Respiratory Physiotherapy in Preterm Neonates with Bronchopulmonary Dysplasia or Respiratory Distress Syndrome - A Comprehensive Review of Clinical Evidence and Therapeutic Implications

Sep 30, 2026

Preterm birth, affecting more than 13.4 million infants worldwide each year, remains a leading cause of neonatal morbidity and mortality, with respiratory distress syndrome and bronchopulmonary dysplasia driving prolonged hospitalization and intensive respiratory support. As survival improves, optimizing respiratory function and reducing complications through non-pharmacological care becomes increasingly important. This review synthesizes current clinical evidence on respiratory physiotherapy techniques for these populations, summarizing effects on ventilation, gas exchange, and secretion clearance, and assessing safety and future research needs.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Introduction

Epidemiology and burden of preterm birth

Respiratory complications: RDS and BPD

Methods and evidence overview

Respiratory physiotherapy modalities

Clinical outcomes reported

Conclusions and future directions

Review Respiratory Physiotherapy in Preterm Neonates with Bronchopulmonary Dysplasia or Respiratory Distress Syndrome: A Comprehensive Review of Clinical Evidence and Therapeutic Implications Paula Rodríguez-Roza 1, Raquel Leirós-Rodríguez 2, Arrate Pinto-Carral 2, * and María José Álvarez-Álvarez 2, * Academic Editor: Warwick Butt Received: 30 November 2025 Revised: 23 December 2025 Accepted: 30 December 2025 Published: 2 January 2026 Copyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Rehabilitation, Hospital Centro Médico de Asturias, 33193 Oviedo, Principado de Asturias, Spain; [paularodriguezroza@hotmail.com](paularodriguezroza@hotmail.com) 2 SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, 24401 Ponferrada, León, Spain; [rleir@unileon.es](rleir@unileon.es) * Correspondence: [apinc@unileon.es](apinc@unileon.es) (A.P.-C.); [mj.alvarez@unileon.es](mj.alvarez@unileon.es) (M.J.Á .-Á .); Tel.: +34-987442094 (A.P.-C.);+34-987442074 (M.J.Á.-Á.) Abstract Background: Preterm birth, affecting more than 13.4 million infants worldwide each year, remains one of the leading causes of neonatal morbidity and mortality. Among its complications, respiratory distress syndrome and bronchopulmonary dysplasia are predominant contributors to prolonged hospitalization and respiratory support needs. As advances in perinatal care have improved survival, attention has increasingly turned to optimizing respiratory function and reducing complications through non-pharmacological interventions. Respiratory physiotherapy has therefore gained recognition as a valuable adjunct to medical management in this population. Purpose: To provide a comprehensive synthesis of the current clinical evidence regarding respiratory physiotherapy techniques used in preterm neonates with respiratory distress syndrome or bronchopulmonary dysplasia. Summary of Evidence: The available literature describes several physiotherapeutic modalities—including prolonged slow expiration, postural treatment, Vöjta therapy, and gentle mechanical techniques—aimed at improving ventilation, gas exchange, and secretion clearance. Across diverse studies, these interventions have been associated with better oxygenation, improved heart and respiratory rates, shorter mechanical ventilation time, and reduced hospital stay, while showing no relevant adverse effects. Although methodological heterogeneity persists, the consistency of beneficial trends supports their integration into multidisciplinary neonatal care. Conclusions: Respiratory physiotherapy represents a safe and promising therapeutic complement for preterm neonates with respiratory distress syndrome or bronchopulmonary dysplasia. Techniques that combine postural control and controlled expiratory maneuvers appear particularly effective in enhancing pulmonary mechanics and recovery. Future research should focus on standardizing intervention protocols, identifying optimal timing and dosing, and evaluating the long-term respiratory and developmental outcomes of these physiotherapeutic strategies. Keywords: preterm neonates; respiratory disorders; physiotherapy 1. Introduction Preterm birth remains a major global health challenge. In 2020, an estimated 13.4 million babies, approximately 1 in 10 births worldwide, occurred before 37 weeks’ gestation, with little improvement in rates over the last decade [1] . Prematurity is the leading cause of neonatal mortality and contributes substantially to morbidity, prolonged hospitalization, and long-term developmental impairment [2] . In 2022, global neonatal mortality reached 2.3 million deaths, nearly half of all deaths among children under five [2] . Epidemiological analyses consistently show that the burden of prematurity is high across countries and healthca

FAQs

What clinical conditions does the review focus on?

The review focuses on preterm neonates with respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD).

Which respiratory physiotherapy techniques are highlighted?

Highlighted modalities include prolonged slow expiration, postural treatment, Vöjta therapy, and gentle mechanical techniques. These aim to improve ventilation, gas exchange, and secretion clearance.

What overall conclusions and safety findings does the review report?

Respiratory physiotherapy is described as a safe and promising complementary therapy, with beneficial trends such as better oxygenation and shorter mechanical ventilation time, and no relevant adverse effects reported in the available literature.

Sep 30, 2026

Upload by Blue Pony