Abstract
BackgroundPneumonia is the single leading cause of death in children younger than 5 years of age. Chest physiotherapy is often prescribed as an additional therapy in children with pneumonia. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. However, it is unclear if these techniques are effective in this population.ObjectiveThe present review aimed to determine the efficacy of different chest physiotherapy techniques compared with no physiotherapy or other chest physiotherapy treatments in hospitalised children with bacterial pneumonia.MethodSix electronic databases (PubMed, Medline, Cochrane Library, PEDro, CINAHL and Africa-wide information), clinicaltrials.gov and pactr.org were searched for eligible studies.ResultsTwo randomised controlled trials and one ongoing study were identified. Neither completed trial reported differences between the control and intervention groups, although one study reported a longer duration of coughing (p = 0.04) and rhonchi (p = 0.03) in the intervention group.ConclusionBecause of the limited number of included articles and different presentations of outcome measures, we could not reject or accept chest physiotherapy as either an effective or harmful treatment option in this population.
Highlights
Description of the conditionPneumonia is an acute respiratory infection, characterised by painful breathing and limited oxygen intake as a result of fluid and pus in the alveoli (World Health Organization [WHO] 2012; WHO/UNICEF 2009)
Treatment of pneumonia consists of interventions in 3 domains: (1) protection for example, breastfeeding during the first 6 months of life, (2) prevention by vaccination and (3) appropriate antibiotic and/or symptomatic treatment (WHO 2012; WHO/UNICEF 2006, 2009)
One study compared standard treatment for pneumonia with standard treatment with additional conventional chest physiotherapy (Paludo et al 2008), whilst the other study compared recommended non-mandatory lateral positioning, cough and diaphragmatic breathing with conventional chest physiotherapy combined with positive expiratory pressure (PEP) in all children and the forced expiratory technique (FET) in children more than 5 years old (Lukrafka et al 2012)
Summary
Description of the conditionPneumonia is an acute respiratory infection, characterised by painful breathing and limited oxygen intake as a result of fluid and pus in the alveoli (World Health Organization [WHO] 2012; WHO/UNICEF 2009). The risk of long-term respiratory sequelae after childhood pneumonia is 5.5%, with restrictive lung diseases being the most common (Edmond et al 2012). Bronchiectasis has been reported in children following hospitalisation with pneumonia (Edmond et al 2012). Pneumonia is the single leading cause of death in children younger than 5 years of age. Different chest physiotherapy techniques are available that aim to improve airway clearance, gas exchange and reduce the work of breathing. It is unclear if these techniques are effective in this population
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