Efectos inmediatos de la fisioterapia respiratoria en lactantes con infección respiratoria aguda

  1. Beatriz Simón-Rodríguez 1
  2. Adrián Arranz-Escudero 2
  3. Ruben Ruiz-Lázaro 3
  4. Teresa García-Barredo-Restegui 4
  5. Patricia Martín-Casas 5
  1. 1 FisioRespiración, Madrid, España
  2. 2 Fundación para la Investigación Biomédica del Hospital Universitario 12 de Octubre, Madrid, España
  3. 3 DACER, Madrid, España
  4. 4 Fisiorespi, Madrid, España
  5. 5 Departamento de Radiología, Rehabilitación y Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, España
Journal:
Academic Journal of Health Sciences: Medicina Balear

ISSN: 2255-0560

Year of publication: 2022

Volume: 37

Issue: 6

Pages: 140-146

Type: Article

DOI: 10.3306/AJHS.2022.37.06.140 DIALNET GOOGLE SCHOLAR lock_openIbdigital editor

Abstract

Background: Respiratory physiotherapy has shown positive effects in acute bronchiolitis, but studies in infants with similar acute respiratory infections (ARI) in outpatient setting are needed. The aim of the study was to evaluate the changes in outpatients with ARI after the first physiotherapy session. Methods: Quasi-experimental, interventional study conducted between February 2019 and February 2020 in patients under 24 months diagnosed with ARI treated by a home-based physiotherapy service. The variables of the Acute Bronchiolitis Severity Scale (ABSS) were collected before and after the intervention. The differences between both measurements were analyzed with the Student’s t-test, the effect size with Cohen’s d and the association between initial variables and ABSS changes with linear regression and analysis of variance (ANOVA).Results: 74 patients received intervention (50.7% males and mean age 7.92 months). In the initial assessment, ABSS mean was 3.24 points, 77.3% patients with mild involvement (ABSS<4). In the final assessment, more than 95% didn’t present wheezing, respiratory effort or altered inspiration/expiration ratio; ABSS mean was 1.09 points, 95.9% patients with mild involvement. Significant (p<0.05) and moderate (d>0.05) changes in wheezing and large (d>0.8) in crackles and total ABSS were detected. A significant association (p<0.05) was obtained between ABSS changes and baseline heart rate, ABSS score, crackles, and inspiration/expiration ratio. Conclusion: Respiratory physiotherapy favors moderate, immediate, and relevant changes in the severity of acute respiratory infection in infants.

