Infant positioning in daily life may mediate associations between physiotherapy and child development

Paediatric physiotherapy (PPT) in high-risk infants comprises family involvement, but it is unclear whether parents mediate the intervention effect.

The aim of this study was to assess whether PPT affects how parents position their infant during bathing and whether this is associated with child outcome. The study used a randomized controlled trial in high-risk infants to compare the family centred programme Coping and Caring for infants with special needs (COPCA) to Traditional Infant Physiotherapy (TIP). The study revealed associations between COPCA-characteristics and outcome.

A total of 21 infants received COPCA and 25 TIP between 3 and 6 months of age. Bathing sessions were videotaped at 3, 6 and 18 months. Time spent with specific infant positions was correlated with quantified PPT-actions and functional mobility at 18 months measured with the Paediatric Evaluation of Disability Inventory (PEDI).

At 3 and 18 months bathing position was similar in both groups, but differed at 6 months (time spent on sitting: COPCA 77.7%, TIP 39.2%; median difference 32.0% (95% CI: 10.6-50.5%). Sitting-time at 6 months was associated with higher PEDI functional mobility scores.

Early PPT may affect parental behaviour, such as infant positioning during bathing, which, in turn, may affect child development.