Infant Physiotherapy Research Articles

Edukasi Infeksi Saluran Pernapasan Atas Di Posyandu Margosari

Introduction: Upper Respiratory Tract Infection (ARI) is an acute respiratory infection caused by pathogens that are transmitted from human to human. Signs and symptoms usually appear quickly within a few hours to a few days. ARI is a very contagious disease and can occur due to decreased body resistance, for example due to fatigue or stress. Upper Respiratory Tract Infection (ARI) is one of the diseases that has the highest incidence rate and is the main cause of death and morbidity in infants and toddlers in Indonesia. Providing education to mothers of babies and toddlers regarding Upper Respiratory Tract Infections (ARI) is important. Objective: To provide counseling and education at toddler posyandu. Method: The strategy used is to carry out health education, where this strategy will be aimed directly at the target, namely mothers of babies and toddlers at Posyandu Balita Margosari RW. 05 Ledug Village. The implementation strategy that has been carried out is by providing health counseling on URTI, with lecture, discussion, and roleplay methods. Result: implementation of health education on Upper Respiratory Tract Infections at the Margosari Toddler Posyandu. Before being given counseling, many participants still did not know or hear about ISPA. After health education, participants already know about the meaning of ISPA infection, pathophysiology of ISPA, risk factors for ISPA, symptoms of ISPA, management of ISPA at home, prevention of ISPA, chest physiotherapy and massage for babies. Conclusion: The counseling material provided is about URTI which includes understanding, pathophysiology, signs and symptoms, risk factors for occurrence, management, and prevention, as well as chest physiotherapy in infants and toddlers. Counseling is carried out using leaflet media, ppt, and baby phantoms

Investigation of the frequency of application of physiotherapy in infants with gastroesophageal reflux

Introduction: Gastroesophageal reflux (GER) is defined as the reflux of gastric and/or intestinal contents into the esophagus. It is a common phenomenon, seen in 40-65% of infants and is due to transient relaxations of the lower esophageal sphincter.Many infants have daily episodes of GER, of short duration after meals, during sleepeven while awake. Its early diagnosis helps towards early intervention and successful treatment of complications. Furthermore, it contributes to improving the infant’s and the family’s quality of life. Physiotherapy as an adjunctive therapeutic intervention seems to be able to contribute significantly to the improvement of GER in infants. The goal is to improve movement, body posture, cardiorespiratory function and coordination in order to limit the phenomenon. Aim:The main purpose of this study was to investigate whether infants with GER, in addition to dietary and other instructions and any pharmaceutical intervention, also undergo physical therapy treatment to improve their symptoms. Additional objectives were to record the infant’s and the family’s quality of life, and to explore parents’ expectations of a physical therapy program. Patients and methods:Thirty infants with GER participated in the study. The research was conducted in Thessaloniki, Greece, in a regular pediatric gastroenterology clinic. The questionnaire was given to the parents and completed under the supervision of the researcher in case of need for clarification. Results:None of the 30 infants studied was following a physical therapy program. In addition, GER was found to have a great impact on parents’ quality of life, since 80% answered that they were significantly affected, not knowing how to manage the condition. Regarding the need for physical therapy intervention and informing parents, 70% answered that they would like to have information and help from a physical therapist. A percentage of 80% of parents were in favor of a physical therapy program that could contribute to the reductioneven the elimination of their children’s medication. Conclusions:Gastroesophageal reflux affects a large percentage of infants. In severe cases, if not treated in time, it can affect the health of young infants and the families’ quality of life. Most parents seem to trust a physical therapy program to improve their children’s health for the fastest recovery from GER. This research can be a pilot for further studies, in the context of a more holistic intervention by doctors and physical therapists in infants with GER symptoms.

The Coping with and Caring for Infants with Special Needs intervention was associated with improved motor development in preterm infants.

