Introduction: Expiratory flow increase is a maneuver of respiratory physical therapy that promotes flow direction to the upper airways however, when applied in newborns, it may result in changes of thoracoabdominal mobility. Objective: To evaluate the thoracoabdominal mobility by photogrammetry in newborns after expiratory flow increase technique. Methods: Experimental blind study performed with newborns in supine position on a support table with upper limbs flexed, abducted and externally rotated and hip flexed at 110°. Adhesive markers were allocated for geometric delimitation of the thoracoabdominal compartment and expiratory flow increase technique was performed for 5 minutes with the therapist's hands on the thorax and abdomen. Newborns were filmed before and after the maneuver and the frames were analyzed in AutoCAD ® software by a blinded investigator at the time of the procedure. The largest and the smallest thoracoabdominal area were expressed in cm 2 and the mean values were compared between two moments (pre and post maneuver) by paired t test. Results: Twenty newborns with a mean age of 39 weeks were included. Before the maneuver, thoracoabdominal area was 56.1 cm 2 during expiration and 59.7 cm 2 during inspiration, and after the maneuver the value was 56.2 cm 2 during expiration and 59.8 cm 2 during inspiration,
Introduction: Previous studies have shown music therapy as a way to improve the clinical status of premature infants, improving vital signs and decreasing crying episodes. Objective: Compare the effects of music on vital signs of premature infants undergoing respiratory physiotherapy. Methods: We performed a randomized clinical trial consisting of 26 premature infants, divided into control group (N=12) and study group (N=14), carried out in a Neonatal Intensive Care Unit. All newborn infants undergone standard practice physiotherapy for 15 minutes: vibration and aspiration. On the study group they were exposed to classical music three minutes before the standard physiotherapy, and finished three minutes after the end of these procedures. A recorder was placed inside the incubator with an intensity of 25 decibels. Measurements of heart and respiratory rate and oxygen saturation were measured before, during and after each sessions of respiratory physiotherapy for two groups. Results: When comparing control and study groups regarding heart rate frequency and oxygen saturation, there was no statistically significant difference, but the inclusion of music determined clinically the variability of these data and 30% of the variation in respiratory rate was due to the inclusion of music during and after the physiotherapy, and the neonatal noninvasive ventilation showed less variation in their respiratory rate when compared to the neonatal on oxygen therapy. Conclusion: The results have showed a beneficial effect of music, showing lower respiratory rate in newborn infants during and after respiratory physiotherapy procedure.
Objective. The present study is aimed at assessing heart rate variability (HRV) and its correlation with visual acuity (VA) assessment of preterm newborns (PTNB) in neonatal intensive care units. Method. Cross-sectional study analyzing HRV during assessment of VA with the aid of a Polar RS800CX heart rate monitor (Polar Electro Oy, Finland). HRV was analyzed according to time and frequency domains and the chaos domain used the autocorrelation coefficient and entropy. The sample consisted of hospitalized PTNB, and static analysis included simple regression diagnosis. Results. A total of 14 PTNB were included in the sample. VA varied between 0.23 and 1.60 cpd, and only five PTNB obtained below-expected values for age. Statistical analysis demonstrated a negative correlation between VA and time domain (SDDN and SD2) and a positive correlation between frequency domain (heart rate and hertz), but in simple linear regression analysis, these variables did not influence VA. Conclusion. The results of the study demonstrate that visual acuity was inversely correlated with SDNN and SD2 and during stimulation, showing that the higher the visual performance, the lower the autonomic modulation response.
Introdução: Considerando a alta complacência da caixa torácica em recém-nascidos, as manobras de fisioterapia, quando aplicadas sobre o tórax, devem ser corretamente indicadas e avaliadas, por meio de instrumentos fidedignos e não invasivos, a fim de assegurar a sua eficácia e segurança. Objetivo: Avaliar a mobilidade toracoabdominal pela biofotogrametria (MT) em recém-nascidos após as manobras de vibrocompressão (VC) e Reequilíbrio Toracoabdominal (RTA). Métodos: A análise foi realizada em 40 recém-nascidos, com idade > 37 semanas, em posição supina, membros superiores em flexão, abdução e rotação externa e quadril flexionado. Cada recém-nascido realizou um tipo de manobra (VC ou RTA) e foi filmado por 60 segundos antes e após a terapia, por uma câmera digital perpendicular ao plano de movimento. A análise biofotogramétrica foi realizada pelo Software AutoCAD® e os resultados foram convertidos para unidades métricas (cm2). Resultados: A manobra de RTA aumentou a amplitude do movimento toracoabdominal e a VC diminuiu. A diferença média da mobilidade toracoabdominal, entre o antes e depois, para estas duas manobras, foi de +0,20 cm2 no RTA e –1,72 cm2 na VC, entretanto não apresentaram diferença estatisticamente significativa. Conclusão: As manobras de RTA e VC apresentaram resultados antônimos sobre a mobilidade toracoabdominal, entretanto esta diferença não foi estatisticamente significativa. Palavras-chave: mecânica respiratória, fotogrametria, recém-nascido, modalidades de Fisioterapia.
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