Effect of bucket hydrotherapy on clinical parameters in infants with bronchopulmonary dysplasia: A pilot randomized clinical trial

Introduction It is unknown whether bucket hydrotherapy is beneficial to premature newborns with bronchopulmonary dysplasia (BPD). Objective To evaluate the effects of bucket hydrotherapy on physiological and behavioural parameters and the oxygen need in preterm infants with BPD during hospitalization. Methods Twenty infants with BPD were randomized into a control (conventional physiotherapy - PG) or an intervention group (conventional physiotherapy plus bucket hydrotherapy - BHG). All infants underwent twelve days of intervention, and data from the first (D1), sixth (D6) and twelfth (D12) days were analyzed. Respiratory rate (RR), heart rate (HR), peripheral oxygen saturation (SpO₂), inspired oxygen fraction (FiO₂), pain, respiratory effort, sleep, and wakefulness status were measured before, immediately after, and at 15, 30, and 60 minutes after the intervention. Results In the BHG, intragroup analysis showed lower values for FiO₂ on D1 (30’: p = 0.03, 60’: p = 0.02), HR on D6 (p = 0.004) and RR on D12 (p < 0.03), and higher values for SpO₂ on D12 (p = 0.0003). Intergroup comparisons favored BHG for SpO₂ (p = 0.03; effect size [ES] =0.99) and FiO₂ (p < 0.02; ES > 0.47) on D1, HR changes on D6 (p < 0.04; ES > 0.9) and D12 (p = 0.009; ES = 0.61). No significant intra- or intergroup differences were found in pain, respiratory effort, sleep, or wakefulness (p > 0.05 for all). Discussion Given the persistent gas exchange abnormalities in BPD, bucket hydrotherapy appears to be a feasible and beneficial non-pharmacological method for reducing oxygen requirements. Conclusion The present pilot study demonstrates that bucket hydrotherapy is a therapeutic intervention that reduces HR, RR and oxygen requirements in premature infants with BPD without inducing changes in behavioural parameters.