AimWe compared the impact of standard infant physiotherapy and the family‐centred programme, Coping with and Caring for Infants with Special Needs (COPCA), in infants born before 32 weeks without significant brain lesions.MethodsThis randomised controlled trial was carried out in patients' homes and outpatient settings in Switzerland between January 2016 and October 2019. We used data from the national SwissNeoNet register and an assessment battery that included infant and family outcomes and video analyses of therapy sessions. The Infant Motor Profile was the primary outcome instrument.ResultsThe COPCA group comprised six boys and two girls with a median gestational age of 27 weeks (range 25‐30), and the standard care group comprised seven boys and one girl with a median gestational age of 29.5 weeks (range 26‐31). COPCA participants improved significantly more between baseline and 18 months in the IMP variation (9.0 percentage points, 95% confidence interval: 0.3‐17.5) and performance (12.0 percentage points, 95% confidence interval: 4.1‐20.6) domains than standard care participants. COPCA coaching was positively associated with IMP scores at 18 months, but some standard care actions were negatively associated.ConclusionCOPCA was associated with better motor outcome in infants born before 32 weeks than standard infant physiotherapy.

LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: family outcome and infant’s functional outcome

Purpose: To compare family and functional outcome in infants at very high risk of cerebral palsy, after receiving the family centred programme “Coping with and Caring for infants with special needs (COPCA)” or typical infant physiotherapy. Materials and methods: Forty-three infants at very high risk were included before 9 months corrected age and randomly assigned to one year COPCA (n = 23) or typical infant physiotherapy (n = 20). Family and infant outcome were assessed before and during the intervention. Physiotherapy intervention sessions were analysed quantitatively for process analysis. Outcome was evaluated with non-parametric tests and linear mixed-effect models. Results: Between-group comparisons revealed no differences in family and infant outcomes. Within-group analysis showed that family’s quality of life improved over time in the COPCA-group. Family empowerment was positively associated with intervention elements, including “caregiver coaching.” Conclusions: One year of COPCA or typical infant physiotherapy resulted in similar family and functional outcomes. Yet, specific intervention elements, e.g., coaching, may increase empowerment of families of very high risk infants and may influence quality of life, which emphasizes the importance of family centred services. Implications for rehabilitation One year of the family centred programme “Coping with and a Caring for infants with special needs” compared with typical infant physiotherapy resulted in similar family outcome and similar functional outcome for the infants at very high risk for cerebral palsy. Specific contents of intervention, such as caregiver coaching, are associated with more family empowerment and increased quality of life. Emphasis on family needs is important in early intervention for infants at very high risk for cerebral palsy.

LEARN2MOVE 0–2 years, a randomized early intervention trial for infants at very high risk of cerebral palsy: neuromotor, cognitive, and behavioral outcome

Purpose: Evidence for efficacy of early intervention in infants at high risk of cerebral palsy (CP) is limited. We compared outcome of infants at very high risk of CP after receiving the family centered program COPing with and CAring for infants with special needs (COPCA) or typical infant physiotherapy. Materials and methods: Forty-three infants were randomly assigned before the corrected age of 9 months to 1 year of COPCA (n = 23) or typical infant physiotherapy (n = 20). Neuromotor development, cognition, and behavior was assessed until 21 months corrected age. Video-recorded physiotherapy sessions were quantitatively analyzed for further process analyses. Outcome was evaluated with nonparametric tests and linear mixed effect models. Results: During and after the interventions, infant outcome in both intervention groups was similar [primary outcome Infant Motor Profile: COPCA 82 (69–94), typical infant physiotherapy 81 (69–89); Hodges Lehman estimate of the difference 0 (confidence interval −5;4)]. Outcome was not associated with contents of intervention. Conclusions: One year of COPCA and 1 year of typical infant physiotherapy in infants at high risk of CP resulted in similar neurodevelopmental outcomes. It is conceivable that combinations of active ingredients from different approaches are needed for effective early intervention. IMPLICATIONS FOR REHABILITATION For infants at very high risk of cerebral palsy, 1 year of intervention with the family-centred programme Coping with and Caring for infants with special needs resulted in similar infant outcome as 1 year of typical infant physiotherapy. Infant’s neuromotor, cognitive, and behavioural outcome was not associated with specific interventional elements, implying that the various elements may have a similar effect on developmental outcome. We suggest that a specific mix of ingredients of different approaches may work best, resulting in comprehensive care including both infant and family needs.

