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VOLUME 17 , ISSUE 6 ( December, 2013 ) > List of Articles


Practice patterns of physiotherapists in neonatal intensive care units: A national survey

Shyam Krishnan, Tejas Chokshi, Gopala Krishna Alaparthi, K. Vaishali, C.P. Zulfeequer

Keywords : Chest physiotherapy, early intervention, neonatal intensive care unit, neuromuscular physiotherapy, survey

Citation Information : Krishnan S, Chokshi T, Alaparthi GK, Vaishali K, Zulfeequer C. Practice patterns of physiotherapists in neonatal intensive care units: A national survey. Indian J Crit Care Med 2013; 17 (6):359-366.

DOI: 10.4103/0972-5229.123448

License: CC BY-ND 3.0

Published Online: 01-09-2014

Copyright Statement:  Copyright © 2013; The Author(s).


Objective: To determine practice pattern of physiotherapists in the neonatal intensive care units (ICUs) in India with regards to cardiopulmonary and neuromuscular physiotherapy. Materials and Methods: A cross-sectional survey was conducted across India, in which 285 questionnaires were sent via e-mail to physiotherapists working in neonatal intensive care units. Results: A total of 139 completed questionnaires were returned with a response rate of 48.7%, with a majority of responses from Karnataka, Maharashtra and Gujarat. More than 90% of physiotherapists performed chest physiotherapy in neonatal ICUs. Chest physiotherapy assessment predominantly focused on vital parameter assessment (86%) and in treatment predominantly focused on percussion (74.1%), vibration (75.5%), chest manipulation (73.3%), postural drainage (67.6%) and suction (65.4%). In neuromuscular physiotherapy more than 60% of physiotherapists used positioning, and parent education, whereas more than 45% focused on passive range of motion exercise and therapeutic handling. Conclusion: The practice pattern of physiotherapists for neonates in neonatal intensive care units involves both chest physiotherapy as well neuromuscular physiotherapy. Chest physiotherapy assessment focused mainly on vital parameter assessment (heart rate, respiratory rate and partial pressure of oxygen saturation SpO 2 ). Treatment focused on airway clearance techniques including percussion, vibration, postural drainage and airway suction. In neuromuscular physiotherapy most physiotherapists focused on parent education and passive range of motion exercise, therapeutic handling, as well as positioning.

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  1. Karlsen KA. National survey to describe the workforce of neonatal transport in the United States. 2007 Dec; Available from:, [Last cited on 2007 Dec].
  2. Smith M, Ball V. The neonatal unit and specialist support. In: Chapman J, Parker A, Yeo L, editors. Cash′s textbook of cardiovascular/respiratory physiotherapy. London: Elsevier; 1998. p. 305.
  3. Bertone N. The role of physiotherapy in a neonatal intensive care unit. Aust J Physiother 1988;34:27-34.
  4. Kilegman RM, Stanton BM, Geme J, Schor N, Behrman RE. Neuromuscular disorder. In: Sarnat HB, editor. Nelson Textbook of Pediatrics. 19 th ed. Philadelphia: Elsevier; 2011. p. 2109-47.
  5. Mahoney M, Cohen MI. Effectiveness of developmental intervention in the neonatal intensive care unit: Implication for neonatal physical therapy. Paediatr Phys Ther 2005;17:194-208.
  6. Giannantonio C, Papacci P, Ciarniello R, Tesfagabir MG, Puraco V, Cota F, et al. Chest physiotherapy in preterm infants with lung diseases. Ital J Paediatr 2010;36:1-5.
  7. Main E, Castle R, Newham D, Stock J. Respiratory physiotherapy vs. suction the effects on respiratory function in ventilated infants and children. Intensive Care Med 2004;30:1144-51.
  8. Sweeney JK, Heriza CB, Blanchard Y, Dusing S. Neonatal physical therapy. Part I: Clinical competencies and neonatal intensive care unit clinical training models. Peadiatr Phys Ther 2009;21:296-307.
  9. McManus BM, Chambliss JH, Rapport MJ. Application of the NICU practice guidelines to treat an infant in a level III NICU. Peadiatr Phys Ther 2013;25:204-13.
  10. Dusing SC, Van Drew CM, Brown SE. Instituting parent education practices in the neonatal intensive care unit: An administrative case report of practice evaluation and statewide action. Phys Ther 2012;92:967-75.
  11. Byrne E, Garber J. Physical therapy intervention in the neonatal intensive care unit. Phys Occup Ther Pediatr 2013;33:75-110.
  12. Umphred DA. Neurological rehabilitation. In: Sweeney JK, editor. Neonatal and infants at neurodevelopment risk. 5 th ed. USA: Elsevier; 2007. p. 303-56.
  13. Norrenberg M, Vincent JL. A profile of European intensive care unit physiotherapists. Intensive Care Med 2000;26:988-94.
  14. Lewis M. Intensive care unit rehabilitation within the United Kingdom. Phys Ther 2003;89:531-8.
  15. Chaboyer W, Gass E, Foster M. Patterns of chest physiotherapy in Australian intensive care units. J Crit Care 2004;19:145-51.
  16. Kumar JA, Maiya AG, Pereira D. Role of physiotherapist in intensive care unit of India: A multicenter survey. Indian J Crit Care Med 2007;11:198-203.
  17. Hodgin KW, Craft AN, Mcfarin KK, Mealer ML, Moss M. Physical therapy utilization in intensive care units: Results from national survey. Crit Care Med 2009;37:561-8.
  18. Jingar A, Alaparthi GK, Vaishali K, Krishnan S, Zulfeequer, Unnikrishnan B. Clinical practices adopted by physiotherapists in India for chronic obstructive pulmonary disease: A national survey. Lung India 2013;30:131-8.
  19. Kisner C, Colby LA. Management of pulmonary conditions. In: editor. Therapeutic exercise foundation and techniques. 5 th ed. Philadephia: Jaypee Brothers; 2007. p. 851-82.
  20. Shapiro BA, Kacmarek RM, Cane RD, Peruzzi WT, Hauptman D. Humidity and aerosol therapy. Clinical application of respiratory care. 4 th ed. St. Louis: Mosby; p. 57-73.
  21. Sweeney JK, Heriza CB, Blanchard Y, Dusing S. Neonatal physical therapy. Part II: Practice frameworks and evidence based practice guidlines. Peadiatr Phys Ther 2010;22:2-16.
  22. Tecklin JS. Pediatric physical therapy. In: Barnes DV, Wood A, editors. The infant at high risk for developmental delay. 4 th ed. USA: Lippincott Williams and Willkins; 2008. p. 101-75.
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