A Collaborative Approach to Defining Neonatal Therapy

Sturdivant, Chrysty

doi:10.1053/j.nainr.2012.12.010

Cited by 15 publications

(21 citation statements)

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“…The overlap and duplication of interventions provided by neonatal therapists in the present study falls in line with previous reports aimed at defining and delineating the roles of neonatal therapists 41,46 . In 2012, the NANT Professional Collaborative, a group of neonatal therapists who work to help define guidelines for practice, found that practice guidelines outlining the role of each neonatal therapist exhibit overlap of skills, but also illustrate skills unique to their scope of practice; an important distinction when many institutions view some of the therapy disciplines as interchangeable 41,46 . Just as therapists working with other populations have a unique role to play in the rehabilitation process, each therapy discipline has a unique role in optimizing outcomes of vulnerable preterm infants in the NICU.…”

Section: Discussionsupporting

confidence: 89%

“…While the role of OT, PT, and SLP has been well described in the literature 41 , no studies to date have reported neonatal therapy usage in a US-based, level IV NICU. In the current study, 100% of infants received PT, 100% received OT, and 51% received SLP in the NICU.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the vulnerability of premature infants, NICU-based therapists necessitate advanced skills to optimize outcomes of the infant, while understanding and adapting to medical interventions that occur simultaneous to therapy interventions 29,35,38–40 . Despite the growing number of therapists involved in treating infants in the NICU 41 and growing evidence on the benefits of specific interventions, no studies to our knowledge have identified the usage of therapy services in the NICU.…”

Section: Introductionmentioning

confidence: 99%

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Occupational therapy, physical therapy and speech-language pathology in the neonatal intensive care unit: Patterns of therapy usage in a level IV NICU

Ross¹,

Heiny²,

Conner

et al. 2017

Research in Developmental Disabilities

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Objectives 1) To describe the use of occupational therapy (OT), physical therapy (PT) and speech-language pathology (SLP) services in a level IV neonatal intensive care unit (NICU), 2) to describe predictors of early therapy usage, and 3) to test the hypothesis that more NICU-based therapy will relate to better neurobehavioral outcomes. Methods Seventy-nine infants born ≤ 32 weeks gestation had therapy interventions, as standard of care, tracked across NICU hospitalization. Infants received neurobehavioral testing prior to NICU discharge. Results All (100%) received OT and PT, and 41 (51%) received SLP. The average age at initiation of OT, PT, and SLP was 30.4 ± 1.4, 30.3 ± 1.4, and 35.9 ± 2.3 weeks postmenstrual age, respectively. Infants received therapy an average of 1.8 ± .44, 1.8 ± .4 and 1.1 ± .53 times per week for OT, PT and SLP, respectively. There were 56 different therapeutic interventions performed. There was overlap in the interventions provided by different NICU therapists; however, interventions unique to each discipline were identified. More therapy was not related to better neurobehavioral outcomes, but rather more frequent therapy could be attributed to more complex medical conditions (p<0.05). Conclusion Early therapy services in the NICU can start early in gestation and continue routinely until NICU discharge in order to optimize outcomes. These findings can aid our understanding of how neonatal therapy services are implemented in a level IV NICU.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Occupational therapy, physical therapy and speech-language pathology in the neonatal intensive care unit: Patterns of therapy usage in a level IV NICU

Ross¹,

Heiny²,

Conner

et al. 2017

Research in Developmental Disabilities

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“…By extending services earlier, it is plausible that more marked improvements in optimizing outcomes can be made. In addition, the use of neonatal therapists in the NICU is increasing (Sturdivant, 2013). At the study site, a dynamic team of OTs, PTs, and SLPs provided services to the infants daily during hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Early Therapy Services Following Neonatal Intensive Care Unit Discharge

Nwabara

Rogers

Inder

et al. 2016

Physical & Occupational Therapy In Pediatrics

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Aims To (1) characterize early therapy services for preterm infants in the first two years of life, and (2) define factors related to accessing early therapy services. Methods Therapy utilization after discharge from the neonatal intensive care unit (NICU) was tracked in 57 infants born ≤30 weeks gestation from 2007 to 2010. Participants returned for developmental testing at two years. Factors related to early therapy utilization were explored. Results Fifty-two (91%) infants received a referral for therapy at NICU discharge but only 44 (77%) received at least one type of therapy during the first two years of life. Infants who received early therapy services were more likely to have more days on ventilation (p = .005), have single mothers (p = .047), and exhibit abnormal neurobehavior at term equivalent age (p = .03). On average, infants first received occupational therapy at a mean age of 5.1±4.6 months with a median of 2.6 (1.3–9.0), physical therapy at a mean age of 4.3 ± 4.1 months with a median of 3.7 (0.1–5.5), and speech-language pathology services at a mean age of 14.0±6.1 months with a median of 15.0 (11.3–17.7) months corrected age. Of the 13 children who did not receive any therapy in the first two years after NICU discharge, seven (53%) had a developmental delay at an age of two years. Conclusions In spite of high referral rates for therapy services, there is a delay in therapy activation following NICU discharge, and some infants who warrant services do not obtain them.