PENGARUH BABY SPA TERHADAP KENAIKAN BERAT BADAN BAYI DI RUMAH SEHAT KITA PURWOKERTO

Baby Spa is one of the physiotherapy in infants and can stimulate baby motor movement. Research on term infants aged 1-3 months, who were massaged 15 minutes, 2 times a week for 6 weeks also gained 50% more weight than control (Riksani, 2012). Purpose of this study was to determine the effect of baby spa on weight gain in infants at Rumah Sehat Kita Purwokerto. Method used in this research is quasy experiment with cross sectional approach. Results showed there was a difference in infant weight gain between before the baby spa after the baby spa is done with the value of p value 0.001. So it can be concluded that baby spa effect on baby's weight gain.
 
 Keywords: Baby Spa, baby's weight gain

Effect of early intervention on functional outcome at school age: Follow-up and process evaluation of a randomised controlled trial in infants at risk

BackgroundThe long-term effect of early intervention in infants at risk for developmental disorders is unclear. The VIP project (n=46, originally) evaluated by means of a randomised controlled trial the effect of the family centred early intervention programme COPCA (Coping with and Caring for infants with special needs) in comparison to that of traditional infant physiotherapy (TIP). AimsTo evaluate the effect of early intervention on functional outcome at school age. Methods and proceduresParents of 40 children (median age 8.3years) participated in this follow-up study. Outcome was assessed with a standardised parental interview (Vineland Adaptive Behaviour Scale) and questionnaires (Developmental Coordination Disorder Questionnaire, Child Behaviour Checklist, Utrechtse Coping List, and questions on educational approach). Quantified video information on physiotherapeutic actions during infancy was available. Outcomes and resultsChild functional outcome in the two randomised groups was similar. Process evaluation revealed that some physiotherapeutic actions were associated with child mobility and parental educational approach at follow-up: e.g., training and instructing were associated with worse mobility. Conclusions and implicationsFunctional outcome at school age after early intervention with COPCA is similar to that after TIP. However, some specific physiotherapeutic actions, in particular the physiotherapist's approach, are associated with outcome. What this paper addsEarly intervention is generally applied in infants at risk for developing disorders, with the aim of improving overall functional outcome. However, little is known on the long-term effect.The VIP project evaluated by means of a randomised controlled trial the effect of the family centred early intervention programme COPCA (Coping with and Caring for infants with special needs) in comparison to that of traditional infant physical therapy (TIP). Outcome at 18months corrected age was virtually similar. Process evaluation of the physiotherapy actions revealed that some characteristics of COPCA were associated with improved developmental outcome at 18months.This paper presents data on functional outcome at school age (median 8.3years) in 87% of the original participants. Outcome of infants who received three months of COPCA and that of infants who received three months of TIP was similar. Yet, parents of families who had received the COPCA intervention still more often used a trial and error approach when the child learned a new skill than parents of children who had received TIP. Process evaluation showed that more time spent on caregiver training and strict instructions during early intervention was associated with worse mobility. Four other physiotherapeutic actions were associated with parental educational approach. None of the neuromotor actions were associated with child outcome at school age.We conclude that long-term outcome after three months of COPCA or TIP is similar. However, our study does suggest that the professional approach of the physiotherapist can make a difference.

