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Objective(s)
The purpose of this systematic review is to compare the effects hydrokinesiotherapy
and immersion bathing on the physiological factors that influence stress on preterm
newborns in the NICU. Therapeutic interventions minimize the negative effects of prematurity
on physiological parameters. Preterm newborns undergo different immersion bathing
techniques such as conventional bathing and swaddle bathing to stabilize vital signs.
Hydrokinesiotherapy is an alternative intervention that uses submersion in water to
promote positive physiological effects while also incorporating muscle strengthening
and relaxation.
Data Sources
A review of literature was conducted using CINAHL Complete, Academic Search Ultimate,
PubMed, PEDro, and Google Scholar. Search terms included neonatal hydrotherapy, NICU
hydrotherapy, water therapy, preterm, hydrokinesiotherapy, and physical therapy. A
hand search was also conducted.
Study Selection
Inclusion criteria consisted of articles published within the last 12 years, premature
infants less than 34 weeks gestation, and infants with no underlying medical diagnoses.
Data Extraction
Sixteen articles met the inclusion criteria with five articles on hydrokinesiotherapy
and 11 articles on conventional bathing. Each article was analyzed for quality using
the hierarchy of evidence scale to assess the methodological quality. There were four
level two, 11 level three, and one level four included in the study.
Data Synthesis
Hydrokinesiotherapy, swaddle bathing and tub bathing decreased RR, HR, crying, salivary
cortisol levels and increased SO2, and sleep. Hydrokinesiotherapy was superior to
all types of bathing, swaddle bathing was superior to conventional bathing, and conventional
bathing was superior to sponge bathing. Hydrokinesiotherapy can be provided simultaneously
while maintaining body temperature, calming atypical physiological responses to movement,
and decreasing overall stress.
Conclusions
Conventional bathing, swaddle bathing, and hydrokinesiotherapy decrease RR, HR, crying,
and salivary cortisol levels and improve SO2, and sleep in preterm infants. Hydrokinesotherapy
can provide neurodevelopmental techniques such as light and slow movements aimed at
tactile-kinesthetic stimulation. It facilitates the flexed posture of body organization
via the effect of the thrusting motion, allows for passive mobilizations of the upper
and lower limbs, global stretching, trunk rotation, and tactile, proprioceptive, and
vestibular stimulation.
Author(s) Disclosures
N/A.
Key Words
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© 2022 Published by Elsevier Inc.
