. M., Carden, H. T., Jacks, C. C., Threadgill, A. Y., & Sidlovsky, T. C. (2017). Evidence to support treatment options for children with swallowing and feeding disorders: A systematic review. J Pediatr Rehab Med, 10(2), 107–136. doi: 10.3233/PRM-170436
  18. Gosa, M. M., Dodrill, P., Lefton-Greif, M. A., & Silverman, A. (2020). A multidisciplinary approach to pediatric feeding disorders: Roles of the speech-language pathologist and behavioral psychologist. Am J Speech Lang Pathol, 29(2S), 956–966. doi: 10.1044/2020_AJSLP-19-00069
  19. Gözen, D. & Aykanat Girgin, B. (2017). Evidence-based interventions supporting oral feeding in preterm infants. Clin Exp Health Sci, 7(4), 171-174. doi: 10.5152/clinexphealthsci.2017.327
  20. Kurt Sezer, H. & Küçükoğlu, S. (2020). Applications to support the development of oral-motor functions in preterm babies. Journal of Inonu University Health Services Vocational School, 8(1), 141-149. doi:10.33715/inonusaglik.628649
  21. Lively, E. J., McAllister, S., & Doeltgen, S. H. (2023). Parents' experiences of their child's transition from tube to oral feeding during an intensive intervention programme. Child Care Health Dev, 49(4), 740–749. doi: 10.1111/cch.13088
  22. Lubbe, W. (2018). Clinicians guide for cue-based transition to oral feeding in preterm infants: An easy-to-use clinical guide. J Eval Clin Pract, 24(1), 80–88. doi: 10.1111/jep.12721.
  23. Marin, D., Căciulan, E., Bota, A., & Gherghel, C. (2024). Manual orofacial stimulation and its impact on children with cerebral palsy. Discobolul – Physical Education, Sports and Kinetotherapy Journal, 63(3), 183–198. doi: 10.35189/dpeskj.2024.63.3.2
  24. Özbey, H., Sezer Efe, Y., & Erdem, E. (2020). Families with preterm infants and nursing approach. Journal of Hacettepe University Faculty of Nursing, 7(3), 292–298. doi: 10.31125/hunhemsire.834246
  25. Propp, R., Gill, P. J., Marcus, S., Ren, L., Cohen, E., Friedman, J., & Mahant, S. (2022). Neuromuscular electrical stimulation for children with dysphagia: A systematic review. BMJ Open, 12(3), e055124. doi: 10.1136/bmjopen-2021-055124
  26. Ross, E. S. & Browne, J. V. (2013). Feeding outcomes in preterm infants after discharge from the Neonatal Intensive Care Unit (NICU): A systematic review. Newborn and Infant Nursing Reviews, 13(2), 87-93. doi: 10.1053/j.nainr.2013.04.003
  27. Serel Arslan, S., Demir, N., & Karaduman, A. A. (2017). Effect of a new treatment protocol called Functional Chewing Training on chewing function in children with cerebral palsy: A double-blind randomised controlled trial. J Oral Rehabil, 44(1), 43–50. doi: 10.1111/joor.12459
  28. Serel Arslan, S., Demir, N., Barak Dolgun, A., & Karaduman, A. A. (2016). Development of a new instrument for determining the level of chewing function in children. J Oral Rehabil, 43(7), 488–495. doi: 10.1111/joor.12399
  29. Terek, D. & Yalaz, M. (2019). The principles of nutrition in term and preterm infants. Klinik Tıp Pediatri Dergisi, 11(5), 233-244.
  30. Törüner, E. K. & Altay, N. (2013). Enteral nutrition and care of risky newborns. Journal of Contemporary Medicine, 3(3), 227-233.
  31. Vural, M. (2017). Early days of enteral nutrition in premature infants. Klinik Tıp Pediatri Dergisi, 9(4), 64-70.
  32. Younesian, S., Yadegari, F. & Soleimani, F. (2015). Impact of oral sensory motor stimulation on feeding performance, length of hospital stay, and weight gain of preterm infants in NICU. Iran Red Crescent Med J, 17(7). doi: 10.5812/ircmj.17(5)2015.13515.
  33. Zengin, H., Karakaya Suzan, O., Hur, G., Kolukısa, T., Eroglu, A., & Cinar, N. (2023). The effects of kangaroo mother care on physiological parameters of premature neonates in neonatal intensive care unit: A systematic review. J Pediatr Nurs, 71, e18–e27. doi: 10.1016/j.pedn.2023.04.010