eS198 The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
Clinical Psychologist, GP with Special Interest in Pain Man-
agement and Chaplaincy Services.
Approach/evaluation: Patients assessed by the Living
with Pain Team, where Urdu was their first language and
would benefit from increasing their understanding of self-
management of living with pain were referred into the pilot
group. 6 patients started the 8 session PMP (1 male, 5
female). The PMP included an overview from the Trust’s
Muslim Chaplain of his role on the PMP, and how Islamic
teachings promote self-management, compassion, physical
activity and dispelling of cultural myths. The GP discusses
pain medication management within holistic care, the phy-
siotherapist emphasises the biopsychosocial approach of the
PMP, including gentle increases in exercise. Psychology
sessions focussed on how pain can affect patients emo-
tionally and emphasised how patients could increase their
self-kindness. As literacy is a common problem, audio and
video material in Urdu were utilised which supported the edu-
cation of standard PMP concepts. SEQ and HADS outcome
measures were administered pre and post PMP. No ethics
approval required.
Outcomes: Patients made improvements in self-efficacy,
anxiety and depression following the programme. There
was a statistically significant change in anxiety (t(3) = 4.7,
P < 0.01), depression (t(3) = 5, P < 0.01), and self-efficacy
(t(3) = −8.18, P < 0.001) following the programme.
The Reliable Change Index (RCI) was used, and this found
that 25% of patients made a reliable change in anxiety and
75% of patients made a reliable change in depression. Sub-
jectively patients reported that they had understood their
persistent pain for the first time within their cultural context.
Discussion and conclusions: Preliminary results suggest
there is value in delivering a language specific and cultur-
ally adapted MDT led PMP for the South Asian community.
It has been able to engage patients to break down cultural
barriers but also increase awareness of the cultural percep-
tion and experience of persistent pain. There is a recognition
that further clinical research is needed into the long term
effectiveness of this approach on self-efficacy, anxiety and
depression.
Impact and implications: Cultural competency is an
important factor to consider when working with patients of
a different background. Accepted for British Pain Society
Annual Scientific Meeting May 2016.
Funding acknowledgement: No external funding was
required, formed part of the authors normal working role.
http://dx.doi.org/10.1016/j.physio.2016.10.240
POS183
Early physiotherapy effects in preterm
infant gross and fine motor development
during the first 18 months of life
F.J. Fernández Rego 1,2 ,
A. Gomez-Conesa 3,∗ , J. Pérez López 4
1 University of Murcia, Physical Therapy
Department, Murcia, Spain
2 Early Intervention Centre ‘Fina Navarro
López’, Lorca, Spain
3 University of Murcia, Physical Therapy
Department, Espinardo-Murcia, Spain
4 University of Murcia, Department of
Developmental and Educational Psychology,
Murcia, Spain
Relevance: Forty per cent of preterm infants suffer
disorders in their development. Early Intervention with phys-
iotherapy treatments promotes the motor development and
the prevention of disabilities in this population.
Purpose: To compare the effect of Vojta method with other
physiotherapy treatments on gross and fine motor develop-
ment of preterm infants during the first 18 months of life.
Methods/analysis: 84 preterm infants diagnosed with
motor delay, with a gestational age mean (GA) of 30.87
weeks (SD = 3.01) and birth weight (BW) of 1491.35 g
(SD = 528.54) were allocated into two study groups: an
experimental group with Vojta therapy (EG, n = 47 par-
ticipants) and a control group with other physiotherapy
treatments (CG, n = 37 participants). Both groups had similar
GA [EG = 31.24 (SD = 2.94) weeks; CG = 30.39 (SD = 3.07)
weeks; P-value = 0.205] BW [EG = 1570.49 (SD = 519.42) g;
CG = 1390.81 (SD = 529.86) g; P-value = 0.124] and gender
distributions [P-value = 0.908].
Both groups received two weekly 50-minute sessions of
physical therapy, EG with Vojta and CG with other physical
therapy methods (Le Métayer and Bobath). Four measure-
ments were performed: during the first trimester of life (3M),
at 6 (6M), 12 (12M) and 18 (18M) months of corrected age,
using the Bayley Scales of Infant and Toddler Development
3rd edition (BSID-III) for gross and fine motor capacities.
A t-Student test was carried out for independent sam-
ples among the gross scalar score (GS), the fine scalar (FS)
and the composite score (CS) of the BSID-III between both
groups, at the different time points. Additionally, effect size
was calculated using d statistics.
Results: We observed significant differences at 3M and
at 6M, between both groups. The CG had better perfor-
mance in the motor scales of the BSID-III at all three levels:
FS (3M: P-value = 0.004, 6M: P-value = 0.044), GS (3M: P-
value < 0.001, 6M: P = 0.004) and CS (3M: P-value < 0.001,
6M: P = 0.010). Additionally, at 18M, EG was superior in the
FS (P-value < 0.001) and CS level (P-value = 0.004).
