Effect of Chest Physiotherapy on the Development of Preterm Infants.
NCT ID: NCT04689386
Last Updated: 2025-03-27
Study Results
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Basic Information
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COMPLETED
NA
51 participants
INTERVENTIONAL
2021-02-26
2024-12-31
Brief Summary
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This application will be carried out in preterm infants of less than 32 weeks of gestation with neonatal respiratory distress syndrome (SDR) and carriers of mechanical ventilation. The intervention will take place in the neonatal intensive care unit (NICU) The intervention period is one month (4 weeks) and different follow-ups will be carried out at term age, at 3, 6, 9 and 12 months of corrected age.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Group I Stimulation of "reflex rolling" from the Vojta method
Group I (GE-I) - Stimulation of "reflex rolling" from the Vojta method
This manoeuvre does not require the newborn to be moved, but only a slight rotation of the head towards the side from which the stimulus is delivered. The starting position for performing the first phase of reflex rolling is the asymmetric supine position, with the limbs freely lying on the resting surface.
A digital pressure will exert on the chest area, where the mammillary line crosses the insertion of the diaphragm, either at the level of the 6th rib, or between the 5th and the 6th, or between the 6th and the 7th. A one minute stimulus will be performed on each side. The intervention will be repeated twice a day, ensuring that the period between one intervention and another is at least two hours.
Group II Expiratory flow increase technique
Group II (GE-II) - expiratory flow increase technique
The technique adapted to the premature infant will be performed. This maneuver consists of slowly applying light pressure to the infant's chest with one hand, obliquely, starting from the end of the inspiratory plateau until the end of expiration, which is prolonged. The hand should be placed between the sternal notch and the xiphoid process of the newborn's sternum. The therapist's other hand is placed on the last ribs (without applying pressure) as a bridge, of which the columns are the thumb and forefinger (or middle finger). Therefore, contact with the infant's abdomen is avoided and the expansion of the lower rib is limited, allowing a better displacement of the diaphragm and avoiding an increase in intra-abdominal pressure. The maneuver will be repeated three times, respecting the infant's responses and their physiological constants. The intervention will be repeated twice a day, trying to ensure that the period between one intervention and another is at least 2 hours.
Control Group
Routine intervention in the NICU with mechanical ventilation.
No interventions assigned to this group
Interventions
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Group I (GE-I) - Stimulation of "reflex rolling" from the Vojta method
This manoeuvre does not require the newborn to be moved, but only a slight rotation of the head towards the side from which the stimulus is delivered. The starting position for performing the first phase of reflex rolling is the asymmetric supine position, with the limbs freely lying on the resting surface.
A digital pressure will exert on the chest area, where the mammillary line crosses the insertion of the diaphragm, either at the level of the 6th rib, or between the 5th and the 6th, or between the 6th and the 7th. A one minute stimulus will be performed on each side. The intervention will be repeated twice a day, ensuring that the period between one intervention and another is at least two hours.
Group II (GE-II) - expiratory flow increase technique
The technique adapted to the premature infant will be performed. This maneuver consists of slowly applying light pressure to the infant's chest with one hand, obliquely, starting from the end of the inspiratory plateau until the end of expiration, which is prolonged. The hand should be placed between the sternal notch and the xiphoid process of the newborn's sternum. The therapist's other hand is placed on the last ribs (without applying pressure) as a bridge, of which the columns are the thumb and forefinger (or middle finger). Therefore, contact with the infant's abdomen is avoided and the expansion of the lower rib is limited, allowing a better displacement of the diaphragm and avoiding an increase in intra-abdominal pressure. The maneuver will be repeated three times, respecting the infant's responses and their physiological constants. The intervention will be repeated twice a day, trying to ensure that the period between one intervention and another is at least 2 hours.
Eligibility Criteria
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Inclusion Criteria
* Admitted to the NICU
* With SDR
* Hemodynamically stable
* Stable convulsive pictures
* Controlled thermoregulation
* Mechanical ventilation (invasive or non-invasive)
* Parents / guardians of legal age, with sufficient cognitive ability to understand consent
* Signature of consent
Exclusion Criteria
* Grade III and IV intraventricular hemorrhage
* Rib fracture
* Asphyxia at birth
* Necrotizing enterocolitis \> or = II B
Abandoned Criteria:
* Appearance of any of the complications mentioned above
* Hospital transfer
* Hospital discharge (if the intervention at home cannot be followed)
* Voluntary decision of parents / guardians to abandon the study
* Medical decision
ALL
No
Sponsors
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Fundación para la Salud Infantil de la Comunidad Valenciana
UNKNOWN
Universidad de Murcia
OTHER
Responsible Party
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Ana Igual Blasco
Degree in Physiotherapy
Locations
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Hospital General Universitario de Elche
Elche, Alicante, Spain
Hospital Universitario Torrecárdenas
Almería, Almería, Spain
Hospital Clínico Universitario Virgen de la Arrixaca
El Palmar, Murcia, Spain
Countries
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References
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Other Identifiers
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74244433
Identifier Type: -
Identifier Source: org_study_id
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