Physio Role in NICU

Question 1

What is:

• average birth weight?
• low BW?
• very low BW?
• extremely low BW?

Answer 1

average = 2500-4000g
low = <2500
very low = < 1500
extremely low = <1000

Question 2

How to calculate corrected age?

Answer 2

Take the baby’s actual age in weeks since birth (eg. 28 weeks)

If born premature (term baby is 40 weeks), then 40 - 28 = 12 weeks

Whatever your baby’s age currently, eg. 24 weeks, subtract 12 from it and work off that - i.e 12 weeks CORRECTED age
- look for developmental milestones for this corrected age

Question 3

Considerations for CP treatment in babies?

Answer 3

• no HDT for babies
• head support throughout treatment
• vibes > perc in babies
• position in prone

Question 4

What is LAPI?

Answer 4

Lacey Assessment of Preterm Infants

• to document motor dev of infant @ preterm age whilst in ICU/SCN
• to monitor normal develop over time and to ID infants at high risk for motor impairment
• designed for minimal handling of baby; mostly obs

Question 5

What are the components of the LAPI?

Answer 5

ATNR>10s
UL tone > LL tone
jitters
Raised ADD tone
Oromotor control
"contradictory signs" - head lack with pull to sit but rigid head in supported sitting

Question 6

What are Prechtl’s?

Answer 6

Observation of general movements of babies; fluid, complex, varied, elegant
- Writhing period
> abnormal = cramped/synchronized/chaotic/monotonous

• Fidgety period
  > can be normal, abnormal, absent

CRAMPED SYNCHRONIZED + ABSENT FIDGETY = predictive of CP!

Poor repetoir of movements = developmental delay or CP? could be normal also

Question 7

Infant care in CP

Answer 7

1. Refer early - earlier the better
2. Enriched environment to promote neuroplasticity (esp in first 2 yrs) for recovery in CP; also intensive task specific activity (GAME study - Goals-Activity-Motor-Enrichment) good for motor and cognitive outcomes

Question 8

What is intraventricular haemorrhage

Answer 8

• bleeding the ventricles of the brain
• the more premature the baby the higher the risk
• d/t underdeveloped/fragile BVs

Grade I - bleeding occurs just in the germinal matrix
Grade II - bleeding also occurs inside the ventricles, but they are not enlarged
Grade III - ventricles are enlarged by the accumulated blood
Grade IV - bleeding extends into the brain tissue around the ventricles

Question 9

What are the effects of prematurity?

Answer 9

CP
cognitive (IQ
Sensory
Learning
Social adjustment
Behaviour
Speech