Physiotherapie in Deutschen Perinatalzentren

Zusammenfassung

Hintergrund Einheitliche Empfehlungen für stationäre und ambulante Physiotherapie bei Frühgeborenen fehlen in Deutschland. Ziel dieser Studie war die Untersuchung der Verordnungspraxis deutscher Perinatalzentren. Werden standardisierte Assessments zur Indikationsstellung genutzt? Welchen Stellenwert nimmt das General Movements Assessment in der postnatalen Diagnostik ein?

Methodik Online-Befragung der deutschen Perinatalzentren mit 21 Fragen zur Indikationsstellung und Verordnungspraxis für stationäre und ambulante Physiotherapie in der Versorgung Frühgeborener, sowie den Kenntnissen zum General Movements Assessment und deren klinische Anwendung via Lime-Survey.

Ergebnisse 81% der Teilnehmer empfehlen indikationsbasiert „immer“ oder „häufig“ stationäre Physiotherapie für Frühgeborene, 53% empfehlen „immer“/„häufig“ ambulante Therapie. Die Indikationsstellung erfolgt v. a. bei diesen Symptomen (N=344) und Diagnosen (N=273) (Mehrfachnennungen): Hypotonie (94%), Tonusregulationsstörung (92%), neurologische Auffälligkeiten (97%) und Hirnschädigungen (94%). Standardisierte Testungen nutzen 41% der Teilnehmer. Das General Movements Assessment ist in 87% der Zentren bekannt, 11% setzen sie mehrmals in der Woche, 17% mehrmals im Monat zur Indikationsstellung ein.

Schlussfolgerung Physiotherapie wird bei Frühgeborenen häufig verordnet. Die Indikationsstellung erfolgt primär nach Symptom- oder Krankheitsbild, weniger anhand standardisierter Testverfahren. Das General Movements Assessment ist eine weithin bekannte, jedoch klinisch noch nicht allgemein eingesetzte Methode.

Abstract

Background Standardized recommendations for inpatient and outpatient physiotherapy for preterm infants are lacking in Germany. The aim of this study was to investigate the prescription practice in German neonatal intensive care units. Are standardized assessments used to determine indications? How important is the General Movements Assessment in postnatal diagnostics?

Methods We conducted an online survey in German neonatal intensive care units asking 21 questions on indication and prescription practices for inpatient and outpatient physiotherapy in preterm infantsʼ care as well as on General Movements Assessment and its clinical application via Lime Survey.

Results 81% of the participating sites “always” or “often” recommend indication-based inpatient physiotherapy for preterm infants and 53% “always”/“often” recommend outpatient therapy. Indications are mainly based on these symptoms (N=344) or diagnoses (N=273) (multiple answers): hypotonia (94%), abnormal and imbalanced muscle tone (92%), neurological abnormalities (97%) and brain damage (94%). Standardized testing is used by 41% of the participants. The General Movements Assessment is known to 87% of the neonatal intensive care units, 11% use it several times a week, 17% several times a month for indication of physiotherapy.

Conclusion Physiotherapy is frequently prescribed for preterm infants. The majority of indications are based on symptoms or clinical pictures rather than on standardized tests. The General Movements Assessment is a widely known method but not systematically applied at the moment.

Schlüsselwörter

Perinatalzentrum - Frühgeborene - Physiotherapie - General Movements

Key words

neonatal intensive care units - preterm infants - physiotherapy - general movements

Publication History

Received: 22 February 2022

Accepted: 07 March 2022

Article published online:
20 May 2022

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