Table 4. Post-surgery physiotherapy intervention.

 PSE: prolonged slow expiratory; LST: lung squeezing technique

Sr.	Physiotherapeutic goals	Physiotherapeutic rehabilitation	Rehabilitation regimen
1.	To make the patient's parents aware of the problem and to get their cooperation and approval for a further plan of management.	Education and counselling for caregivers regarding the patient's condition and the need for the following physiotherapeutic measures.	At the commencement of the intervention, caregivers were taught about the role of physiotherapists in the patients' care.
2.	To improve ventilation/perfusion matching	Positioning using a cushion is beneficial because a baby's lungs are not supported by the thoracic cavity, and the baby's normal resting pleural pressure is closer to atmospheric pressure than in adults, causing airway closure in more dependent zones.	Every two hours, alternate positioning to the opposite side.
3.	To remove excess phlegm secretions from smaller airways to the centre of the chest	1. Chest percussion: A percussor cup is used to percuss various portions of the chest wall based on auscultatory results. 2. Expiratory vibration: The neonatal resuscitation mask is attached to the nebulizer machine, which provides a vibratory effect when it is powered on.	Holding the percussor cup between the fingers, gently pat the infant's chest and back for two to four minutes. Vibration is given for five minutes during the expiratory phase, from the periphery to the centre of the chest.
4.	To promote clear airways and eliminate mucosal secretions and foreign particles.	Suctioning: oropharyngeal and nasopharyngeal suctioning were done as required.	To remove secretions from the central airways following chest physiotherapy.
5.	To minimise pulmonary congestion in infants suffering from pneumonia.	The PSE technique [8]: The patient is lying supine with the therapist placing one hand on the chest cavity and the other on the peritoneal cavity. At the termination of the exhalation phase, the therapist applies compressive pressure in the caudal direction from the above hand and in the cranial direction from the below hand.	The compressive force is sustained for four to five seconds following a gradual relaxation. Three sets of three compressions are applied three times a day, with a 30-second break between each compression.
6.	To restore uniform pulmonary inflation with low-frequency rhythmic thoracic compressions	The LST technique: The physiotherapist places one hand on the patient's anterior thoracic wall and the other on the posterolateral aspect, then applies sustained compression for five seconds.	Each set includes two to five thoracic compressions, three times per day. The hemithorax should be compressed for at least ten minutes, five minutes maximum on each side.
7.	To promote the establishment of suitable normal movement patterns, and as a result, noted an improved breathing pattern.	Vojta technique: The infants progressed via the stage of reflex rolling in a supine position. Slight tilting of the head in the direction where the stimulation is given. Each simulation consists of a slight amount of pressure being applied to the spine diagonally in the dorsal, medial, and cranial directions.	Every session comprises four stimuli, two given to the left side of the thorax and the other two stimuli given to the right side of the thorax. The therapy must be performed three times every day.
8.	To avoid muscle tightness and to enhance joint stability and flexibility	Passive joint mobility exercises for bilateral upper and lower extremities.	10 repetitions x one set a couple of times a day in the beginning, then gradually progressed to 10 repetitions x two sets, three times a day.