Background and aims Caring for a child with disability can be expensive not only for the family itself but also to society. Premature neonates are more likely to be re-hospitalised than babies born at full term and the healthcare costs in the first year are significantly higher for premature babies.

The cost of caring for a disabled child is clearly immense. As a result it is important to try to find ways to prevent disabilities or improve the condition of neonates who are at a risk of developing disabilities. For this reason the Intensive Neonatal care unit at the regional hospital of Ruse has focused on an early physiotherapy intervention (EPI) program on neonates with hypoxic and ischaemic impairment of the central nervous system (CNS).

Methods The study covers a period of 4 years and includes 172 randomised premature infants of different sexes who were placed in 2 groups (control and experimental). The placement in one of the two groups takes place after a conversation with the parents and informing them about the risk for motor impairments.

Results Hammersmith neurodevelopment and motor development test that was performed to both groups of preterm neonates shows considerable improvement in the motor development to those neonates with EPI immediately after birth.

Conclusion Neonate’s brain has a high plasticity after birth and great opportunities for recovery. As the EPI improves the condition of neonates at risk of development motor disabilities it can help reduce the cost of disability in the long run.