Physical Therapy Observation and Assessment in the Neonatal Intensive Care Unit

Abstract

This article presents the elements of the Observation and Assessment section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy assessments presented in this path are evidence-based and the suggested timing of these assessments is primarily based on practice knowledge from expert therapists, with supporting evidence cited. Assessment in the NICU begins with a thorough review of the health care record. Assessment proceeds by using the least invasive methods of gathering the behavioral, developmental, physiologic, and musculoskeletal information needed to implement a physical therapy plan of care. As the neonate matures and can better tolerate handling, assessment methods include lengthier standardized tests with the psychometric properties needed for informing diagnosis and intervention planning. Standardized tests and measures for screening, diagnosis, and developmental assessment are appraised and special considerations for assessment of neonates in the NICU are discussed.

Effect of Early Physical Activity Programs on Motor Performance and Neuromuscular Development in Infants Born Preterm: A Randomized Clinical Trial

“…It considers the influences of the infant’s neurological maturation, the environment, the force of gravity, and posture on motor development. 28-30 …”

Survey of neurodevelopmental allied health teams in Australian and New Zealand neonatal nurseries: Staff profile and standardised neurobehavioural/neurological assessment

“…11,12 Moreover, standardised assessment tools affect clinical decision-making, facilitate treatment options and support clinical research. 11,13 Many standardised neurobehavioural/neurological assessment tools have been developed for use in NICU/SCN. 14,15 Although standardised neurobehavioural/neurological assessment tools are recommended, [15][16][17] it is unclear which tools are used throughout Australian and New Zealand NICUs/SCNs; their implementation policy; and whether assessments inform clinical decisions regarding infant treatment and follow-up.…”

“…Neurodevelopmental allied health staff have a key role in the administration of standardised neurobehavioural/neurological assessments, including when and which assessment tools to use. These assessments provide valuable insight into an infant's multifaceted developmental capabilities, which can be shared with parents and staff . Moreover, standardised assessment tools affect clinical decision‐making, facilitate treatment options and support clinical research .…”

“…These assessments provide valuable insight into an infant's multifaceted developmental capabilities, which can be shared with parents and staff . Moreover, standardised assessment tools affect clinical decision‐making, facilitate treatment options and support clinical research . Many standardised neurobehavioural/neurological assessment tools have been developed for use in NICU/SCN …”

Avaliação do neurocomportamento de recém-nascidos pré-termos tardios e do papel dos profissionais de reabilitação nas unidades de terapia intensiva neonatal canadenses

“…Esse novo olhar sobre "colocar a evidência científica em prática" demonstra que não somente se faz necessário colocar o bebê de forma passiva em um posicionamento adequado, corrigir sua postura, alinhá-lo, etc, mas sim a influência desse posicionamento na autorregulação do bebê, combinado com intervenções no ambiente em seu comportamento. Além de tudo, buscar oportunidades de diálogos entre os pais e terapeutas permite que os familiares sejam eficientes cuidadores na promoção do desenvolvimento da criança (113,117,118) .…”