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Neonatal Physical Therapy. Part II: Practice Frameworks and Evidence-Based Practice Guidelines

Sweeney, Jane K. PT, PhD, PCS, FAPTA; Heriza, Carolyn B. PT, EdD, FAPTA; Blanchard, Yvette PT, ScD; Dusing, Stacey C. PT, PhD

doi: 10.1097/PEP.0b013e3181cdba43
Special Communication

Purpose: (1) To outline frameworks for neonatal physical therapy based on 3 theoretical models, (2) to describe emerging literature supporting neonatal physical therapy practice, and (3) to identify evidence-based practice recommendations.

Key Points: Three models are presented as a framework for neonatal practice: (1) dynamic systems theory including synactive theory and the theory of neuronal group selection, (2) the International Classification of Functioning, Disability and Health, and (3) family-centered care. Literature is summarized to support neonatal physical therapists in the areas of examination, developmental care, intervention, and parent education. Practice recommendations are offered with levels of evidence identified.

Conclusions: Neonatal physical therapy practice has a theoretical and evidence-based structure, and evidence is emerging for selected clinical procedures. Continued research to expand the science of neonatal physical therapy is critical to elevate the evidence and support practice recommendations.

The authors provide 3 models for neonatal physical therapy practice, emerging literature supporting physical therapy for neonates, and evidence-based practice guidelines.

Doctoral Programs in Pediatric Science (J.K.S., C.B.H.), Rocky Mountain University of Health Professions, Provo, Utah; Pediatric Rehab Northwest, LLC (J.K.S.), Gig Harbor, Washington; Physical Therapy Program (Y.B.), University of Hartford, Hartford, Connecticut; and Department of Physical Therapy, Virginia Commonwealth University (S.C.D.), Richmond, Virginia

Address Correspondence to: Jane Sweeney, PT, PhD, PCS, FAPTA, 8814 30th Street, Ct NW, Gig Harbor, WA 98335. E-mail:

Grant Support: Supported in part by the Section on Pediatrics, APTA, for which the authors served as members of the NICU Task Force.

© 2010 Lippincott Williams & Wilkins, Inc.