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Published on: February 5, 2019
Focus on physiotherapy and manual therapy for infants in Norway, a cross-sectional study on referral practice, and
Hege Handeland1, Kari Anne Indredavik Evensen2,3,4, Hilde Stendal Robinson5
1Institute of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway.
Insights
Infants in Norway are referred to physiotherapists and manual therapists for various reasons, often by healthcare professionals or concerned parents. Early examination is recommended for infants with asymmetries.
Area of Science:
- Pediatrics
- Physical Therapy
- Public Health
Background:
- Norway's universal child healthcare system includes systematic follow-up.
- Infants are sometimes referred to physiotherapists and manual therapists in primary care.
- Referral patterns and reasons for infant referrals to these therapists are not well understood.
Purpose of the Study:
- To explore infant referral practices to physiotherapy and manual therapy in Norway.
- To compare infant care by physiotherapists versus manual therapists in primary care.
- To describe planned interventions for infants receiving physiotherapy or manual therapy.
Main Methods:
- A cross-sectional study was conducted.
- Included 444 infants under 12 months old referred to primary care physiotherapists or manual therapists in Norway.
- Data collected on referral sources, age at examination, and planned interventions.
Main Results:
- Most infants were referred by health personnel, while parents initiated more referrals to manual therapists.
- 42% of infants were examined between weeks 1-12.
- Motor development issues were common referrals; premature infants were exclusively referred to physiotherapists. Both therapist types used advice and handling; physiotherapists emphasized motor development advice and prone play.
Conclusions:
- Infants are referred for diverse reasons to physiotherapists and manual therapists in Norway.
- Referrals originate from healthcare professionals and parental concerns.
- Earlier examination is advised for infants with asymmetries.
Background:
The Norwegian health care system has a mandatory program for close and systematically follow-up on all children, starting in early infancy through the Child Health Care Centers in the municipalities. Additionally, some infants are referred to physiotherapists and manual therapists for several reasons. Little is known about who is referring them and the cause for the referral. In Norway, physiotherapists working with infants can be employed in the communities or work in outpatient clinics, both are within the primary health care system. The main purpose of the present study was to explore the referral practice of infants to physiotherapy and compare those treated by physiotherapists and manual therapists in primary health care in Norway. Furthermore, to describe the planned interventions.
Methods:
Cross-sectional study including 444 infants (age under 12 months) referred to physiotherapists or manual therapists working in primary health care in Norway.
Results:
Median age (range) of the infants was 14 (1, 52) weeks and 344 were born at due date. Most infants examined by a physiotherapist were referred from other health personnel and more of the referrals to manual therapists were from parents due to their concern. Age at examination was between week 1-12 for 42% of the participants. Infants referred for motor development problems were equally distributed between the physiotherapists and manual therapists. All premature infants were referred to the physiotherapists. Concerning the interventions, both physiotherapists and manual therapists planned to use advice, handling, and stimulation. More of the physiotherapists reported to focus on advice related to motor development and the use of prone play.
Conclusion:
The infants in Norway are referred to physiotherapists and/or manual therapists for numerous reasons, and the distribution of diagnoses between the therapists seem reasonable. Infants are mostly referred by other health personnel but also because of parents' own concern. Based on recommendations, some infants with asymmetries should be examined earlier.
Trial Registration:
ClinicalTrials.gov Identifier NCT03626389. Registered on August 13th, 2018 (retrospectively registered).
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