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

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.