Infant positioning in daily life may mediate associations between physiotherapy and child development—video-analysis of an early intervention RCT

BackgroundPaediatric physiotherapy (PPT) in high-risk infants comprises family involvement, but it is unclear whether parents mediate the intervention effect. We demonstrated in a randomized controlled trial in high-risk infants comparing the family centred programme Coping and Caring for infants with special needs (COPCA) and Traditional Infant Physiotherapy (TIP) that process evaluation revealed associations between COPCA-characteristics and outcome. AimsTo assess whether PPT affects how parents position their infant during bathing and whether this is associated with child outcome. Methods and procedures21 infants received COPCA and 25 TIP between 3 and 6 months corrected age. Bathing sessions were videotaped at 3, 6 and 18 months. Time spent with specific infant positions was correlated with quantified PPT-actions and functional mobility at 18 months measured with the Paediatric Evaluation of Disability Inventory (PEDI). Outcomes and resultsAt 3 and 18 months bathing position was similar in both groups, but differed at 6 months (time spent on sitting: COPCA 77.7%, TIP 39.2%; median difference 32.0% (95% CI: 10.6–50.5%). Sitting-time at 6 months was associated with higher PEDI functional mobility scores. Conclusions and implicationsEarly PPT may affect parental behaviour, such as infant positioning during bathing, which, in turn, may affect child development.

Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old.

This Cochrane review was first published in 2005 and updated in 2007, 2012 and now 2015. Acute bronchiolitis is the leading cause of medical emergencies during winter in children younger than two years of age. Chest physiotherapy is sometimes used to assist infants in the clearance of secretions in order to decrease ventilatory effort. To determine the efficacy of chest physiotherapy in infants aged less than 24 months old with acute bronchiolitis. A secondary objective was to determine the efficacy of different techniques of chest physiotherapy (for example, vibration and percussion and passive forced exhalation). We searched CENTRAL (2015, Issue 9) (accessed 8 July 2015), MEDLINE (1966 to July 2015), MEDLINE in-process and other non-indexed citations (July 2015), EMBASE (1990 to July 2015), CINAHL (1982 to July 2015), LILACS (1985 to July 2015), Web of Science (1985 to July 2015) and Pedro (1929 to July 2015). Randomised controlled trials (RCTs) in which chest physiotherapy was compared against no intervention or against another type of physiotherapy in bronchiolitis patients younger than 24 months of age. Two review authors independently extracted data. Primary outcomes were change in the severity status of bronchiolitis and time to recovery. Secondary outcomes were respiratory parameters, duration of oxygen supplementation, length of hospital stay, use of bronchodilators and steroids, adverse events and parents' impression of physiotherapy benefit. No pooling of data was possible. We included 12 RCTs (1249 participants), three more than the previous Cochrane review, comparing physiotherapy with no intervention. Five trials (246 participants) evaluated conventional techniques (vibration and percussion plus postural drainage), and seven trials (1003 participants) evaluated passive flow-oriented expiratory techniques: slow passive expiratory techniques in four trials, and forced passive expiratory techniques in three trials.Conventional techniques failed to show a benefit in the primary outcome of change in severity status of bronchiolitis measured by means of clinical scores (five trials, 241 participants analysed). Safety of conventional techniques has been studied only anecdotally, with one case of atelectasis, the collapse or closure of the lung resulting in reduced or absent gas exchange, reported in the control arm of one trial.Slow passive expiratory techniques failed to show a benefit in the primary outcomes of severity status of bronchiolitis and in time to recovery (low quality of evidence). Three trials analysing 286 participants measured severity of bronchiolitis through clinical scores, with no significant differences between groups in any of these trials, conducted in patients with moderate and severe disease. Only one trial observed a transient significant small improvement in the Wang clinical score immediately after the intervention in patients with moderate severity of disease. There is very low quality evidence that slow passive expiratory techniques seem to be safe, as two studies (256 participants) reported that no adverse effects were observed.Forced passive expiratory techniques failed to show an effect on severity of bronchiolitis in terms of time to recovery (two trials, 509 participants) and time to clinical stability (one trial, 99 participants analysed). This evidence is of high quality and corresponds to patients with severe bronchiolitis. Furthermore, there is also high quality evidence that these techniques are related to an increased risk of transient respiratory destabilisation (risk ratio (RR) 10.2, 95% confidence interval (CI) 1.3 to 78.8, one trial) and vomiting during the procedure (RR 5.4, 95% CI 1.6 to 18.4, one trial). Results are inconclusive for bradycardia with desaturation (RR 1.0, 95% CI 0.2 to 5.0, one trial) and bradycardia without desaturation (RR 3.6, 95% CI 0.7 to 16.9, one trial), due to the limited precision of estimators. However, in mild to moderate bronchiolitis patients, forced expiration combined with conventional techniques produced an immediate relief of disease severity (one trial, 13 participants). None of the chest physiotherapy techniques analysed in this review (conventional, slow passive expiratory techniques or forced expiratory techniques) have demonstrated a reduction in the severity of disease. For these reasons, these techniques cannot be used as standard clinical practice for hospitalised patients with severe bronchiolitis. There is high quality evidence that forced expiratory techniques in severe patients do not improve their health status and can lead to severe adverse events. Slow passive expiratory techniques provide an immediate and transient relief in moderate patients without impact on duration. Future studies should test the potential effect of slow passive expiratory techniques in mild to moderate non-hospitalised patients and patients who are respiratory syncytial virus (RSV) positive. Also, they could explore the combination of chest physiotherapy with salbutamol or hypertonic saline.

