title: Chest physiotherapy in preterm infants with lung diseases.
abstract: BACKGROUND
  In neonatology the role of chest physiotherapy is still uncertain because of the controversial outcomes.
  
  
  METHODS
  The aim of this study was to test the applicability in preterm infants of 'reflex rolling', from the Vojta method, in preterm neonates with lung pathology, with particular attention to the effects on blood gases and oxygen saturation, on the spontaneous breathing, on the onset of stress or pain. The study included 34 preterm newborns with mean gestational age of 30.5 (1.6) weeks - mean (DS) - and birth weight of 1430 (423) g - mean (DS) -, who suffered from hyaline membrane disease, under treatment with nasal CPAP (continuous positive airways pressure), or from pneumonia, under treatment with oxygen-therapy. The neonates underwent phase 1 of 'reflex rolling' according to Vojta method three times daily. Respiratory rate, SatO2, transcutaneous PtcCO2 e PtcO2 were monitored; in order to evaluate the onset of stress or pain following the stimulations, the NIPS score and the PIPP score were recorded; cerebral ultrasound scans were performed on postnatal days 1-3-5-7, and then weekly.
  
  
  RESULTS
  In this population the first phase of Vojta's 'reflex rolling' caused an increase of PtcO2 and SatO2 values. No negative effects on PtcCO2 and respiratory rate were observed, NIPS and PIPP stress scores remained unmodified during the treatment; in no patient the intraventricular haemorrhage worsened in time and none of the infants developed periventricular leucomalacia.
  
  
  CONCLUSIONS
  Our experience, using the Vojta method, allows to affirm that this method is safe for preterm neonates, but further investigations are necessary to confirm its positive effects and to evaluate long-term respiratory outcomes.
authors.affiliation: Department of Paediatrics, Division of Neonatology, Sacro Cuore Catholic University, Largo Francesco Vito 1, Rome, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Giannantonio
authors.forename: Patrizia
authors.initials: P
authors.lastname: Papacci
authors.forename: Roberta
authors.initials: R
authors.lastname: Ciarniello
authors.forename: Mikael Ghennet
authors.initials: MG
authors.lastname: Tesfagabir
authors.forename: Velia
authors.initials: V
authors.lastname: Purcaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Cota
authors.forename: Carla Maria
authors.initials: CM
authors.lastname: Semeraro
authors.forename: Costantino
authors.initials: C
authors.lastname: Romagnoli
mesh_terms: D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000097:blood; D045422:Continuous Positive Airway Pressure; D005260:Female; D006257:Head; D006801:Humans; D006819:Hyaline Membrane Disease / Q000503:physiopathology / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D010812:Physical Stimulation; D026741:Physical Therapy Modalities; D011014:Pneumonia / Q000503:physiopathology / Q000628:therapy*; D012018:Reflex; D056152:Respiratory Rate; D012399:Rotation
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen