Effects Of Chest Physical Therapy Research Articles

Acute Effect of Chest Physical Therapy on Arterial Blood Gases for Mechanical Ventilated Patients

Abstract Background: Patients receiving mechanical ventilation have an increased risk of complications resulting in excess morbidity and mortality. Aim of Study: This study aimed to identify the acute effect of chest physical therapy on arterial blood gases of mechanically ventilated patients. Material and Methods: Sixty mechanically ventilated patients participated in the study. Their age ranged from 40 to 60 years. The patients were assigned into one study group including both sexes who received a chest physiotherapy protocol in form of (manual hyperinflation, vibration, percus-sion, suctioning, upper and lower limbs exercise and ending position) for one session. Arterial Blood Gases (ABG) includ-ing (pH, PaO2, SO2, PaCO2 and HCO3) were assessed by arterial blood sample analysis through the Laboratory GEM premier 3000 device. All the assessment was done for every patient pre and post chest physiotherapy protocol. Results: The results revealed a marked improvement in arterial blood gas exchange as compared to base line reflected by a highly significant statistical increase in PaO2 and SaO2 (p < 0.001) and a significant decrease in PaCO2 (p < 0.001) while with no significant changes regarding pH and HCO3 (p=0.36 and 0.15 respectively). Conclusion: Chest physiotherapy protocol is an effective method for improving arterial blood gases of mechanical ventilated patients acutely.

The application of beside lung ultrasound in emergency-plus protocol for chest physical therapy in patients with severe pneumonia

Objective To explore the effect of chest physical therapy guided by ultrasound in patients with severe pneumonia. Methods One hundred patients with mechanical ventilation in the ICU were divided into a control group and a test group according to the occupancy time. The control group was given chest physical therapy according to routine imaging data and pulmonary auscultation. The experimental group was given physical therapy of the chest according to the routine imaging and pulmonary auscultation, also according to the BLUE ultrasound protocol. The mechanical ventilation time, ICU hospitalization time and the drainage capacity of 1 day, 2 days, 4 days, and 7 days after treatment were observed. Results The mechanical ventilation time was (7.82±1.38) days and ICU hospitalization time were (10.16±1.88) days in the test group. The mechanical ventilation time was (10.14±1.73) days and ICU hospitalization time were (12.78±2.11) days in the control group. There were significant differences between the two groups (t=7.42, 6.56, P 0.05). Conclusions Pulmonary ultrasound can continuously monitor lung changes. Nurses can perform targeted nursing treatment on the basis of ultrasound. Key words: Ultrasound; Chest physical therapy; Mechanical ventilation

Effectiveness of Chest Physical Therapy in Improving Quality of Life and Reducing Patient Hospital Stay in Chronic Obstructive Pulmonary Disease

Objective: To find out the effectiveness of chest physical therapy along with standard medical treatment versus standard medical treatment alone in improving quality of life and reducing patient's hospital stay in Chronic Obstructive Pulmonary Disease (COPD) patients. Methods: A randomized controlled trial was conducted in a tertiary care hospital of Peshawar, from September 2016 to February 2017. Thirty COPD patients were included in the study. All patients were randomized into control group and experimental group. The experimental group received chest physical therapy along with standard medical treatment while control group received standard medical treatment alone. Results: The mean age of the participants was 54.2±7.2 years. Both groups were similar with respect to age (p-value 0.432) and gender distribution (p-value 0.464). At baseline mean Saint George's respiratory questionnaire (SGRQ) score was 38.1±7.3 for control group while 37.9±9.2 for experimental group (p- value 0.947). The post-treatment mean SGRQ score was 34.6±6.5 for control group while 28.1±8.7 for experimental group with p-value 0.028. The mean hospital stay of control group was 9.26±1.43 days while mean hospital stay of experimental group was 8.20±1.47 days (p-value 0.055). Conclusion: Chest physical therapy combined with standard medical treatment has considerable effect on improving functional status and quality of life of COPD patients. Yet the effect of chest physical therapy in reducing hospital stay in COPD patients is insignificant.

Effect of Chest Physical Therapy Modalities on Oxygen Saturation and Partial Pressure of Arterial Oxygen in Mechanically Ventilated Patients

Background: Chest physical therapy plays an important role in increasing Pao2 and SaO2 among ICU patients which is considered as a good indicator for the general improvement of the patient besides decreasing ICU staying and costs. Purpose: To figure out the effect of chest physical therapy on oxygen saturation and partial pressure of arterial oxygen. Patients and Method: Thirty patients post MV, their age ranged from 50 to 60 years old were recruited in this study. The patients were selected from ICUs of Kasr al Ainy hospital, Faculty of Medicine, Cairo University. The patients received chest physiotherapy (percussion, vibration, manual hyperinflation), positioning and upper and lower limbs exercises. Results: Increase in Pao2 and SaO2 in addition to decreased incidence of chest infection and decreased ICU stay. Conclusion: The results of this study support the importance of chest physiotherapy on increasing SaO2 and Pao2, decrease ICU duration and decrease health care costs.

Study of Chest Physical Therapy Effect on Full Term Neonates with Primary Pneumonia: A Clinical Trial Study

Background Chest physiotherapy has been used to clear secretions in pediatrics for many respiratory problems. The aim of this study was to investigate the effect of chest physical therapy on full term neonates with primary pneumonia. Materials and Methods Sixty full term neonates admitted to neonatal intensive care unit (NICU), Minia University, Egypt, during the period from September 2016 to September, 2017 divided into two equal groups: group I included 30 patients received routine medical treatment according to American Academy of Pediatrics (AAP) recommendations and group II included another 30 patients received routine medical treatment plus chest physical therapy modalities in the form of positioning, postural drainage, percussion and vibration. We compared between the two groups as regards the duration for mechanical ventilation and/or oxygen therapy, clinical improvement, oral feeding and duration of hospitalization. Results There was significant differences between group I, neonates who received routine medical treatment) and group II, neonates who received routine medical treatment plus chest physical therapy regarding the duration needed for mechanical ventilation and/or oxygen (p <0.045), the duration needed for clinical improvement (p <0.042), the duration needed for oral feeding (p <0.035) and the duration of hospitalization (p <0.031). Conclusion According the results, chest physical therapy has a positive supportive effect on full term neonates with primary pneumonia regarding the duration needed for mechanical ventilation and/or oxygen therapy, the duration needed for clinical improvement and the duration of hospitalization.

Effects of Chest Physical Therapy in Patients with Non-Tuberculous Mycobacteria.

Antibiotic therapy against non-tuberculous mycobacteria (NTM) is prolonged and can be associated with toxicity. We sought to evaluate whether chest physical therapy (PT) was associated with clinical improvement in patients with NTM not receiving anti-mycobacterial pharmacotherapy.A retrospective review of 77 subjects that were followed from June 2006 to September 2014 was performed. Baseline time point was defined as the first positive sputum culture for NTM; symptoms, pulmonary function, and radiology reports were studied. Subjects were followed for up to 24 months and results analyzed at specified time points.Half of the subjects received chest PT at baseline. Cough improved at 12 (p = 0.001) and 24 months (p = 0.003) in the overall cohort when compared with baseline, despite lack of NTM antibiotic treatment. Cough decreased at 6 (p = 0.01), 9 (p = 0.02), 12 (p = 0.02) and 24 months (p = 0.002) in subjects that received chest PT. Sputum production also improved at 24 months in the overall cohort (p = 0.01). There was an increase in the percent change of total lung capacity in subjects that received chest PT (p = 0.005).Select patients with NTM may have clinical improvement with chest PT, without being subjected to prolonged antibiotic therapy. Future studies are warranted to prospectively evaluate outcomes in the setting of non-pharmacologic treatment and aid with the decision of antibiotic initiation.

Physiological effects of asingle chest physiotherapy session in mechanically ventilated and extubated preterm neonates.

To assess the changes on various physiological cardio-respiratory parameters with asingle chest physiotherapy session in mechanically ventilated and extubated preterm neonates with respiratory distress syndrome. This is aprospective observational study in a neonatal intensive care unit setting. Sixty preterm neonates with respiratory distress syndrome, thirty mechanically ventilated and thirty extubated preterm neonates requiring chest physiotherapy were enrolled in the study. Parameters like heart rate (HR), respiratory rate (RR), Silverman Anderson score (SA score in extubated), oxygen saturation (SpO2) and auscultation findings were noted just before, immediately after chest physiotherapy but before suctioning, immediately after suctioning and after 5 minutes of the session. The mean age of neonates was 9.55±5.86 days and mean birth weight was 1550±511.5 g. As there was no significant difference in the change in parameters on intergroup comparison, further analysis was done considering two groups together (n = 60) except for SA score. As SA score was measured only in extubated neonates. HR did not change significantly during chest physiotherapy compared to the baseline but significantly decreased after 15 minutes (p = 0.01). RR and SA score significantly increased after suctioning (p = 0.014) but reduced after 15 minutes (p = <0.0001). SpO2 significantly reduced post-suctioning compared to the baseline and increased after positioning and 15 minutes of chest physiotherapy (p = <0.0001). Clinically, there was areduction in HR, RR and SA score with an improvement in SpO2. This signifies that chest physiotherapy may help facilitate the overall well-being of afragile preterm neonate. Lung auscultation finding suggests that after suctioning, there was asignificant reduction in crepitation (p = 0.0000) but significant increase in crepitation after 15 minutes (p = <0.01), suggesting the importance of around-the-clock chest physiotherapy. Chest physiotherapy is safe in preterm neonates. Suctioning causes significant cardio-respiratory parameter changes, but within normal physiological range. Thus, chest physiotherapy should be performed with continuous monitoring only when indicated and not as aroutine procedure. More research is needed to study the long term effects of chest physical therapy.

Effect of Chest Physical Therapy on Pediatrics Hospitalized With Pneumonia

Background: Pneumonia is a major cause of death among all age groups resulting in 4 million deaths yearly especially in those under five years. Chest physical therapy has been used to treat pediatrics hospitalized with pneumonia with lack of scientific evidence for the beneficial effect in pediatrics. Objectives: The aim of this study was to evaluate the effect of chest physiotherapy on pediatrics hospitalized with pneumonia. Method and Materials: A randomized controlled study was conducted in Pediatric University Hospital and Cairo University Hospitals. Fifty children aged 29 days to 5 years hospitalized with pneumonia between October 2014 and January 2015 was obtained, 25 were randomly allocated to the study group (chest physical therapy and standard treatment for pneumonia) and 25 to the control group (standard treatment for pneumonia alone without chest physical therapy). The primary measurement was time to clinical resolution. The secondary measurements were changes of respiratory rate and arterial oxygen saturation. Results: There were significant differences in terms of median time to clinical resolution (4.0 vs 7.0 days, p = 0.012) and the study group had greater improvement in respiratory rate (40 to 30 b/m vs 39 to 34 b/m) and in arterial oxygen saturation (93 to 98% vs 93 to 95%) than the control group. Conclusion: It was concluded that chest physical therapy showed significant improvements in pediatrics hospitalized with pneumonia.

Effect of Chest Physical Therapy on Pediatrics Hospitalized With Pneumonia

Effect of Chest Physical Therapy on Pediatrics Hospitalized With Pneumonia

Efeito da continuidade da fisioterapia respiratória até a alta hospitalar na incidência de complicações pulmonares após esofagectomia por câncer

O presente estudo avaliou os efeitos na incidência de complicações pulmonares do cuidado contínuo de fisioterapia respiratória no pós-operatório de esofagectomia, até a alta hospitalar. Examinaram-se retrospectivamente 40 prontuários de pacientes de esofagectomia consecutivos (nenhuma exclusão), que foram divididos em dois grupos: um dos que receberam fisioterapia respiratória apenas na unidade de tratamento intensivo (gUTI, n=20) e outro dos que a receberam até a alta hospitalar (gALTA, n=20). Foram coletadas informações referentes ao pré, intra e pós-operatório. Os resultados mostram que gUTI e gALTA, respectivamente, apresentaram-se similares (média±dp) quanto a idade (55,5±9,9 e 57,1±10,8 anos), IMC (22,5±3,3 e 18±4 kg/m²), tempo de cirurgia (400±103,8 e 408,5±142 min), tempo de anestesia (498,3±107,3 e 516±148,9 min) e número de atendimentos de fisioterapia na UTI (9,6±14,9 e 8,3±7,6). Apesar de o gALTA apresentar história de tabagismo superior (35,7±17,6 vs 26,1±18,4 maços-ano, p&lt;0,05), houve menos 20% de complicações respiratórias após esofagectomia nesse grupo quando comparado ao gUTI (10% vs 30%, p&lt;0,05): incidência 75% menor de derrame pleural e 50% menos broncopneumonia. Além disso, o gALTA teve permanência menor de dreno pleural no hemitórax direito (menos 4,5 dias, p&lt;0,05). Estes achados sugerem que os cuidados de fisioterapia respiratória até a alta hospitalar podem reduzir a incidência de complicações pulmonares após esofagectomia por câncer.

