Author(s): Joy Varghese DPT MSc MIAP ISCP, Senior Physiotherapist

Department: St. Michael’s House

Keywords: Respiration, Facilitation, Intellectual Disability

In-house Publication

The purpose of this study was to compare the effectiveness of the neurophysiological facilitation of respiration (NFR) techniques with traditional chest physiotherapy techniques in respiratory care of people with Intellectual Disability.

Twenty-two male and female intellectual disability subjects aged between 8 and 55 years with recurrent chest infections or restrictive ventilatory defect or hyper-ventilation participated in the study.

Equal numbers of subjects were assigned to the control group (CON) and to NFR group. Groups received twice a week treatment for 8 weeks. The following measures were recorded before and after at 8 weeks, 12 weeks and 16 weeks intervention: 1) Oxygen saturation, 2) Respiratory rate, 3) Chest measurement, 4) Abdomen measurement, 5) Hospital admission, 6) Medication were.

The results showed no significant difference between mean NFR and CON groups for measures 1 – 4 of the outcome measures. However 4 out of 9 subjects from the NFR and 2 out of 9 from the Con groups recorded normal pattern of breathing. Those who required frequent hospital admission in the NFR and in the CON did not require hospital admissions during the 3 post weeks. Those who required Medication in the NFR and in the CON did not require Medication during the 3 post weeks. One subject (NFR) with frequent seizures and cyanosis improved dramatically with reduced seizure attacks and cyanosis. One subject (NFR) with tongue thrust showed improvement in swallowing and controlling tongue thrust. While two subjects (NFR) with severe drooling showed reduction up to half the quantity of saliva. One subject (NFR) with high noise levels showed reduction in noise levels and improvement in communicating with sign language. 1 hyperactive subject (NFR) improved noticeably calm.

The outcome measures used in this small study were not sensitive enough to measure the changes that are relevant to this population as a result of CON or NFR intervention. Single case studies with outcome measures that can record the changes that were observed in this study may be the way forward in research for this population.

Contact:  Joy Varghese