Moving in the water: A randomized controlled trial on the effects of aquatic therapy on general movements and clinical outcomes in preterm newborns.

Background: Bucket hydrokinesiotherapy, a supportive aquatic intervention for newborns, has been widely applied, although it lacks robust evidence regarding its clinical and neuromotor effects. While the General Movements Assessment (GMA) sensitively detects early neurological risk, the influence of...

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Publicado en:Physiotherapy Theory & Practice Vol. 42; no. 9; pp. 1152 - 1171
Autores principales: França, Andressa Lagoa Nascimento, Tedesco, Natália Matos, Chorna, Olena, de Souza Mallmann, Geruza, de Oliveira Nunes Reco, Mariane, de Almeida, Priscila Rimoli, Rocchitelli, Lucia, Costagli, Ginevra, Del Secco, Sabrina, Guzzetta, Andrea, Soares-Marangoni, Daniele
Formato: pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Taylor & Francis Ltd Sep2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2026
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      pub: Taylor & Francis Ltd
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        10.1080/09593985.2026.2621956
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        atl: Moving in the water: A randomized controlled trial on the effects of aquatic therapy on general movements and clinical outcomes in preterm newborns.
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          França, Andressa Lagoa Nascimento
          Tedesco, Natália Matos
          Chorna, Olena
          de Souza Mallmann, Geruza
          de Oliveira Nunes Reco, Mariane
          de Almeida, Priscila Rimoli
          Rocchitelli, Lucia
          Costagli, Ginevra
          Del Secco, Sabrina
          Guzzetta, Andrea
          Soares-Marangoni, Daniele
        affil: Graduate Program in Health and Development, Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
      sug:
        subj:
          Hydrotherapy
          Infant, Premature Psychosocial Factors
          Motor Activity Physiology
          Movement Physiology
          Hospitalization
          Treatment Outcomes
          Human
          Male
          Female
          Infant, Newborn
          Randomized Controlled Trials
          Random Assignment
          Infant Behavior
          Body Weight
          Intensive Care Units, Neonatal
          Neurologic Examination
          Psychomotor Performance
          Arousal
          Heart Rate
          Respiration
          Oxygen Saturation
          Body Temperature
          T-Tests
          Chi Square Test
          Mann-Whitney U Test
          Data Analysis Software
          Descriptive Statistics
          Funding Source
          Infant, Newborn: birth-1 month
          Male
          Female
      ab: Background: Bucket hydrokinesiotherapy, a supportive aquatic intervention for newborns, has been widely applied, although it lacks robust evidence regarding its clinical and neuromotor effects. While the General Movements Assessment (GMA) sensitively detects early neurological risk, the influence of therapeutic interventions on general movements (GMs) remains unclear. Objective: This study aimed to examine the effect of hydrokinesiotherapy on the GMs of hospitalized preterm infants and their clinical outcomes. Methods: Parallel-arm randomized controlled trial in which newborns were randomly assigned to two balanced groups and assessed at 34 (baseline), 36, 40–42, and 50–52 weeks postmenstrual age. Main inclusion criteria were: poor repertoire-GMs, admitted to a Neonatal Intermediate Care Unit, clinically stable. Assessors of main outcomes were blinded to group allocation. Interventions consisted of 10-minute bucket hydrokinesiotherapy followed by diaper change over 6 sessions on alternate days, or a diaper change only (control). Body weight and GMA were primary outcomes. Behavioral state was a secondary outcome; physiological parameters and respiratory distress were monitoring outcomes. Results: Thirty-four infants were included. Body weight (p = 0.43; d = 0.28) and global quality of GMs (p's > 0.25; d's < 0.39) were not affected by the intervention. Controls presented higher total (95%CI: 3.28–19.71; p <.001), upper (95%CI: 1.74–9.36; p < 0.001), and lower limb (95%CI: 0.79–8.14; p = 0.02) movement scores in the detailed GMA after the diaper changes protocol, at 36 weeks. The hydrokinesiotherapy group was more alert than controls after each session (p's < 0.01; V's > 0.53). Physiological parameters showed transient between-group differences within normal ranges (p's < 0.05). Adverse effects were not found. Conclusion: Bucket hydrokinesiotherapy was safe for the newborns. The technique was not effective in improving the global quality or detailed aspects of GMs after the two-week protocol. The intervention may be recommended to increase alertness, potentially supporting readiness for active feeding and engagement during care; however, caution is warranted given its acute effects on detailed aspects of GMs. Trial registrations: Trial registered in the Brazilian Clinical Trials Registry (ReBec). ReBec is a Primary Registry in the WHO Registry Network. Trial nº. RBR-5n82tv.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Unknown
    language: English
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