{"id":6313,"date":"2026-08-28T08:04:57","date_gmt":"2026-08-28T08:04:57","guid":{"rendered":"https:\/\/wp2027.world.physio\/?page_id=6313"},"modified":"2026-08-28T08:04:57","modified_gmt":"2026-08-28T08:04:57","slug":"fs-15","status":"publish","type":"page","link":"https:\/\/wp2027.world.physio\/pt\/fs-15\/","title":{"rendered":"FS-session-15"},"content":{"rendered":"
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Focused symposium: Evidence exists, equity doesn\u2019t: why neonatal physiotherapy fails in LMICs and what must change now (FS-15)<\/div>\n

Moderator: <\/strong>Fatma A. Hegazy (United Arab Emirates)
Speakers: <\/strong>Sonia Khurana (United States), Bhamini Krishna Rao (India), Omnia Mohammed (Egypt)<\/p><\/div>\n <\/div>\n\n

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\n Learning objectives <\/div>\n\n
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  1. \n

    Critically evaluate the effectiveness, limitations, and transferability of neonatal physiotherapy interventions initiated in NICU on neurodevelopmental outcomes<\/p>\n<\/li>\n

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    Analyse key barriers, controversies, and system-level challenges influencing implementation in LMICs<\/p>\n<\/li>\n

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    Apply practical, context-adapted strategies to scale early intervention through family-centred and resource-sensitive approaches<\/p>\n<\/li>\n<\/ol> <\/div>\n\n \n <\/div>\n <\/div>\n<\/section><\/div>\n\n

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    Abstract<\/div>\n \n <\/div>\n
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    Neonatal physiotherapy is supported by strong evidence\u2014yet remains inaccessible to most infants globally. Globally, approximately 13 million infants are born preterm each year, with over 90% occurring in low- and middle-income countries (LMICs). These infants are at increased risk of adverse neurodevelopmental outcomes, yet access to early rehabilitation remains profoundly inequitable. Nearly 43% of children in LMICs fail to reach their developmental potential, highlighting a major global health challenge. Despite decades of research and clear clinical guidelines, neonatal physiotherapy remains inconsistently implemented where it is needed most raising a critical question: why does evidence fail to translate into practice?<\/p>\n

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    Two uncomfortable realities underpin this gap. First, much of the current evidence base is generated in high-income settings and assumes resources, workforce capacity, and health system structures that do not exist in LMICs. Second, implementation strategies often prioritise fidelity to protocols over feasibility in context, limiting real-world adoption. Together, these tensions contribute to a persistent \u201cevidence\u2013equity gap\u201d in neonatal care.<\/p>\n

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    Neonatal physiotherapy aims to optimize early neurodevelopment through timely identification, prevention of complications, and enhancement of parent\u2013infant interaction. The early postnatal period represents a critical window of neuroplasticity, where targeted interventions can significantly influence long-term outcomes. Evidence supports interventions incorporating environmental enrichment, task-specific practice, active infant participation, and family-centred care. However, uncertainty remains regarding optimal delivery models, sustainability, and contextual adaptation across diverse health systems.<\/p>\n

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    Implementation in LMICs is shaped by complex and interrelated challenges, including workforce shortages, limited training opportunities, financial constraints, and fragmented health systems. Families central to early intervention, often face additional barriers related to health literacy, access, and continuity of care. Addressing these challenges requires a paradigm shift: from focusing solely on intervention efficacy to embracing implementation science, context-sensitive adaptation, and family empowerment as core components of care delivery.<\/p>\n

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    This symposium presents a cohesive and multidisciplinary narrative bridging evidence, clinical practice, and implementation. The moderator will frame the global landscape and key controversies. Presentations will: (1) synthesise evidence from systematic reviews and randomized controlled trials; (2) present real-world clinical and community-based experiences from LMIC settings, highlighting practical adaptations; and (3) explore scalable implementation pathways, including family-centred models and task-sharing approaches.<\/p>\n

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    Interactive elements including real-time polling, case-based decision-making, and audience prioritisation exercises will actively engage participants in addressing context-specific challenges. A moderated panel discussion will facilitate critical reflection on balancing evidence fidelity with feasibility.<\/p>\n

