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.