Respiratory physiotherapy interventions used during hospitalization of children and adolescents with asthma

Professional reports

Authors

DOI:

https://doi.org/10.15448/1980-6108.2021.1.39356

Keywords:

asthma, physiotherapy modalities, respiratory therapy, hospitalization, pediatrics

Abstract

Aims: to describe and to compare the airway clearance techniques used for asthma during hospitalization in three pediatric age groups. In addition, we sought to investigate the main reasons for choosing the interventions.
Methods: the sample consisted of physiotherapists working in hospitals who reported attending children and adolescents with asthma. The professionals answered an online questionnaire on personal, academic and professional data, as well as regarding the airway clearance techniques used in, preschoolers and schoolchildren/adolescents. The interventions were grouped into nine classifications: conventional, manual, volume-based, high-frequency oral oscillation/positive expiratory pressure (HFOO/PEP), ventilatory exercises, non-invasive ventilation, forced expiratory technique (FET), upper airway aspiration (UAA) and others.
Results: nine-three physiotherapists were included, aged between 31 and 40 years (47.3%) and female (87.1%). The most frequent interventions in infants were UAA (78.5%), expiratory flow acceleration (EFA) (50.5%) and chest compression (45.2%). In preschoolers, coughing (75.3%), aspiration of upper airways (52.7%), EFA (51.6%) and chest compression/slow and prolonged expiration (SPE) (50.5%) were the most used. In schoolchildren/adolescents, coughing (83.9%), varying expiratory exercises (73.1%) and SPE (57.0%) were the most frequent. There was less use (p<0.01) of OOAF/PEP, ventilatory and FET exercises in infants and also of conventional, manual methods, aspiration of UUA and other therapies (p<0.01) in schoolchildren/adolescents. The professionals reported using these interventions because they are more effective in clinical practice (78.5%).
Conclusions: manual and expectoration techniques aiming at airway clearance were the most frequently used, being related to the age group and chosen due to effectiveness in clinical practice.

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Author Biographies

Daniele Oppermann Ruckert, Centro Universitário Cenecista de Osório (UNICNEC), Osório, RS, Brasil.

Bacharel em Fisioterapia pelo Centro Universitário Cenecista de Osório (UNICNEC), em Osório, RS, Brasil.

Márcio Vinícius Fagundes Donadio, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.

Doutor em Ciências Biológicas (Fisiologia) pela Universidade Federal do Rio Grande do Sul (UFRGS), em Porto Alegre, RS, Brasil; professor da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil.

João Paulo Heinzmann-Filho, Centro Universitário Cenecista de Osório (UNICNEC), Osório, RS, Brasil.

Doutor em Saúde da Criança pela Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), em Porto Alegre, RS, Brasil; professor do Centro Universitário Cenecista de Osório (UNICNEC), em Osório, RS, Brasil.

References

Macêdo TM, Freitas DA, Chaves GS, Holloway EA, Mendonça KM. Breathing exercises for children with asthma. Cochrane Database Syst Rev. 2016;4(4):CD011017. https://doi.org/10.1002/14651858.CD011017.pub2

Roncada C, Oliveira SG, Cidade SF, Sarria EE, Mattiello R, Ojeda BS, et al. Burden of asthma among inner-city children from Southern Brazil. J Asthma. 2016;53(5):498-504. https://doi.org/10.3109/02770903.2015.1108438

Dias CS, Dias MAS, Friche AAL, Almeida MCM, Viana TC, Mingoti AS. Temporal and spatial trends in childhood asthma-related hospitalizations in Belo Horizonte, Minas Gerais, Brazil and their association with social vulnerability. Int J Environ Res Public Health. 2016;13(7):1-13. https://doi.org/10.3390/ijerph13070704

Solé D, Nunes, I, Wandalsen GF, Mallozi MC. Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC). Rev Paul Pediatr. 2014;32(1):114-25. https://doi.org/10.1590/S0103-05822014000100018

Cardoso TA, Roncada C, Silva ER, Pinto LA, Jones MH, Stein RT, et al. The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system. J Bras Pneumol. 2017;43(3):163-68. https://doi.org/10.1590/s1806-37562016000000352

Amaral LM, Palma PV, Leite ICG. Asthma from the perspective of public health: epidemiology, economic impact and public policy. Rev APS. 2012;15(4):508-16.

IV Diretrizes Brasileiras para o Manejo da Asma. J Bras Pneumol. 2006;32 Suppl 7:447-74. https://doi.org/10.1590/S1806-37132006001100002

Tecklin JS. Physical therapy for children with chronic lung disease. Phys Ther. 1981; 61(12):1774-82. https://doi.org/10.1093/ptj/61.12.1774

Zhang W, Wang Q, Liu L, Yang W, Liu H. Effects of physical therapy on lung function in children with asthma: a systematic review and meta-analysis. Pediatr Res. 2021;89:1343-56. https://doi.org/10.1038/s41390-020-0874-x

Silva PS, Barreto SS. Noninvasive ventilation in status asthmaticus in children: levels of evidence. Rev Bras Ter Intensiva. 2015;27(4):390-96. http://dx.doi.org/10.5935/0103-507X.20150065

Laurino RA, Barnabé V, Saraiva-Romanholo BM, Stelmach R, Cukier A, Nunes Mdo P. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety. Clinics (Sao Paulo). 2012;67(11):1291-7. https://doi.org/10.6061/clinics/2012(11)12

Bruurs ML, Van der Giessen LJ, Moed H. The effectiveness of physiotherapy in patients with asthma: A systematic review of the literature. Respir Med. 2013; 107(4):483-94. https://doi.org/10.1016/j.rmed.2012.12.017

