Chest Physiotherapy: A Neonatologist’s Perspective on the Role of Physiotherapy in NICU

Published on: 2017/05/01

Dr. S. M. Dhaded,  Professor, Department of PaediatricsJawaharlal Nehru Medical College, Belgaum, India


Physiotherapist is an important team member in the management of a high risk neonate especially those with severe respiratory and neurological complications. Our experience with babies receiving Chest physiotherapy in the NICU has shown to be beneficial in terms of early weaning from ventilator, improved oxygenation and decrease the length of stay in the hospital. This, in turn, has been beneficial for parents in terms of cost and early recovery which decreases the stress level of parents.

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Chest physiotherapy, NICU

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Chest physiotherapy in NICU

The role of a Neonatal physiotherapist is to look after the medical care of newborn babies who may be at the risk of movement or developmental difficulties. These problems may arise during or after the birth of the child and are associated with joints or muscles that inhibit movement. The physiotherapist may watch the baby’s movements when they are awake, placing them on the back or side to check for movement and strength.

The NICU or neonatal Intensive care unit is an ICU dedicated to babies that are critically ill or receiving diagnostic, therapeutic or life support care. Babies who are born preterm, born with low birth weight, congenital abnormalities, respiratory disorders, or neuromuscular disorders are placed in the NICU.

Neonatologists diagnose and treat newborns with breathing disorders, infections, and birth defects. They coordinate care and medically manage premature newborns, make sure that critically ill newborns receive proper nutrition, stabilize and treat babies with a life-threatening illness.

Chest physiotherapy in NICU is performed to help patients breathe more freely and get oxygen flowing into their bodies. Good respiratory health depends on a clear airway. Poor lung health can lead to a lot of diseases or disabilities.

The common techniques used in chest physiotherapy are percussion, vibration, positioning for postural drainage, and airway suctioning. This helps in clearing the airways, maintain levels of oxygen and help in early weaning. Chest physiotherapy is usually done in combination with other methods of treatments like suctioning, nebulizer treatment or the use of other drugs.

Importance of chest physiotherapy in NICU

Chest physiotherapy in the NICU has helped a lot of babies wean sooner from ventilators, develop better oxygenation and reduced the stay time at hospitals. This also benefits the parents by reducing costs and helps the child recovery sooner, reducing the stress levels of parents or caregivers. This is a personalized form of treatment that greatly depends on the condition of each child. It has been observed that chest physiotherapy has helped infants with Erb’s palsy, feeding difficulties, and joint stiffness.

In the cases where there is neuromuscular dysfunction, common methods include kangaroo care, motion exercises, hydrotherapy etc. The physiotherapy helps in promoting proper posture and movement corresponding to the gestational age, physiological stability, infant-parent attachment, oral motor deficits etc.

Physiotherapy helps with problems with the joints, muscles or posture by observing the movement of the child’s joints and evaluates how strong the muscles are. Physical therapy focuses on physical rehabilitation and helps children who need assistance with balance, muscle control, and milestones.

Read more – A Neonatologist’s Perspective on the Role of Physiotherapy in NICU