Possible Beneficial Effect of Chest Physical Therapy in Hospitalized Asthmatic Children

Patients with acute asthma often demonstrate impaired clearance of secretions from large and small airways. However, chest physical therapy is not generally recommended for acute asthma. Flutter VRP1 is a hand-held device approved by the Federal Drug Administration in the United States for patients with cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) to promote mucus clearance. The purpose of this study is to determine whether the addition of chest physical therapy such as the Flutter VRP1 device has any effect on pediatric patients hospitalized with acute asthma in an open label, prospective, randomized-controlled clinical trial. Forty-five children between 6 and 16 years of age who were admitted to a tertiary care children's hospital in a large metropolitan area with uncomplicated acute asthma were enrolled in the study. Of these, 20 were randomized to receive the Flutter treatment in addition to the standard therapy for acute asthma upon hospitalization and compared with 20 who receive just the standard therapy. The standard treatment included systemic steroids (methyl-prednisolone 2 mg/kg per dose every 6 hours) and aerosolized albuterol treatments every 2-4 hours. Spirometry and an asthma clinical score were measured every day. The group receiving Flutter therapy had more severe disease as demonstrated by their asthma score and increased need for supplemental oxygen (p < 0.01 and 0.05, respectively). There was a significant increase in FVC and FEV1 by those who received Flutter treatment on the first and second hospital day (p < 0.05) compared with those who received the standard treatment. Although FEF25-75% at the time of discharge was higher in the Flutter treatment group, it was not statistically significant (p = 0.08) and there was no significant difference in length of hospital stay (p = 0.3). However, there was not enough power to statistically show a difference in the latter. Therefore, institution of chest physical therapy such as Flutter therapy was not detrimental and may instead be beneficial in hospitalized children with acute asthma.

Effects of cisapride and chest physical therapy on the gastroesophageal reflux of wheezing babies based on scintigraphy

OBJECTIVE: To evaluate the effect of cisapride and chest physical therapy on the gastroesophageal reflux of wheezing babies. METHODS: We prospectively assessed the presence of technetium ((99)Tc) in the upper, middle, and lower esophagus of 25 wheezing babies (13 with GERD and 12 without GERD) using scintigraphy. Both groups underwent clinical investigation, including laboratory, X-ray and scintigraphy tests, for the etiology of the wheezing baby syndrome (WBS) and GERD. Expiratory Flow Acceleration (EFA) was performed before and after treatment with cisapride. The total time of GER episodes was accounted for each portion of the esophagus during scintigraphy and during EFA. RESULTS: Cisapride significantly reduced the total reflux time in the upper esophagus (P<0.05), but showed no influence during EFA. After cisapride therapy, EFA increased the total reflux time in the upper and medium esophagus; however, no statistical significance was found. Infants with GERD presented a shorter total reflux time in the distal esophagus (P<0.05) during EFA. After cisapride treatment, no statistical significance was found. Infants without GERD also presented reduced total reflux time in the distal esophagus during EFA (P<0.05). Those with GERD had increased total reflux time in the distal esophagus (P<0.05) before and after cisapride treatment during EFA and scintigraphy. CONCLUSIONS: Cisapride was effective in reducing the total reflux time, mainly in the upper esophagus. EFA apparently increased the number of episodes of GER, without achieving statistical significance. Further studies are necessary to investigate the effects of chest physical therapy according to body positions.

The Effects of Chest Physical Therapy on Acute Pulmonary Insufficiency

The Effects of Chest Physical Therapy on Acute Pulmonary Insufficiency

The effect of chest physical therapy on survival rate

The effect of chest physical therapy on survival rate

The Effects of Chest Physical Therapy Upon Percent Oxygen Saturation in Postoperative Cardiac Surgery Patients

The Effects of Chest Physical Therapy Upon Percent Oxygen Saturation in Postoperative Cardiac Surgery Patients

Effects of chest physical therapy on lung function in children recovering from acute severe asthma

The effects of chest physical therapy in acute severe asthma in children have been studied in 38 children aged 6 to 13 years in a randomized placebo controlled trial. The study began between 6 and 24 hours after admission to hospital; 19 children received chest physical therapy (PT) and 19 children received placebo visits. Each child had 4 treatments over 2 days which were preceded by nebulized salbutamol. Lung volumes and flow rates were measured in a body plethysmograph before salbutamol and before and after either PT or placebo on the first and fourth treatments. Throughout the study standard asthma drug therapy was given. In both groups characteristics such as sex, race, age, height, weight, severity, and baseline lung function were similar. Taking into account the baseline, lung function at the end of the study was similar in both groups. Three 12 year old children in the PT group showed improvements in flows above those seen in any children in the placebo group. We conclude that chest PT, when combined with asthma drug therapy, does not improve lung function in most children in this age group with acute severe asthma.