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    Participants will leave with actionable, scalable strategies to integrate neonatal physiotherapy into diverse healthcare systems. By directly addressing the gap between evidence and practice, this session aims to inform clinical decision-making, strengthen health systems, and improve developmental outcomes for high-risk infants and their families globally.<\/p>\n

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    These insights will also inform policy-level decision-making and workforce development strategies for integrating neonatal physiotherapy into health systems globally. If evidence cannot be implemented, it is not enough. This session challenges the profession to redefine success as scalable impact rather than controlled efficacy.<\/p><\/div>\n

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    References<\/div>\n \n <\/div>\n
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    1. \n

      Kanagasabai PS, Mohan D, Lewis LE, Kamath A, Rao BK. Effect of multisensory stimulation on neuromotor development in preterm infants. Indian J Pediatr. 2013 Jun;80(6):460-4. doi: 10.1007\/s12098-012-0945-z. Epub 2013 Jan 4. PMID: 23288407.<\/p>\n<\/li>\n

    2. \n

      Khurana S, Rao BK, Lewis LE, Bhat R, Purkayastha J, Kamath A, Dharmaraj SK. Development and Validation of Educational Leaflet for Caregivers of Preterm Infants. J Clin Diagn Res. 2016 Jul;10(7):YC01-4. doi: 10.7860\/JCDR\/2016\/19206.8109. Epub 2016 Jul 1. PMID: 27630939; PMCID: PMC5020196.<\/p>\n<\/li>\n

    3. \n

      Khurana S, Rao BK, Lewis LE, Bhat RY, Purkayastha J, Kamath A et al. Neurobehavioral profile of moderate to late preterm infants admitted in a tertiary care centre in South India. Online Journal of Health and Allied Sciences. 2016;15(2).<\/p>\n<\/li>\n

    4. \n

      Khurana S, Kane AE, Brown SE, Tarver T, Dusing SC. Effect of neonatal therapy on the motor, cognitive, and behavioral development of infants born preterm: a systematic review. Dev Med Child Neurol. 2020 Jun;62(6):684-692. doi: 10.1111\/dmcn.14485. Epub 2020 Feb 19. PMID: 32077096; PMCID: PMC7920849.<\/p>\n<\/li>\n

    5. \n

      Khurana S, Rao BK, Lewis LE, Kumaran SD, Kamath A, Einspieler C, Dusing SC. Neonatal PT Improves Neurobehavior and General Movements in Moderate to Late Preterm Infants Born in India: An RCT. Pediatr Phys Ther. 2021 Oct 1;33(4):208-216. doi: 10.1097\/PEP.0000000000000824. PMID: 34618744.<\/p>\n<\/li>\n

    6. \n

      Raghupathy MK, Rao BK, Nayak SR, Spittle AJ, Parsekar SS. Effect of family-centered care interventions on motor and neurobehavior development of very preterm infants: a protocol for systematic review. Syst Rev. 2021 Feb 18;10(1):59. doi: 10.1186\/s13643-021-01612-w. PMID: 33602324; PMCID: PMC7890856.<\/p>\n<\/li>\n

    7. Novak I et al Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr. 2017 Sep 1;171(9):897-907. doi: 10.1001\/jamapediatrics.2017.1689. Erratum in: JAMA Pediatr. 2017 Sep 1;171(9):919. PMID: 28715518; PMCID: PMC9641643.<\/li>\n
    8. AlKetbi H, Hegazy F, Alnaqbi A, Shousha T. Evidence-based practice by physiotherapists in UAE: investigating behavior, attitudes, awareness, knowledge and barriers. PLoS One. 2021;16(6):e0253215. doi:10.1371\/journal.pone.0253215<\/li>\n
    9. AlNaqbi HA, Kim M, Al-Yateem N, Hegazy F. Parents’ satisfaction with physiotherapy services for neuropediatric outpatients in the United Arab Emirates: a cross-sectional study. F1000Res. 2024;13:739. doi:10.12688\/f1000research.151041.1<\/li>\n
    10. Ali OI, Salem OM, Mohamed SAA, Ali SAH, Embaby EA. Physiotherapy professionals: a questionnaire for the evaluation of telerehabilitation services in Egypt. Int J Telerehabil. 2025;16(2):e6654. doi:10.5195\/ijt.2024.6654<\/li>\n<\/ol><\/div>\n
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