Chest Physiotherapy Does Not Induce Bronchospasm in Stable Asthma

Abstract

Study objectives A recent systematic review concluded that it is not possible to judge manual chest physiotherapy safety in asthma. This study measured the effects of chest physiotherapy on pulmonary function and symptoms and safety in people with stable asthma. Design Prospective controlled study. Setting University general hospital. Patients Eighty-one asthma patients attending an asthma clinic with stable asthma, 62 adults and 19 children, and 15 adults without asthma recruited from members of staff of the hospital. Interventions Spirometry was performed before and five minutes after chest physiotherapy, which included postural drainage, percussion, vibratory-shaking and the forced expiration technique – ‘huffing'. Measurements and results There were no significant changes in FEV1 and FEF25-75% induced by chest physiotherapy in adults with mild and moderate or severe asthma and in children with mild and moderate asthma. After chest physiotherapy there was no decrease in FEV1 greater than 20%. Of the children 32% and of the adults 4% complained of worsening in asthma symptoms after physiotherapy manoeuvres. However, FEV1 did not decrease more than 10% in any of them. Eight hours after treatment, participants with moderate asthma did not show a significant change in FEV1. Conclusions Chest physiotherapy manoeuvres, including postural drainage, percussion, vibratory-shaking and ‘huffing', do not induce a significant worsening in airway obstruction in subjects with stable asthma, including patients with severe asthma. A recent systematic review concluded that it is not possible to judge manual chest physiotherapy safety in asthma. This study measured the effects of chest physiotherapy on pulmonary function and symptoms and safety in people with stable asthma. Prospective controlled study. University general hospital. Eighty-one asthma patients attending an asthma clinic with stable asthma, 62 adults and 19 children, and 15 adults without asthma recruited from members of staff of the hospital. Spirometry was performed before and five minutes after chest physiotherapy, which included postural drainage, percussion, vibratory-shaking and the forced expiration technique – ‘huffing'. There were no significant changes in FEV1 and FEF25-75% induced by chest physiotherapy in adults with mild and moderate or severe asthma and in children with mild and moderate asthma. After chest physiotherapy there was no decrease in FEV1 greater than 20%. Of the children 32% and of the adults 4% complained of worsening in asthma symptoms after physiotherapy manoeuvres. However, FEV1 did not decrease more than 10% in any of them. Eight hours after treatment, participants with moderate asthma did not show a significant change in FEV1. Chest physiotherapy manoeuvres, including postural drainage, percussion, vibratory-shaking and ‘huffing', do not induce a significant worsening in airway obstruction in subjects with stable asthma, including patients with severe asthma.