Design and development of a mechatronic infant torso simulator for respiratory physiotherapy learning

Currently, constraint-free realistic context training is nonexistent in infant physiotherapy. In order to enhance the vocational learning of novices, in close collaboration with expert physiotherapists, we designed an innovative simulator dedicated to the training of infant respiratory physiotherapy. This paper describes the simulator’s functionalities and the method used to design its physical structure and the learning paradigm. Firstly, regarding a cognitive approach, relevant vocational and didactic criteria were defined in order to characterize the gesture and determine its limits for a nondangerous practice. Subsequently, we chose physical parameters to assess the criteria and define the specifications of the simulator. The mechatronic functions arose from a didactic transposition of the expected simulation-based functionalities. A 6-month-old infant torso physical structure has been designed with the use of finite element simulations. Its mechanical behaviour provides the possibility to deform the mannequin like a real infant during physiotherapy manoeuvres. A prototype has been realized and validated.

Does physiotherapeutic intervention affect motor outcome in high-risk infants? An approach combining a randomized controlled trial and process evaluation

The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders on motor outcome, as measured by the Infant Motor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation. At a corrected age of 3 months, 46 infants (20 males, 26 females) recruited from the neonatal intensive care unit at the University Medical Centre Groningen (median birthweight 1210 g, range 585-4750 g; median gestational age 30 wks, range 25-40 wks) were included on the basis of definitely abnormal general movements. Exclusion criteria were severe congenital disorders and insufficient understanding of the Dutch language. The infants were assigned to either the family-centred COPing with and CAring for Infants with Special Needs (COPCA) intervention group (n=21; 9 males, 12 females) or the traditional infant physiotherapy (TIP) intervention group (n=25; 11 males, 14 females) for a period of 3 months. Three infants assigned to the TIP group (one male, two females) did not receive physiotherapy. IMP scores were measured by blinded assessors at 3, 4, 5, 6, and 18 months. At each age, the infants were neurologically examined. Physiotherapeutic sessions at 4 and 6 months were videotaped. Quantified physiotherapeutic actions were correlated with IMP scores at 6 and 18 months. The IMP scores of both the COPCA and TIP groups before, during, and after the intervention did not differ. Some physiotherapeutic actions were associated with IMP outcomes; the associations differed for infants who developed cerebral palsy (n=10) and those who did not (n=33). At randomized controlled trial level, the scores of both the TIP and COPCA groups did not differ in effect on motor outcome, as measured with the IMP. The analysis of physiotherapeutic actions revealed associations between these actions and IMP outcomes. However, the small sample size of this study precludes pertinent conclusions.

