In her doctoral capstone, Philbeck examined how water can encourage musculoskeletal and neurobehavioral development in infants.
Occupational therapists have long used hydrotherapy—the use of water to provide support, resistance, and other effects that cannot otherwise be utilized without the weightlessness of water—as an intervention to address diverse medical conditions.
However, utilizing hydrotherapy in the Neonatal Intensive Care Unit (NICU) is a relatively new and developing area of practice—one that recent Presbyterian College Occupational Therapy Doctoral graduate Caroline Philbeck ‘24 chose to study as her doctoral capstone.
Her capstone, titled “Hydrotherapy in the Neonatal Intensive Care Unit: How Occupational Therapists use Water to Facilitate Musculoskeletal and Neurobehavioral Development,” was centered around her implementation experience in the NICU at the Medical University of South Carolina’s Shawn Jenkins Children’s Hospital in Charleston during the summer of 2024.
Philbeck’s prior research on the topic indicated that the benefits of utilizing hydrotherapy with infants are significant, including the development of endurance, facilitation of typical movement, vital sign stabilization, promotion of deeper sleep, and increase in weight gain due to improved feeding proficiency.
“Water therapy has been proven to aid in the reduction of pain, stress, irritability, and the neuromusculoskeletal changes acquired by infants during long periods of hospitalization,” according to Philbeck’s capstone abstract. Together with her site mentor, Rachel Crone Eagan, MSOT, OTR/L, Philbeck had the opportunity to demonstrate these benefits firsthand and provide evidence backing the usefulness and need for neonatal hydrotherapy. Through her capstone, she wanted to develop and disseminate the process of initiating the implementation of this therapeutic intervention in the NICU.
Following six weeks of protocol development, Philbeck implemented neonatal hydrotherapy over eight weeks, working with nine infants for a total of 20 neonatal hydrotherapy sessions. During each session, occupational therapists used water to facilitate tactile stimulation and passive movement of infants’ trunk, pelvis, and limbs, allowing the patient to overcome gravity’s limitations. The infant is undressed, unswaddled, and submerged in a tub of warm water, in a supine position, up to their shoulders. The therapist unswaddled the infant slowly while simultaneously performing various range of motion exercises, shifts in orientation, and providing tactile stimulation.
Philbeck’s findings from her capstone implementation at Shawn Jenkins Children’s Hospital aligned with her existing research findings that neonatal hydrotherapy provides long-term and cost-effective benefits for infant development.
“I have always been interested in working in pediatrics,” said Philbeck. “I enjoy the hospital setting, and I knew that if given the opportunity, I would love to experience OT in the NICU. I am very thankful for the chance to bring the emerging practice of Neonatal Hydrotherapy to Charleston.”
To learn more about the Presbyterian College Occupational Therapy Doctoral Program, visit the program website.
