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Chest physiotherapy in paediatric patients hospitalised with community-acquired pneumonia: a randomised clinical trial
  1. Janice Luisa Lukrafka1,
  2. Sandra C Fuchs2,
  3. Gilberto Bueno Fischer3,
  4. José A Flores4,
  5. Jandira M Fachel5,
  6. Jose A Castro-Rodriguez6
  1. 1Department of Physiotherapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brasil
  2. 2Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
  3. 3Department of Pediatrics, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
  4. 4Department of Radiology, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
  5. 5Department of Statistics, Mathematics Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
  6. 6Departments of Pediatrics and Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
  1. Correspondence to Janice Luisa Lukrafka, Department of Physiotherapy, Universidade Federal de Ciências da Saúde de Porto Alegre, St. Sarmento Leite 245, CEP 90050-170, Porto Alegre, Rio Grande do Sul, Brasil; jllukrafka{at}bol.com.br

Abstract

Background Chest physiotherapy has been used to treat children hospitalised with pneumonia with no clear scientific evidence to support a beneficial effect. The objective of the current study was to evaluate the efficacy of chest physiotherapy as an adjuvant treatment in children hospitalised with acute community-acquired pneumonia.

Methods Children (aged 1–12 years) with a clinical and confirmed radiological diagnosis of pneumonia sequentially admitted to a tertiary children hospital were eligible for this study. Participants were randomly selected to receive a standardised respiratory physiotherapy (positioning, thoracic vibration, thoracic compression, positive expiratory pressure, breathing exercises and forced exhalation with the glottis open or ‘huffing’) three times daily in the ‘intervention group’ or a non-mandatory request to breathe deeply, expectorate the sputum and maintain a lateral body position once a day in the ‘control group’. The primary outcomes were reduction in respiratory rate and severity score (respiratory rate, recession, fever, oxygen saturation and chest x-ray) from baseline to discharge. Secondary outcome was duration of hospitalisation.

Results In all, 72 patients were randomly allocated to the intervention (n=35) or control (n=37) groups. There were no differences at admission on severity of pneumonia between groups. Respiratory rate and severity score significant decreased between admission to discharge within each group; however, there were no differences when comparing groups. Also, there was no significant difference in duration of hospitalisation between the control and intervention groups (6 vs 8 days, p=0.11, respectively).

Conclusions This clinical trial suggests that, in children hospitalised with moderate community-acquired pneumonia, chest physiotherapy did not have clinical benefits in comparison to control group.

  • Respiratory
  • General Paediatrics

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