Does physiotherapeutic intervention affect motor outcome in high-risk infants? An approach combining a randomized controlled trial and process evaluation

Aim The aim of this study was to examine the effects of intervention in infants at risk of developmental disorders on motor outcome, as measured by the Infant Motor Profile (IMP) and using the combined approach of a randomized controlled trial and process evaluation. Method At a corrected age of 3 months, 46 infants (20 males, 26 females) recruited from the neonatal intensive care unit at the University Medical Centre Groningen (median birthweight 1210g, range 585–4750g; median gestational age 30wks, range 25–40wks) were included on the basis of definitely abnormal general movements. Exclusion criteria were severe congenital disorders and insufficient understanding of the Dutch language. The infants were assigned to either the family-centred COPing with and CAring for Infants with Special Needs (COPCA) intervention group (n=21; 9 males, 12 females) or the traditional infant physiotherapy (TIP) intervention group (n=25; 11 males, 14 females) for a period of 3 months. Three infants assigned to the TIP group (one male, two females) did not receive physiotherapy. IMP scores were measured by blinded assessors at 3, 4, 5, 6, and 18 months. At each age, the infants were neurologically examined. Physiotherapeutic sessions at 4 and 6 months were videotaped. Quantified physiotherapeutic actions were correlated with IMP scores at 6 and 18 months. Results The IMP scores of both the COPCA and TIP groups before, during, and after the intervention did not differ. Some physiotherapeutic actions were associated with IMP outcomes; the associations differed for infants who developed cerebral palsy (n=10) and those who did not (n=33). Interpretation At randomized controlled trial level, the scores of both the TIP and COPCA groups did not differ in effect on motor outcome, as measured with the IMP. The analysis of physiotherapeutic actions revealed associations between these actions and IMP outcomes. However, the small sample size of this study precludes pertinent conclusions.

LEARN 2 MOVE 0-2 years: effects of a new intervention program in infants at very high risk for cerebral palsy; a randomized controlled trial

BackgroundIt is widely accepted that infants at risk for cerebral palsy need paediatric physiotherapy. However, there is little evidence for the efficacy of physiotherapeutic intervention. Recently, a new intervention program, COPCA (Coping with and Caring for infants with special needs - a family centered program), was developed. COPCA has educational and motor goals. A previous study indicated that the COPCA-approach is associated with better developmental outcomes for infants at high risk for developmental disorders. LEARN 2 MOVE 0-2 years evaluates the efficacy and the working mechanisms of the COPCA program in infants at very high risk for cerebral palsy in comparison to the efficacy of traditional infant physiotherapy in a randomized controlled trial. The objective is to evaluate the effects of both intervention programs on motor, cognitive and daily functioning of the child and the family and to get insight in the working elements of early intervention methods.Methods/designInfants are included at the corrected age of 1 to 9 months and randomized into a group receiving COPCA and a group receiving traditional infant physiotherapy. Both interventions are given once a week during one year. Measurements are performed at baseline, during and after the intervention period and at the corrected age of 21 months. Primary outcome of the study is the Infant Motor Profile, a qualitative evaluation instrument of motor behaviour in infancy. Secondary measurements focus on activities and participation, body functions and structures, family functioning, quality of life and working mechanisms. To cope with the heterogeneity in physiotherapy, physiotherapeutic sessions are video-recorded three times (baseline, after 6 months and at the end of the intervention period). Physiotherapeutic actions will be quantified and related to outcome.DiscussionLEARN 2 MOVE 0-2 years evaluates and explores the effects of COPCA and TIP. Whatever the outcome of the project, it will improve our understanding of early intervention in children with cerebral palsy. Such knowledge is a prerequisite for tailor-made guidance of children with CP and their families.Trial registrationThe trial is registered under NTR1428.