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“…Multidisipliner ekipte yeni doğan uzmanları ve iliş-kili tıp ve sağlık profesyonellerinin yanı sıra neonatal terapistler olarak adlandırılan fizyoterapist, ergoterapist, konuşma-dil patolojilerini tedavi eden terapistler de yer almalıdır. Neonatal terapistler özellikle yenidoğan yoğun bakım ünitesinde (YYBÜ) prematür ve tıbbi komplikasyonlu yeni doğanlara holistik ve konsultatif tedavi veren; entegre, nöroprotektif, aile merkezli model kullanan, ileri uzmanlık gerektiren ve olgu tabanlı uygulamalar yapan profesyonellerdir (2). Yeni doğan fizyoterapi ve rehabilitasyonu, nörolojik gelişimsel problemlerin sıklığı nedeni ile nörolojik fizyoterapi klinisyenlerine özgü bilinse de, sözü edilen fizyoterapistlerin yeni doğan solunum problemlerini kardiyopulmoner fizyoterapi klinisyenleri ile intradisipliner çalışmasını gerektirir.…”

Section: Introductionunclassified

Pulmonary Rehabilitation in Newborns

Yurdalan¹

2015

Toraks Cer Bult

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Pulmonary Rehabilitation (PR) is clinically recognized in newborns and clinics and intensive care units that are related with neonatal management. The primary problems in the scope of PR seen in newborns are respiratory distress syndrome, hyalin membrane disease, post-extubation collapse, bronchopulmonary dysplasia, congenital diaphragmatic hernia, congenital heart diseases, and cardiac surgery complications. It is essential to initiate a physiotherapy program in 48 hours in newborn intensive care units with frequent and close patient follow-up. On the grounds that cases involve newborns, developmental-themed and holistic approaches are required. Positioning, percussion techniques, range of motion exercises, oxygen treatment, and positive pressure resuscitator are routines followed in clinics in newborns with PR. Casespecific physiotherapy and a rehabilitation program in ventilated newborns and/or those developing complications are performed with continual monitoring of blood pressure, pulmonary variables, and blood gases. Due to more complicated clinical progress of pulmonary problems in risky, premature, and low birth weight newborns, contents of PR should be configured as instantaneously adjustable to clinical variables. These type of cases should be followed-up in school age and the years ahead in terms of the developmental aspect. Trendelenburg position in chest physiotherapy of newborns must be restricted because of the high risk of intracranial pressure increase, pneumonia risk due to gastroesophageal reflux, and even cerebral hemorrhages may be caused in babies weighing lower than 1500 g if it is applied in the first 3 days of birth. Precautions should be taken in bronchial drainage and supplementary oxygen use due to the severe problems that they can cause. For newborns with increased survivability and with development in neonatology, support of neonatal therapists with further knowledge, clinical investigations, and practical experiences will increase the treatment success of the newborn multidisciplinary team. Keywords: Neonate, pulmonary rehabilitation, neonatal intensive care unit, chest physiotherapy Özet Pulmoner Rehabilitasyon (PR) yeni doğanlarda ve yeni doğan tedavisinin yürütüldüğü yeni doğan ünite ve yoğun bakım birimlerinde klinik kabul görmektedir. Yeni doğanlarda PR problemleri kapsamında Respiratuar Disstres Sendromu, hyalin membran hastalığı, postekstü-basyon kollaps, bronkopulmoner displazi, konjenital diafragmatik herniler, doğumsal kalp hastalıkları ve kardiyak cerrahi komplikasyonları öncelikli sayılabilir. Yeni doğan yoğun bakım ünitesinde (YYBÜ) fizyoterapiye 48 saat içinde başlanarak, sık ve yakın hasta takibi zorunludur.Yeni doğan olması nedeniyle olgulara gelişimsel temalı ve bütüncül yaklaşımlar gerekir. Pulmoner rehabilitasyon kapsamında yeni doğanlarda pozisyonlama, perküsif teknikler, eklem açıklığı egzersizleri, oksijen tedavisi ve pozitif solutucular klinik rutindedir. Olguya özelleştirilmiş fizyoterapi ve rehabilitasyon ventile edilen ve/ veya komplikasyon gelişmi...

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A Collaborative Approach to Defining Neonatal Therapy

Cited by 15 publications

References 4 publications

Occupational therapy, physical therapy and speech-language pathology in the neonatal intensive care unit: Patterns of therapy usage in a level IV NICU

Occupational therapy, physical therapy and speech-language pathology in the neonatal intensive care unit: Patterns of therapy usage in a level IV NICU

Early Therapy Services Following Neonatal Intensive Care Unit Discharge

Pulmonary Rehabilitation in Newborns

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