Bibliographic References

  • Troeger C, Blacker B, Khalil IA, Rao PC, Cao J, Zimsen SRM, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018; 18: 1191-210. https://doi.org/10.1016/S1473-3099(18)30310-4
  • García García ML, Ordobás Gabin M, Calvo Rey C, González Álvarez MI, Aguilar Ruiz J, Arregui Sierra A, et al. Infecciones virales de vías respiratorias inferiores en lactantes hospitalizados: etiología, características clínicas y factores de riesgo. An Pediatría. 2001; 55: 101-7.https://doi.org/10.1016/S1695-4033(01)77644-8
  • González García H, García García FM, Fernández Alonso JE, Izquierdo López B, Pino Vázquez A, Blanco Quirós A. Estudio clinicoepidemiológico de la bronquiolitis aguda. An Pediatría. 2000; 53: 520-6.https://doi.org/10.1016/S1695-4033(00)77493-5
  • Hasegawa K, Tsugawa Y, Brown DFM, Mansbach JM, Camargo CA. Trends in bronchiolitis hospitalizations in the United States, 2000-2009. Pediatrics. 2013; 132: 28-36. https://doi.org/10.1542/peds.2012-3877
  • Hasegawa K, Tsugawa Y, Brown DFM, Mansbach JM, Camargo CA. Temporal Trends in Emergency Department Visits for Bronchiolitis in the United States, 2006-2010. Pediatr Infect Dis J. 2014; 33: 11-18. https://doi.org/10.1097/INF.0b013e3182a5f324
  • Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014; 134: e1474-e1502. https://doi.org/10.1542/peds.2014-2742
  • Cano-Garcinuño A, Praena-Crespo M, Mora-Gandarillas I, Carvajal-Urueña I, Callén-Blecua MT, García-Merino Á, et al. Heterogeneidad de criterios en el diagnóstico de bronquiolitis aguda en España. An Pediatría. 2019; 90: 109-17. https://doi.org/10.1016/j.anpedi.2018.07.004
  • Simó Nebot M, Claret Teruel G, Luaces Cubells C, Estrada Sabadell MD, Pou Fernández J. Guía de práctica clínica sobre la bronquiolitis aguda: recomendaciones para la práctica clínica. An Pediatría. 2010; 73: 208.e1-10. https://doi.org/10.1016/j.anpedi.2010.04.015
  • Rodriguez-Martinez CE, Sossa-Briceño MP, Nino G. Systematic review of instruments aimed at evaluating the severity of bronchiolitis. Paediatr Respir Rev. 2018; 25: 43–57. https://doi.org/10.1016/j.prrv.2016.12.006
  • Ramos Fernández JM, Cordón Martínez A, Galindo Zavala R, Urda Cardona A. Validación de una escala clínica de severidad de la bronquiolitis aguda. An Pediatría. 2014; 81: 3-8. https://doi.org/10.1016/j.anpedi.2013.06.020
  • Chalumeau M, Foix-l’Helias L, Scheinmann P, Zuani P, Gendrel D, Ducou-le-Pointe H. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants. Pediatr Radiol. 2002; 32: 644-7. https://doi.org/10.1007/s00247-002-0755-y
  • Lanza FC, Wandalsen G, dela Bianca AC, Cruz CL, Postiaux G, Solé D. Prolonged slow expiration technique in infants: effects on tidal volume, peak expiratory flow, and expiratory reserve volume. Respir Care. 2011; 56: 1930-5. https://doi.org/10.4187/respcare.01067
  • Van Ginderdeuren F, Vandenplas Y, Deneyer M, Vanlaethem S, Buyl R, Kerckhofs E. Effectiveness of airway clearance techniques in children hospitalized with acute bronchiolitis. Pediatr Pulmonol. 2017; 52: 225-31.https://doi.org/10.1002/ppul.23495
  • Moreno-Bermejo I, Martín-Casas P, Martín-Nieto A, Bravo-Llatas C, Atín-Arratibel MA. Efectividad de la fisioterapia respiratoria combinada con higiene postural en niños con afectación neurológica crónica. An Sist Sanit Navar. 2021; 44: 427-36. https://doi.org/10.23938/ASSN.0982
  • Conesa-Segura E, Reyes-Dominguez SB, Ríos-Díaz J, Ruiz-Pacheco MÁ, Palazón-Carpe C, Sánchez-Solís M. Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial. Clin Rehabil. 2019; 33: 504-15. https://doi.org/10.1177/0269215518809815
  • Roquéi Figuls M, Giné-Garriga M, Granados Rugeles C, Perrotta C, Vilaró J. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane database Syst Rev. 2016; 2: CD004873. https://doi.org/10.1002/14651858.CD004873.pub5
  • Maze A, Bloch E. Stridor in pediatric patients. Anesthesiology. 1979; 50: 132-45. https://doi.org/10.1097/00000542-197902000-00011
  • Harrison VC, Heese HV, Klein M. The significance of grunting in hyaline membrane disease. Pediatrics. 1968; 41: 549-59. https://doi.org/10.1542/peds.41.3.549
  • Rudolph AJ, Desmond MM, Pineda RG. Clinical diagnosis of respiratory difficulty in the newborn. Pediatr Clin North Am. 1966; 13: 669-92. https://doi.org/10.1016/s0031-3955(16)31876-4
  • Horeczko T, Enriquez B, McGrath NE, Gausche-Hill M, Lewis RJ. The Pediatric Assessment Triangle: accuracy of its application by nurses in the triage of children. J Emerg Nurs. 2013; 39: 182-9. https://doi.org/10.1016/j.jen.2011.12.020
  • Gomes GR, Calvete FPG, Rosito GF, Donadio MVF. Rhinopharyngeal Retrograde Clearance Induces Less Respiratory Effort and Fewer Adverse Effects in Comparison With Nasopharyngeal Aspiration in Infants With Acute Viral Bronchiolitis. Respir Care. 2016; 61: 1613-9. https://doi.org/10.4187/respcare.04685
  • Cohen J. Statistical Power Analysis for the Behavioural Sciences. 2ª ed. Hillsdale, New Jersey: Lawrence Erlbaum Associates, 1988.
  • Bellido VG, Torres-Castro R, Regidor MT, Buría JLA, Esteo MDCJ, Caraballo RG, et al. Short-term effects of respiratory physiotherapy in infants with bronchiolitis and outpatient care: A multicentre study. Eur Respir J. 2018; 52: PA1463. https://doi.org/10.1183/13993003.congress-2018.PA1463
  • Pinto FR, Alexandrino AS, Correia-Costa L, Azevedo I. Ambulatory chest physiotherapy in mild-to-moderate acute bronchiolitis in children under two years of age — A randomized control trial. Hong Kong Physiother J. 2021; 41: 99-108. https://doi.org/10.1142/S1013702521500098
  • Gomes GR, Donadio MVF. Effects of the use of respiratory physiotherapy in children admitted with acute viral bronchiolitis. Arch Pédiatrie. 2018; 25: 394-8. https://doi.org/10.1016/j.arcped.2018.06.004
  • Suárez-Castañón C, Modroño-Riaño G, López-Vilar P, Martínez-Blanco J, Iglesias-Cabo T, Solís-Sánchez G. Uso de anticatarrales en menores de 14 años en consultas de Atención Primaria. An Pediatría. 2016; 84: 10-7. https://doi.org/10.1016/j.anpedi.2015.02.022
  • Montejo Fernández M, Benito Manrique I, Montiel Eguía A, Benito Fernández J. Una iniciativa para reducir el uso de medicación innecesaria en lactantes con bronquiolitis en atención primaria. An Pediatría. 2019; 90: 19-25. https://doi.org/10.1016/j.anpedi.2018.02.016
  • D’Abrosca F, Garabelli B, Savio G, Barison A, Appendini L, Oliveira LVF et al. Comparing airways clearance techniques in chronic obstructive pulmonary disease and bronchiectasis: positive expiratory pressure or temporary positive expiratory pressure? A retrospective study. Brazilian J Phys Ther. 2017; 21: 15-23. https://doi.org/10.1016/j.bjpt.2016.12.001
  • Postiaux G, Ladha K, Gillard C, Charlier JL, Lens E. La kinésithérapie respiratoire du tout-petit (< 24 mois) guidée par l’auscultation pulmonaire. Rev Française d’Allergologie d’Immunologie Clin. 1997; 37: 206-22. https://doi.org/10.1016/S0335-7457(97)80047-0
  • Marques A, Bruton A, Barney A, Hall A. Are crackles an appropriate outcome measure for airway clearance therapy? Respir Care. 2012; 57: 1468-75. https://doi.org/10.4187/respcare.01625