Potential Impact of Kangaroo Mother Care Combined With Structured Physiotherapy on Neurodevelopmental Outcomes in a Low-Birth-Weight Infant: A Case Report

Preterm and low-birth-weight (LBW) infants have a significant risk of neurodevelopmental deficits from an underdeveloped brain and a stressful neonatal intensive care unit (NICU) environment. This is a case report of a single LBW preterm male infant (34 weeks corrected gestational age, birth weight 1.82 kg) treated with a structured seven-day physiotherapy protocol, delivered during Kangaroo Mother Care (KMC) sessions in the NICU. The infant had a poor repertoire GM (general movement) and immature primitive reflexes at baseline. The individualized, developmentally appropriate physiotherapy protocol was developed and implemented for seven consecutive days, with the infant in skin-to-skin contact during KMC, and the protocol consisted of four phases: tactile containment, kinesthetic stimulation, postural alignment, and empowering the caregiver. Pre- and post-assessments were conducted using Prechtl's General Movements Assessment (GMA) and Neonatal Behavioral Assessment Scale (NBAS). The infant responded to the seven-day intervention by moving from a poor repertoire GM to an improved GM repertoire with increased variability and complexity within the writhing phase, and by improving in 10/13 NBAS reflex domains, although spontaneous neurological maturation may also have contributed to these changes. During the intervention period, no adverse events were noted. This case report demonstrates that a structured physiotherapy prescription can be integrated with KMC in one LBW infant and highlights the need for further investigation of its feasibility and potential benefit in larger controlled studies.