 The 4th European Congress of the ER-WCPT / Physiotherapy 102S (2016) eS67–eS282
The control group had large effect size for EG and CS at
3M (0.91 and 0.86) and moderate for FS (0.65); at 6M a low
size for FS (0.45) and moderate for GS and CS (0.65 and
0.60). Whereas Vojta therapy demonstrated had high effect
FS (0.93), moderate for CS (0.65) and low the GS (0.40) at
18M.
Discussion and conclusions: Infants treated with Vojta
therapy had improved scores during every assessment despite
starting at lower scores in the first time points. Using the
BSID-III motor scale, preterm infants treated with Vojta
showed a superior motor development at 18 months, espe-
cially in the fine motor skills, compared to infants treated
with other modalities of physical therapy.
Impact and implications: Vojta method is effective in
promoting motor development of preterm infants receiving
during the first 18 months of corrected age. Additionally, it
contributes to improve the protocol of physical therapy inter-
ventions and prevent future disabilities in this population.
Funding acknowledgement: It is not funding.
No acknowledgement is required.
http://dx.doi.org/10.1016/j.physio.2016.10.241
POS184
Vojta therapy in the reduction of perinatal
risk in preterm infants with respiratory
distress syndrome and bronchopulmonary
dysplasia
A. Gomez-Conesa 1,∗ ,
F.J. Fernández Rego 1 , J.J. Agüera Arenas 2
1 University of Murcia, Physical Therapy
Department, Espinardo-Murcia, Spain
2 Virgen de la Arrixaca University Hospital,
Neonatal Intensive Care Unit, Murcia, Spain
Relevance: Preterm infants are at increased risk of suf-
fering respiratory problems and concomitant diseases due
to the immaturity of their systems, increasing the days of
hospitalization and the risk of disorders in their development.
Purpose: To study if Vojta therapy can reduces the peri-
natal risk and decrease the days of hospitalization of preterm
infants with Respiratory Distress Syndrome (RDS) and Bron-
chopulmonary Dysplasia (BPD).
Methods/analysis: Sixty preterm infants with gestational
age (GE) ≤ 32 weeks and a diagnosis of RDS were randomly
allocated into two groups: experimental group (EG, n = 32
preterm infants; 15 girls and 17 boys), and a control group
(CG, n = 28 preterm infants; 11 girls and 17 boys). Both
groups received standard of care in the neonatal intensive
care unit (NICU), additionally the EG received two daily ses-
sions of 10 minutes during 30 days of Vojta physiotherapy.
There were no significant differences between the groups in
GE [EG: 28.2 weeks, CG: 28.9weeks, P-value = 0.218], birth
weight [EG: 1122.56 g, CG: 1160.35 g, P-value = 0.630] and
gender distribution [P-value = 0.554].
eS199
All infants were assessed with the Perinatal Risk Inventory
(PERI) when discharged. Two t-Student tests were carried
out of mean differences for independent samples between
the scores of perinatal risk and of the days of hospitalization
of both groups. D statistic was calculated to determine the
effect size.
Results: Our findings reveal significant differences
between both groups, with significantly better outcome
among the infants who received Vojta Therapy; infants in
EG obtained lower PERI scores [P-value < 0.001] and were
less days in hospital [P = 0.001] when compared to the CG.
The effect size was large among the EG in the reduction of
perinatal risk (d = 0.95) and of the days in hospital (d = 1.86).
Discussion and conclusions: The Vojta method has high
clinical relevance; it is effective in reducing perinatal risk
scores and days of hospitalization of preterm infants with
RDS and BPD.
Impact and implications: Early treatment with Vojta
method in the NICU can be effective in reducing perinatal risk
and the days of hospitalization in preterm infants with RDS
and BPD. This reduction in risk can lead to a better devel-
opment of these infants, decreasing the possibilities of future
disabilities. Applying Vojta methods in the NICU may lead
to reduced health, social and educational expenses generated
by this population.
Funding acknowledgement: It is not funding.
No acknowledgement is required.
http://dx.doi.org/10.1016/j.physio.2016.10.242
POS185
The development of a specialist model of
care for transitional paediatric
neuromuscular patients: collaboration
between respiratory, neurological and
neuro-rehabilitation specialties
R. Moses 1,∗ , A. Vyas 1 , D. Shakespeare 2 ,
C. Degoode 3
1 Lancashire Teaching Hospitals,
Respiratory Medicine, Preston, United
Kingdom
2 Lancashire Teaching Hospitals,
Neuro-Rehabilitation, Preston, United
Kingdom
3 Lancashire Teaching Hospitals, Paediatric
Neurology, Preston, United Kingdom
Relevance: Physiotherapy has an integral role in ensuring
the development of children with complex health care needs.
As children transition into adult services they will experi-
ence a number of physical, emotional, social and behavioural
changes. The impact on this can have huge implications on
their physical and mental health. Often these children have
complex needs that necessitate a high demand on a number
of services. The physiotherapists working with these chil-