Das RR, Sankar J, Kabra SK. Role of breathing exercises and yoga/pranayama in childhood asthma: a systematic review. Curr Pediatr Rev. 2019;15(3):175-83. https://doi.org/10.2174/1573396315666190121122452

Lanza FC, Corso SD. Fisioterapia no paciente com asma: intervenção baseada em evidências. Arq Asma Alerg Imunol. 2017:1(1):59-64. https://doi.org/10.5935/2526-5393.20170008

Asher MI, Douglas C, Airy M, Andrews D, Trenholme A. Effects of chest physical therapy on lung function in children recovering from acute severe asthma. Pediatr Pulmonol. 1990;9(3):146-51. https://doi.org/10.1002/ppul.1950090305

Paulin E, Favoreto PB, Vidotto CC. Benefits of respiratory physiotherapy in asthma case report. Arq Ciênc Saúde Unipar. 2001;5(2):149-54. https://revistas.unipar.br/index.php/saude/article/view/1119/982

Herrera AM, Cavada CHG, Mañalich MJ. Pediatric asthma hospitalization in Chile: 2001-2014. Rev Chil Pediatr. 2017;88(5):602-07. http://dx.doi.org/10.4067/S0370-41062017000500005

Donadio MVF, Campos NE, Vendrusculo FM, Stofella AM, Almeida ACDS, Ziegler B, et al. Respiratory physical therapy techniques recommended for patients with cystic fibrosis treated in specialized centers. Braz J Phys Ther. 2020;24(6):532-8. http://dx.doi.org/10.1016/j.bjpt.2019.11.003

Sociedade Brasileira de Pediatria. Manual de orientação para a alimentação do lactente, do pré-escolar, do escolar, do adolescente e na escola. Departamento de Nutrologia. 3 ed. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2012. p. 17-53.

Andrade RF, Paixao A. Principais técnicas fisioterapêuticas utilizadas no tratamento da criança asmática- revisão. Rev Pediatria SOPERJ [Internet]. 2006 [cited 2020 Out 10];7(1):4-9. Available from: http://revistadepediatriasoperj.org.br/detalhe_artigo.asp?id=54

Ribeiro MAGO. Técnicas de remoção de secreção das vias aéreas. ASSOBRAFIR Ciência. 2019;10(Supl1):61-98. http://dx.doi.org/10.47066/2177-9333/ac.36631

Morrow BM. Airway clearance therapy in acute paediatric respiratory illness: A state-of-the-art review. S Afr J Physiother. 2019;75(1):a1295. http://dx.doi.org/10.4102/sajp.v75i1.1295

Rodrigues MS, Galvão IM. Pathophysiological aspects of cough reflex: a literature. Rev Med (São Paulo). 2017;96(3):172-6. http://dx.doi.org/10.11606/issn.1679-9836.v96i3p172-176

Nogueira MCP, Ribeiro SNS, Silva EP, Guimarães CL, Wandalsen GF, Solé D, et al. Is prolonged slow expiration a reproducible airway clearance technique? Phys Ther. 2019; 99(9):1224-30. http://dx.doi.org/10.1093/ptj/pzz080

Antunes LCO, Silva EG, Bocardo P, Daher DR, Faggiotto RD, Rugolo LMSS. Efeitos da fisioterapia respiratória convencional versus aumento do fluxo expiratório na saturação de O2, freqüência cardíaca e freqüência respiratória, em prematuros no período pós-extubação. Rev Bras Fisioter. 2006;10(1):97-103. http://dx.doi.org/10.1590/S1413-35552006000100013

Lanza FC, Gazzotti MR, Augusto LA, Mendes LMS, de Paula C, Solé D. Oscilação oral de alta frequência reduz a obstrução das vias aéreas em crianças com pneumonia? Rev Bras Alerg Imunopatol. 2009;32(2):59-62.

Veronezi J, Scortegagna D. Respiratory physiotherapy in cystic fibrosis. Rev HCPA. 2011;31(2):192-6.

Santana JCB, Barreto SSM, Carvalho PRA. Fatores associados com asma aguda grave na infância - aspectos epidemiológicos e clínicos. J Pediatr (Rio J). 1997;73(5):324-34. http://dx.doi.org/10.2223/JPED.548

Muchão FP, Silva-Filho LVRF. Avanços na inaloterapia em pediatria. J. Pediatr. (Rio J.) 2010;86(5):367-76. https://doi.org/10.1590/S0021-75572010000500004

Roncada C, Andrade J, Bischoff LC, Pitrez PM. Comparação de duas técnicas inalatórias para administrar broncodilatador em crianças e adolescentes com crise aguda de asma: metanálise. Rev Paul Pediatr. 2018; 36(3):364-71. https://doi.org/10.1590/1984-0462/;2018;36;3;00002

Matilde INE, Eid RAC, Nunes AF, Ambrozin ARP, Moura RH, Carnieli-Cazati, et al. Bronchial hygiene techniques in patients on mechanical ventilation: what are used and why? Einstein (Sao Paulo). 2018;16(1):1-7. https://doi.org/10.1590/S1679-45082018AO3856

Published

2021-07-08

How to Cite

Ruckert, D. O., Donadio, M. V. F., & Heinzmann-Filho, J. P. (2021). Respiratory physiotherapy interventions used during hospitalization of children and adolescents with asthma: Professional reports. Scientia Medica, 31(1), e39356. https://doi.org/10.15448/1980-6108.2021.1.39356

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