Chest Percussion and Postural Drainage in Patients with Bronchiectasis

Patients with chronic obstructive pulmonary disease have been treated routinely with chest physical therapy for many years in spite of a lack of scientific validation of this procedure. Only recently have the indications for chest physical therapy been clarified. It is currently believed that such therapy is especially beneficial in patients with copious secretions, and that it is less effective in patients with scanty secretions. No study has specifically evaluated the efficacy of chest physical therapy in patients with bronchiectasis. We accordingly evaluated 13 patients with stable bronchiectasis to determine the effects of chest physical therapy on pulmonary function, arterial oxygenation, and sputum production and to assess whether this therapy was associated with any significant side-effects. We found that chest physical therapy was safe and well tolerated and assisted the patients in mobilization of their sputum. However, such therapy had no immediate delayed effects on pulmonary function or oxygen saturation.

Immediate and long-term effects of chest physiotherapy in patients with cystic fibrosis

Both the immediate and long-term effects of chest physical therapy administered by a parent were evaluated in eight children with cystic fibrosis. Spirometric and plethysmographic evaluations were performed pre-CPT and at 5 and 30 minutes post-CPT. The pre-CPT measurements after a three-week period with no CPT were compared with the values while receiving CPT on a regular twice daily basis. There was a significant decrease after three weeks without CPT for FVC (P less than 0.025), FEV1 (P less than 0.005), FEF25-75 (P less than 0.005), and Vmax60TLC (P less than 0.025). When the patients had been receiving CPT on a regular basis, the only immediate effect was an increase in PEFR after 30 minutes post-CPT (P less than 0.05). After three weeks without CPT, there were increases at 30 minutes post-CPI for FVC (P less than 0.005) and Vmax60TLC (P less than 0.05). These findings indicate that although there may be little immediate functional improvement when CPT is received on a regular basis, a three-week period without CPT leads to a worsening of the functional status, which is reversed with renewal of regular CPT.

Radionuclide assessment of the effects of chest physical therapy on ventilation in cystic fibrosis.

This study assesses the use of krypton 81m scintigraphy as a measurement tool in evaluating the effectiveness of bronchial drainage with percussion and vibration on peripheral ventilation in patients with cystic fibrosis. Ten patients with cystic fibrosis participated. Each patient underwent a krypton 81m ventilation study and traditional pulmonary function tests. Forty-five minutes later, these studies were repeated before and after a chest physical therapy treatment. Each patient acted as his own control. All krypton 81m scintiscans were recorded and analyzed visually and numerically using a digital computer to assess distribution of ventilation. Visual analysis of the scintiscans indicated individual variation in treatment response: in some patients ventilation improved with therapy; in others, no change was noted; still others had changes independent of treatment. Numerical data derived from the scintiscans and pulmonary function tests showed no important differences among the three studies of each patient. Airway abnormalities characteristic of cystic fibrosis, progression of the disease, sputum production, or a combination of these factors may account for the individual variation in response to treatment. Krypton 81m scintigraphy is a reliable measure of regional ventilation and should be useful for assessing the efficacy of chest physical therapy because of the consistent, high quality visual data retrieved.

Physical Therapy for Neonates with Respiratory Dysfunction

Chest physical therapy for neonates with pulmonary dysfunction is a growing specialty of physical therapy practice. The purpose of this article is to provide physical therapists current information regarding chest physical therapy for the newborn infant. The neonatal diagnoses for which chest physical therapy is useful or has good rationale are discussed. Common complications are reviewed that affect physical therapy and medical treatment for infants with respiratory diseases and prematurity. Specific indications, contraindications, and precautions for physical therapy techniques are listed. Chest physical therapy evaluation and treatment are described and rationale for the application of various techniques is provided. Literature is reviewed dealing with the effects of chest physical therapy on neonates with pulmonary dysfunction. The strengths and weaknesses of each reviewed study are analyzed and suggestions for direction of future research for physical therapists are provided.