Effectiveness of tummy time exercise using playmat versus mattress on gross motor development in infants aged 0-6 months: A randomized controlled trial.

BACKGROUND: Early infancy is a critical period for gross motor development. Although tummy time is widely recommended, evidence regarding whether the support surface influences its developmental benefits is limited. METHODS: This randomized controlled trial included 30 healthy infants aged 0-6 months, who were randomly allocated to a playmat group (n = 15) or a mattress group (n = 15). Both groups performed supervised, age-adjusted tummy time three times daily for two weeks. Gross motor development was assessed before and after the intervention using the Denver Developmental Screening Test. RESULTS: Gross motor scores significantly improved in both groups. The playmat group increased from 5.20 ± 1.14 to 7.13 ± 1.06, while the mattress group increased from 5.07 ± 1.16 to 6.80 ± 1.21. Between-group comparison showed a significantly greater improvement in the playmat group (mean difference = 0.20, 95% CI 0.01-0.39; p = 0.041; Cohen's d = 0.78). CONCLUSION: Structured tummy time improved gross motor development in infants aged 0-6 months, with greater improvement observed on a playmat than on a mattress. IMPLICATIONS FOR PRACTICE: Pediatric nurses should recommend supervised age-appropriate tummy time on firm, flat, and stable surfaces and provide practical guidance to parents regarding safe positioning, frequency, duration, and infant tolerance. This low-cost intervention can be integrated into infant developmental education in primary healthcare and home environments.