{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:53:34Z","timestamp":1789682014305,"version":"4.0.1"},"reference-count":10,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,14]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A common and serious illness that frequently necessitates specific respiratory and developmental assistance is Neonatal Respiratory Distress Syndrome (NRDS), which affects premature infants. A neurophysiological physiotherapy technique called Vojta therapy has demonstrated potential in enhancing neuromotor development and breathing patterns. However, the availability of qualified healthcare professionals frequently limits its administration. This gap might be closed by involving mothers as qualified caretakers, particularly in environments with limited resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Comparing the effects of Vojta therapy administered by trained mothers against trained healthcare professionals on clinical, pulmonary and neurodevelopmental outcomes in neonates with NRDS is the goal of this randomised controlled experiment. Preterm neonates before 36 weeks of gestation who have stable vital signs (pulse rate (PR) 160\u2013180\u2009bpm, respiratory rate (RR) &gt;60 or apnoea), mild to severe NRDS and no mechanical breathing will be included in this randomised controlled experiment. On the Silverman-Anderson Respiratory Severity Score, neonates must have a score between 1 and 7. Standardised training will be provided to mothers and healthcare professionals, and participation in care delivery will only be permitted for those who receive a score of \u22659\/10 on a paediatric physiotherapy competency evaluation. Two groups will be formed at random from the participants. Group B will receive the Vojta Approach from a trained healthcare worker, whereas Group A will receive the Vojta Approach in conjunction with maternal participation in healthcare. The Hammersmith Infant Neurological Examination will be used to measure neurodevelopmental status, early feeding skills (as determined by the Early Feeding Skills Assessment Tool), oxygen saturation, PR, RR, Silverman-Anderson Score and length of hospital and neonatal intensive care unit stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study is approved by the Institutional Ethics Committee of Datta Meghe Institute of Higher and Research (DU) under ID: (DMIHER(DU)\/IEC\/2024\/15) and by Clinical Trial Registry\u2014India CTRI\/2024\/12\/078619.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105327","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:55:46Z","timestamp":1774932946000},"page":"e105327","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of comparative efficacy of healthcare delivery by mothers versus trained healthcare workers in adjunct to Vojta therapy on clinical outcomes in neonates with respiratory distress syndrome: a protocol for randomised controlled trial"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2926-5609","authenticated-orcid":false,"given":"Sharath","family":"Hullumani","sequence":"first","affiliation":[{"name":"Vice Dean (R&D), Doctoral Scholar, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"},{"name":"Paedaitrics and Neonatal Physiotherapy, Ravi Nair Physiotherapy College, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irshad","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Paedaitrics and Neonatal Physiotherapy, Ravi Nair Physiotherapy College, Wardha, Maharashtra, India"},{"name":"Neuro Physiotherapy, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghuveer","family":"Raghumahanti","sequence":"additional","affiliation":[{"name":"Paedaitrics and Neonatal Physiotherapy, Ravi Nair Physiotherapy College, Wardha, Maharashtra, India"},{"name":"Neuro Physiotherapy, Datta Meghe Institute of Higher Education and Research Deemed to be University, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"2026033021551506000_16.3.e105327.1","unstructured":"Sachdeva A , Dutta AK , Jain MP . Respiratory distress in newborn: advance in paediatrics. Medical publisher, 2012:83\u201391."},{"key":"2026033021551506000_16.3.e105327.2","first-page":"2","article-title":"A Clinical Study of Respiratory Distress In Newborn and Its Outcome","volume":"1","author":"Santosh","year":"2013","journal-title":"Indian Journal of Neonatal Medicine and Research"},{"key":"2026033021551506000_16.3.e105327.3","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.18203\/2349-3291.ijcp20232238","article-title":"Evaluation of etiology and clinical spectrum of respiratory distress in neonates admitted in tertiary care NICU","volume":"10","author":"Pawar","year":"2023","journal-title":"Int J Contemp Pediatr"},{"key":"2026033021551506000_16.3.e105327.4","unstructured":"Yadav S , Lee B , Kamity R . Neonatal respiratory distress syndrome. Treasure Island (FL): StatPearls Publishing, 2023."},{"key":"2026033021551506000_16.3.e105327.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02744-7"},{"key":"2026033021551506000_16.3.e105327.6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.5455\/medarh.2019.73.183-186","article-title":"Incidence, Risk factors and Outcome of Respiratory Distress Syndrome in Term Infants at Academic Centre, Jeddah, Saudi Arabia","volume":"73","author":"Alfarwati","year":"2019","journal-title":"Med Arch"},{"key":"2026033021551506000_16.3.e105327.7","unstructured":"Ojta V , Shweizer E . The Discovery of Ideal Motor Skills; Editorial Morata. 2011."},{"key":"2026033021551506000_16.3.e105327.8","doi-asserted-by":"crossref","DOI":"10.3390\/medicina57111149","article-title":"Vojta Therapy in Neuromotor Development of Pediatrics Patients with Periventricular Leukomalacia: Case Series","volume":"57","author":"De-La-Barrera-Aranda","year":"2021","journal-title":"Medicina (Kaunas)"},{"key":"2026033021551506000_16.3.e105327.9","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1038\/s41372-018-0049-3","article-title":"Performance of the Silverman Andersen Respiratory Severity Score in predicting PCO2 and respiratory support in newborns: a prospective cohort study","volume":"38","author":"Hedstrom","year":"2018","journal-title":"J Perinatol"},{"key":"2026033021551506000_16.3.e105327.10","doi-asserted-by":"crossref","DOI":"10.1186\/1824-7288-36-65","article-title":"Chest physiotherapy in preterm infants with lung diseases","volume":"36","author":"Giannantonio","year":"2010","journal-title":"Ital J Pediatr"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-105327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:55:54Z","timestamp":1774932954000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-105327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,30]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bmjopen-2025-105327"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-105327","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}