Effectiveness of Chest Physiotherapy in Infants Hospitalized with Acute Bronchiolitis: A Multicenter, Randomized, Controlled Trial

Acute bronchiolitis treatment in children and infants is largely supportive, but chest physiotherapy is routinely performed in some countries. In France, national guidelines recommend a specific type of physiotherapy combining the increased exhalation technique (IET) and assisted cough (AC). Our objective was to evaluate the efficacy of chest physiotherapy (IET + AC) in previously healthy infants hospitalized for a first episode of acute bronchiolitis. We conducted a multicenter, randomized, outcome assessor-blind and parent-blind trial in seven French pediatric departments. We recruited 496 infants hospitalized for first-episode acute bronchiolitis between October 2004 and January 2008. Patients were randomly allocated to receive from physiotherapists three times a day, either IET + AC (intervention group, n=246) or nasal suction (NS, control group, n=250). Only physiotherapists were aware of the allocation group of the infant. The primary outcome was time to recovery, defined as 8 hours without oxygen supplementation associated with minimal or no chest recession, and ingesting more than two-thirds of daily food requirements. Secondary outcomes were intensive care unit admissions, artificial ventilation, antibiotic treatment, description of side effects during procedures, and parental perception of comfort. Statistical analysis was performed on an intent-to-treat basis. Median time to recovery was 2.31 days, (95% confidence interval [CI] 1.97-2.73) for the control group and 2.02 days (95% CI 1.96-2.34) for the intervention group, indicating no significant effect of physiotherapy (hazard ratio [HR]=1.09, 95% CI 0.91-1.31, p=0.33). No treatment by age interaction was found (p=0.97). Frequency of vomiting and transient respiratory destabilization was higher in the IET + AC group during the procedure (relative risk [RR]=10.2, 95% CI 1.3-78.8, p=0.005 and RR=5.4, 95% CI 1.6-18.4, p=0.002, respectively). No difference between groups in bradycardia with or without desaturation (RR=1.0, 95% CI 0.2-5.0, p=1.00 and RR=3.6, 95% CI 0.7-16.9, p=0.10, respectively) was found during the procedure. Parents reported that the procedure was more arduous in the group treated with IET (mean difference=0.88, 95% CI 0.33-1.44, p=0.002), whereas there was no difference regarding the assessment of the child's comfort between both groups (mean difference=-0.07, 95% CI -0.53 to 0.38, p=0.40). No evidence of differences between groups in intensive care admission (RR=0.7, 95% CI 0.3-1.8, p=0.62), ventilatory support (RR=2.5, 95% CI 0.5-13.0, p=0.29), and antibiotic treatment (RR=1.0, 95% CI 0.7-1.3, p=1.00) was observed. IET + AC had no significant effect on time to recovery in this group of hospitalized infants with bronchiolitis. Additional studies are required to explore the effect of chest physiotherapy on ambulatory populations and for infants without a history of atopy. ClinicalTrials.gov NCT00125450.

Effects of Intensive Physiotherapy in Infants Newly Diagnosed with Cerebral Palsy

Effects of Intensive Physiotherapy in Infants Newly Diagnosed with Cerebral Palsy

Effects of Intensive Physiotherapy in Infants Newly Diagnosed with Cerebral Palsy

This study was designed to examine effects of blocks of daily physiotherapy in 5 infants with cerebral palsy. A single-subject design was used. Intervention consisted of two 4-week periods of daily physiotherapy, interrupted by 8 weeks of physiotherapy as usual. The children were assessed every 4th week using the Gross Motor Function Measure. Results were visually analyzed, and statistical significance of Gross Motor Function Measure-66 scores was established with the 2 SD band method. Compliance was high. All infants showed gross motor progress compared with baseline, but separating effect of daily physiotherapy from physiotherapy as usual was inconclusive. Parents preferred the intensive treatment alternative. Blocks of intensive therapy can be an alternative to regular dosage of physiotherapy, but until further studies are conducted, the physiotherapy intervention, intensity, and frequency should be tailored to meet the needs of each individual infant and family.

