Effectiveness of short-term respiratory physiotherapy in children under 12 months with non-hospitalized mild and moderate bronchiolitis
Authors: Vanessa González-Bellido
Keywords: Airway cleaning techniques. Chest physiotherapy. Airway mucus clearance. Infant. bronchiolitis
Abstract : Acute bronchiolitis (AB) is a common viral respiratory infection that causes frequent hospitalization. The objectives set for this study were to evaluate the efficacy of slow expiratory manual pressures and provoked cough in non-hospitalized children with mild and moderate AB, according to Wang's clinical severity scale.
07-05-2018
Vanessa González-Bellido
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| Citation: Vanessa González-Bellido. Effectiveness of short-term respiratory physiotherapy in children under 12 months with non-hospitalized mild and moderate bronchiolitis. https://doi.org/10.24175/sbd.2018.000088 |
| Received: May 07, 2018 Accepted: May 07, 2018 Published: May 07, 2018 |
| Copyright: © 2018 Vanessa González-Bellido. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC), which allows, distribution, reproduction in any medium, provided the original author and source are credited and non-commercial use. |
| Funding: I certify that no funding has been received for the conduct of this study and/or preparation of this manuscript. |
| Conflicts of Interest: I have no conflicts of interest to declare |
Effectiveness of short-term respiratory physiotherapy in children under 12 months with non-hospitalized mild and moderate bronchiolitis
Vanesa González-Bellido1,2 PT, M.Sc, Verónica Velaz-Baza1 PT, Rocío Marta Pérez-Morales1 PT, Mª del Carmen Jimeno Esteo3 MD, Rubén García Caraballo 4 MD, José Luis Arias-Buría5,6 PT, MSc, PhD.
1 Fisiobronquial, Coslada, Madrid, España, 2 Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, España, 3 Directora Clínica Vionta. A Coruña, 4 Servicio de Urgencias. Hospital da Barbanza. A Coruña, 5 Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física Universidad Rey Juan Carlos, Alcorcón, España, 6 Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
Key words: Airway cleaning techniques. Chest physiotherapy. Airway mucus clearance. Infant. Bronchiolitis.
Introduction and objectives
Acute bronchiolitis (AB) is a common viral respiratory infection that causes frequent hospitalization. The objectives set for this study were to evaluate the efficacy of slow expiratory manual pressures and provoked cough in non-hospitalized children with mild and moderate AB, according to Wang's clinical severity scale.
Methodology
This is a quasi-experimental, prospective double-blinded, multicenter study (Madrid 64.5% and A Coruña 35.5%) in which 76 children were included. Two physicians evaluated the participants with the Wang scale prior to treatment initiation (pre), then 10 min (post) and 48 hours (follow-up) after the physiotherapy session. A single session of respiratory physiotherapy of 45 min of duration was performed, with control of the patient's heart rate, oxygen saturation, respiratory rate and Wang scale, differentiating between infants under 6 months and over 6 months of age, following scientific evidence.
Results
The baseline clinical characteristics of the patients were 31.6% (24) females and 68.4% (52) males, of ages between 7.59 ± 2.72 months, 8.19 ± 1.49 kg of weight and 68, 8 ± 7.56 cm of height. Analyzing the variables, we obtained significant changes in all the measured variables: heart rate (HR) (t = 2,124, P 0.037), oxygen saturation (SaO2) (t = 14,200, P <0.001), and respiratory frequency (RF) (F = 342.486, P <0.001). Regarding the Wang scale, in infants <6 months 35% (7) initiated with a moderate-severe value, which was eliminated completely after the session, and 48h later only 1 patient had not reached normality. In those patients > 6 months of age 26.8% (15) started with moderate-severe degree, after the session 66.1% (37) reached normality, and 48h later only 7.1% (4) had not reached normal values (Wang: F = 230.860, P <0.001).
Discussion
The majority of investigations in respiratory physiotherapy have been developed in in-hospital patients with AB. However, the majority of cases are resolved on an outpatient basis, which makes it necessary to evaluate whether the therapeutic result is equally optimal.
Conclusions
We found that the inclusion of a single session of respiratory physiotherapy that includes manual slow expiratory pressure and provoked cough in children with mild and moderate bronchiolitis is effective in the short term according to Wang's bronchiolitis severity scale.
