Background: the progress of medical care techniques has allowed an increase in the survival of children born preterm, who are affected by an alteration of neuromotor, cognitive and behavioral development. The figure of the physiotherapist in the NICU is still little involved and encouraged, despite that his intervention could support and improve development trajectories. Purpose: the primary purpose of this study was to investigate the validity of an early enabling intervention in the premature newborn during hospitalization in the NICU, to highlight the role of physiotherapy in the neuropsychomotor development and the parent’s involvement. Materials and methods: a bibliographic search was carried out from March 2023 to July 2023, in the PubMed and Cochrane Library databases, searching for studies dating back to the last 5 years (2018-2023). According to the inclusion and exclusion criteria, the search led to the identification of 10 RCT studies. The studies were then subjected to a quality assessment according to the PEDro scale. Results: the studies present in the literature do not demonstrate significant differences between the experimental and control groups in the various interventions carried out, however a more in-depth analysis of the results brings to light some significant improvements in the neuropsychomotor development of the premature newborn, particularly in gross motor skills. The importance of the involvement and active participation of the parental figure in the habilitative treatment is also highlighted. However, the results cannot be defined as exhaustive and satisfactory due to the small amount of evidence, small population involved, lack of unambiguity and homogeneity of the intervention models, treatment, follow up times and outcome measures. Conclusions: early enabling intervention could be proposed in clinical practice and in the management of preterm newborns as results have been achieved which demonstrate the optimization of development, as well as the promotion of the well-being of the family unit. However, it proves necessary to carry out further studies to identify more evidence and define more precisely the roles, tasks and intervention models of the physiotherapist.
-Background: il progresso e il potenziamento delle tecniche assistenziali in campo medico, ha permesso un incremento della sopravvivenza di bambini nati pretermine all’interno di realtà come la Terapia Intensiva Neonatale (TIN), determinando parallelamente l’aumento dello sviluppo di disabilità neuromotorie, cognitive e comportamentali. La figura del fisioterapista all’interno delle TIN ad oggi è ancora poco coinvolta ed incentivata, nonostante il suo intervento di abilitazione possa sostenere e migliorare le traiettorie dello sviluppo. Scopo: comprendere la validità di un intervento abilitativo precoce nel neonato prematuro durante il ricovero in TIN, evidenziando le potenzialità e i ruoli che potrebbe assumere la figura del fisioterapista al suo interno, ai fini di promuovere e sostenere lo sviluppo neuropsicomotorio, incentivare il ruolo delle figure genitoriali e il benessere del nucleo famigliare. Materiali e metodi: è stata effettuata una ricerca bibliografica da Marzo 2023 a Luglio 2023, nelle banche dati PubMed e Cochrane Library, ricercando studi risalenti agli ultimi 5 anni (2018-2023). Secondo i criteri di inclusione ed esclusione, la ricerca ha conseguito all’individuazione di 10 studi RCT. Gli studi sono stati quindi sottoposti ad una valutazione della qualità secondo la scala PEDro. Risultati: gli studi presenti in letteratura non dimostrano significative differenze tra il gruppo sperimentale e di controllo nei diversi interventi effettuati, tuttavia un’analisi più approfondita dei risultati porta alla luce alcuni significativi miglioramenti nello sviluppo neuropsicomotorio del neonato prematuro, in particolar modo nelle capacità grosso motorie. Si evidenzia inoltre l’importanza del coinvolgimento e della partecipazione attiva della figura genitoriale nel trattamento abilitativo. Tuttavia i risultati non possono esser definiti esaustivi e soddisfacenti a causa del ridotto numero di evidenze, ridotta popolazione coinvolta, mancanza di univocità ed omogeneità dei modelli di intervento, trattamento, tempi di follow up e misure di outcome. Conclusioni: l’intervento abilitativo precoce può essere proposto nella pratica clinica e nella gestione del neonato pretermine in quanto sono stati conseguiti risultati che dimostrano l’ottimizzazione dello sviluppo, oltre alla promozione del benessere del nucleo famigliare. Tuttavia si dimostra necessario svolgere ulteriori studi per individuare maggiori evidenze e definire con maggior precisione i ruoli, compiti e modelli di intervento del fisioterapista.
Il ruolo dell'intervento abilitativo fisioterapico nella presa in carico del neonato pretermine in Terapia Intensiva Neonatale: revisione narrativa della letteratura
ZANETTI, SARA
2022/2023
Abstract
Background: the progress of medical care techniques has allowed an increase in the survival of children born preterm, who are affected by an alteration of neuromotor, cognitive and behavioral development. The figure of the physiotherapist in the NICU is still little involved and encouraged, despite that his intervention could support and improve development trajectories. Purpose: the primary purpose of this study was to investigate the validity of an early enabling intervention in the premature newborn during hospitalization in the NICU, to highlight the role of physiotherapy in the neuropsychomotor development and the parent’s involvement. Materials and methods: a bibliographic search was carried out from March 2023 to July 2023, in the PubMed and Cochrane Library databases, searching for studies dating back to the last 5 years (2018-2023). According to the inclusion and exclusion criteria, the search led to the identification of 10 RCT studies. The studies were then subjected to a quality assessment according to the PEDro scale. Results: the studies present in the literature do not demonstrate significant differences between the experimental and control groups in the various interventions carried out, however a more in-depth analysis of the results brings to light some significant improvements in the neuropsychomotor development of the premature newborn, particularly in gross motor skills. The importance of the involvement and active participation of the parental figure in the habilitative treatment is also highlighted. However, the results cannot be defined as exhaustive and satisfactory due to the small amount of evidence, small population involved, lack of unambiguity and homogeneity of the intervention models, treatment, follow up times and outcome measures. Conclusions: early enabling intervention could be proposed in clinical practice and in the management of preterm newborns as results have been achieved which demonstrate the optimization of development, as well as the promotion of the well-being of the family unit. However, it proves necessary to carry out further studies to identify more evidence and define more precisely the roles, tasks and intervention models of the physiotherapist.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/58549