Fractures costales au cours des bronchiolites aiguës virales : à propos de 2 cas

The 2000 French consensus conference for acute viral bronchiolitis management underlined the fundamental role of chest physiotherapy. According to Chalumeau and al., rib fractures were found out in 1/1000 children hospitalized for bronchiolitis or pneumonia. However, such complication of chest physiotherapy is exceptional. We report 2 cases with third to sixth lateral rib fractures after chest physiotherapy in infants with bronchiolitis. Despite the rarity of these complications, clinicians must keep in mind this etiology while facing rib fractures in infants.

Chest physiotherapy, gastro-oesophageal reflux, and arousal in infants with cystic fibrosis

Background: Postural drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard...

Benefits of music therapy as an adjunct to chest physiotherapy in infants and toddlers with cystic fibrosisResearch conducted at the Royal Children's Hospital, Victoria, Australia.Copies of the recorded music and questionnaires used in this study are available from the corresponding author.

Routine chest physiotherapy (CPT) is an important component of prophylactic therapy in children with cystic fibrosis (CF) and requires a significant commitment of time and energy. It is important, therefore, to establish CPT as a positive experience. In this study, we evaluated the effect of recorded music as an adjunct to CPT. Specifically, we compared the use of newly composed music, familiar music, and the family's usual routine on children's and parents' enjoyment of CPT and the parents' perception of time taken to complete CPT. Enjoyment and perception of time were evaluated via questionnaires designed specifically for this study. Participants were caregivers of one or more children with CF who were aged between 4½ months and 24 months at the commencement of the clinical trial and required CPT on a daily basis. Participants were randomly allocated into control and treatment groups. Control group participants experienced two conditions consecutively: no audiotape (NT; control) and familiar music tape (FT; placebo control). Treatment group participants were given the treatment music tape (TT), which was composed and compiled by a music therapist. After baseline assessment, evaluation occurred at two 6-weekly intervals. Children's enjoyment increased significantly after use of the TT (+1.25 units) compared to NT (−0.5 units; P = 0.03), as did parents' enjoyment (+1.0 vs. 0.0 units, P = 0.02). Children's enjoyment did not change significantly after use of the FT (+0.75 units) compared to NT (n.s.). Likewise, parents' enjoyment did not change significantly after use of the FT (+1.0 units, n.s.). There was no change in perception of time after use of the TT (−4.5 vs. +0.2 min, n.s.) or the FT (+3.3 min, n.s.). These results indicate that children's and parents' enjoyment of CPT significantly increased after the use of specifically composed and recorded music as an adjunct. We therefore recommend that recorded music, such as that provided in this study, be given to parents to use as an adjunct to CPT when their young children are diagnosed with CF, in order to assist the establishment of a positive routine. Pediatr Pulmonol. 2000; 29:371–381. © 2000 Wiley-Liss, Inc.

124. Contact-stimulating physiotherapy in infants with CF (birth to 2 years)

A new differential measurement method for a LAPS (light-addressable potentiometric sensor) has been developed and applied to fabricate an integrated taste sensor with artificial lipid membranes as the ion-sensitive material. The differential measurement procedure is based on a time-sharing technique, which makes it possible to achieve a very sensitive and highly stabilized response due to the noise-compensation effect. Sensitivity enhancement is further achieved by cancelling the base component of the differential response current. These techniques improve the sensitivity by at least two orders of magnitude compared to a conventional LAP system. The sensor shows highly sensitive responses to various taste substances, which makes it possible to identify a sweet taste through pattern-recognition routines. Miniaturization of the LAPS is also attained by using a small metal pseudo-reference electrode instead of a glass electrode.