Dr Barbara Lucas
Innovative physiotherapy aims to boost outcomes for premature babies
not saying we cured them, but I think we helped optimise their development.” The initial investigation with 13 babies led Barbara to run the Best Start Trial (BeST) in 2019, a bigger study of ultra-early parent- administered physiotherapy for 30 infants at high risk of cerebral palsy or motor delay. The trial involved physiotherapy for premature babies starting four to five months earlier than usual, with therapy delivered by parents through short, frequent bursts of activity. The sessions lasted for just five minutes and were conducted three times a day. Babies’ motor development was assessed at four, 12, and 24 months to evaluate the effectiveness of the early intervention. While Barbara and her team didn’t see any significant differences in outcomes between the babies on the trial and those in the control group, their carers did. “The parents in the experimental group said they felt that the treatment was highly beneficial, and that it really improved their infant’s function,” she said. Barbara is hoping to conduct more studies down the track, particularly as the first pilot trial was interrupted by the COVID-19 pandemic. “Overall, we feel encouraged to continue working more on this project.”
In 2016, when Dr Barbara Lucas was on the ward at Royal North Shore Hospital’s neonatal intensive care unit (NICU), she was asked the same question by three fathers whose premature babies had all experienced severe brain bleeds. They wanted to know what would make a difference to their babies’ development. Some of the infants, born up to three months premature, were very fragile. Babies who need care in the NICU can have a range of adverse developmental outcomes, including cerebral palsy, the most common motor disability in childhood. Barbara, a senior physiotherapist in NICU and a postdoctoral research fellow with the John Walsh Centre for Rehabilitation Research at the University of Sydney, suggested that when the babies were a little bit older – around the six-week premature mark from term age – the parents could work on five key “milestones”. They included head control, orientation of their hands towards their middle, balance activities, reciprocal kicking of their legs, and visual activities to fix their gaze on their parent’s face. They could be done three times a day for five minutes. “I couldn’t believe how quickly these babies improved,” recalled Barbara. “Surprisingly, none of these babies went on to have cerebral palsy and they were all at risk. I’m
NSLHD NEWS | ISSUE 5| 28 MARCH 2025
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