Abstract
Abstract Objectives The use of chest physiotherapy (CP) has not, to date, been shown to be effective in the care of infants hospitalized for bronchiolitis. However, it has not yet been studied in outpatient settings. The aim of our study was to examine the short-term benefit of CP with the increased exhalation technique (IET) on the respiratory conditions of nonhospitalized infants. Methods Our research consisted of a multicenter, randomized, controlled, single-blind study of infants under 1 year old. A decrease in the severity score of the infants' respiratory condition was compared between two groups: one receiving CP and one without CP. Eighty-two infants were randomized: 41 in the CP group and 41 in the control group. Blinded assessors determined the Wang Clinical Severity Score at inclusion (T0) and 30 minutes later (T1) for each group. Results Improvement in the severity score was observed for 29 infants (70.7%) in the group receiving CP, compared with 4 infants (9.76%) in the control group (p < 0.001). The mean decrease in the Wang Clinical Severity Score was −2 (±1.32) in the group receiving physiotherapy compared with −0.22 (±0.99) in the control group (p < 0.001). Conclusion For outpatient care of infants with bronchiolitis, the results of this study suggest that CP with IET leads to a short-term improvement of mucus airway obstruction parameters.
Highlights
In every part of the world, bronchiolitis is common among infants and leads many parents to seek medical care and physiotherapy in outpatient settings
The use of chest physiotherapy (CP) has not, to date, been shown to be effective in the care of infants hospitalized for bronchiolitis
Improvement in the severity score was observed for 29 infants (70.7%) in the group receiving Chest physiotherapy (CP), compared with 4 infants (9.76%) in the control group (p < 0.001)
Summary
In every part of the world, bronchiolitis is common among infants and leads many parents to seek medical care and physiotherapy in outpatient settings. Several studies and international recommendations have found that there is no effective drug to treat a first episode of bronchiolitis. The authors of the most recent Cochrane Review recommended testing the potential effect of exhalation techniques among mildly to moderately affected nonhospitalized patients. The studies that have evaluated the effects on airflow have primarily been interested in a patient population of hospitalized infants.. In France, the National Health Authority has called for randomized “ambulatory” studies to be conducted to evaluate such techniques which remain rather widely prescribed by doctors, given that, to date, the amount of evidence from studies in outpatient settings (private practice) was deemed to be insufficient. The studies that have evaluated the effects on airflow have primarily been interested in a patient population of hospitalized infants. Recently in France, the National Health Authority has called for randomized “ambulatory” studies to be conducted to evaluate such techniques which remain rather widely prescribed by doctors, given that, to date, the amount of evidence from studies in outpatient settings (private practice) was deemed to be insufficient.
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