Back to the liquid environment: effects of aquatic physiotherapy intervention performed on preterm infants

Abstract At birth, preterm newborns (PTNB) often require Neonatal-ICU hospitalization, which, despite being a care setting, also causes stress such as pain, sleep disturbances and wakefulness, and alterations of physiological parameters. The aim of this study was to analyze the effects of aquatic physiotherapy on pain, sleep disturbances and wakefulness, and physiological variables of PTNB in Neonatal-ICU. Pain, sleep disturbances and wakefulness, and alterations of physiological parameters were evaluated at three moments: 5 minutes before intervention, immediately after and 10 minutes after intervention. At intervention, participants were wrapped in soft fabric and immersed at shoulder level in warm water (36 ° C to 37.5 ° C). Sideways, forward, backward and rotational movements were performed. Twenty-two newborns participated in the study. The results obtained in relation to pain, sleep state and wakefulness showed significant improvements in reevaluations after intervention. Physiological variables also underwent significant changes and remained within normality parameters. The results indicate that aquatic physiotherapy is effective in reducing pain, improving sleep and wakefulness and physiological variables of PTNB in Neonatal-ICU.

摘要
早产新生儿（preterm newborns, PTNB）出生后常需入住新生儿重症监护室（Neonatal Intensive Care Unit, NICU）。尽管该场所属于临床照护环境，但仍会引发疼痛、睡眠障碍、觉醒异常及生理参数改变等应激反应。本研究旨在探讨水中物理疗法对新生儿重症监护室内早产新生儿的疼痛、睡眠障碍、觉醒异常及生理变量的影响。
研究分别于干预前5分钟、干预即刻及干预后10分钟三个时间点，对疼痛、睡眠障碍、觉醒异常与生理参数改变情况开展评估。干预期间，受试新生儿以柔软织物包裹，肩部以下浸入温度为36℃至37.5℃的温水中，并完成侧向、前后及旋转运动。本研究共纳入22名新生儿。
针对疼痛、睡眠状态及觉醒情况的评估结果显示，干预后的复测指标均获得显著改善。生理变量同样出现显著变化，且均维持在正常参考范围内。研究结果表明，水中物理疗法可有效减轻新生儿重症监护室内早产新生儿的疼痛症状，改善其睡眠与觉醒状态及生理变量。