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Chest Physiotherapy (chest + physiotherapy)

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Medical Sciences	100%

Selected Abstracts

Chest physiotherapy with positive expiratory pressure breathing after abdominal and thoracic surgery: a systematic review

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010
J. ÖRMAN
A variety of chest physiotherapy techniques are used following abdominal and thoracic surgery to prevent or reduce post-operative complications. Breathing techniques with a positive expiratory pressure (PEP) are used to increase airway pressure and improve pulmonary function. No systematic review of the effects of PEP in surgery patients has been performed previously. The purpose of this systematic review was to determine the effect of PEP breathing after an open upper abdominal or thoracic surgery. A literature search of randomised-controlled trials (RCT) was performed in five databases. The trials included were systematically reviewed by two independent observers and critically assessed for methodological quality. We selected six RCT evaluating the PEP technique performed with a mechanical device in spontaneously breathing adult patients after abdominal or thoracic surgery via thoracotomy. The methodological quality score varied between 4 and 6 on the Physiotherapy Evidence Database score. The studies were published between 1979 and 1993. Only one of the included trials showed any positive effects of PEP compared to other breathing techniques. Today, there is scarce scientific evidence that PEP treatment is better than other physiotherapy breathing techniques in patients undergoing abdominal or thoracic surgery. There is a lack of studies investigating the effect of PEP over placebo or no physiotherapy treatment. [source]

Chest physiotherapy and porencephalic brain lesions in very preterm infants

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2001
DB Knight
Objective: National Women's Hospital is one of two hospitals to report a destructive brain lesion, namely encephaloclastic porencephaly (ECPE), in extremely preterm infants. It has been associated with non-cephalic presentation, early hypotension and the number of chest physiotherapy treatments in the first month. The aim of the present study was to determine the temporal relationship between ECPE and chest physiotherapy use in very low-birth weight (VLBW) infants in our unit. Methodology: Cerebral ultrasound scan reports, post-mortem reports, clinical and physiotherapy records and, if indicated, original ultrasound films were reviewed for all VLBW babies admitted between 1985 and 1998. Results: Over the 14 year period in question, 2219 babies with a birth weight , 1500 g were admitted. Encephaloclastic porencephaly was found in only the 13 previously reported babies born between 1992 and 1994. Encephaloclastic porencephaly was excluded in 1564 (70%) babies. In 621 (28%) babies who did not have late ultrasound scans, ECPE was thought to be unlikely either because the babies never had any chest physiotherapy (n = 479) or because they had chest physiotherapy but were known to be neurodevelopmentally normal on follow up (n = 142). Data were incomplete for 21 babies (0.9%). The number of chest physiotherapy treatments per baby decreased from a median of 95 prior to 1989 to 38 and the age of starting treatment increased from 5 to 8 days after 1990. The use of chest physiotherapy ceased in 1995. Conclusions: Encephaloclastic porencephaly emerged as a problem at a time when the use of chest physiotherapy had decreased. The cluster of cases seen between 1992 and 1994, although associated with the number of chest physiotherapy treatments given, began to appear because of some other factor. [source]

Subclinical pulmonary dysfunction in spinocerebellar ataxias 1, 2 and 3

ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
S. J. Sriranjini
Sriranjini SJ, Pal PK, Krishna N, Sathyaprabha TN. Subclinical pulmonary dysfunction in spinocerebellar ataxias 1, 2 and 3. Acta Neurol Scand: 2010: 122: 323,328. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, Evaluation of pulmonary function in patients with spinocerebellar ataxias (SCA) 1, 2 and 3 without clinical evidence of pulmonary dysfunction. Methods,,, Thirty patients (F:M = 7:23; age: 35 ± 11.3 years; SCA1 , 13, SCA2 , 9 and SCA3 , 8) without clinical manifestations of respiratory dysfunction and 30 controls underwent pulmonary function tests. The percentage predicted values of forced vital capacity (FVC), volume of air exhaled during first second of FVC (FEV1), peak expiratory flow rate (PEFR) and maximal voluntary ventilation (MVV), actual values of maximal inspiratory and expiratory pressures (MIP and MEP in mmHg), and ratios of actual values of FEV1/FVC (%) and FEV1/PEFR (ml/l/min) were analyzed. Results,,, Compared with controls SCA patients had significant reductions of FVC (71.1 ± 17.5 vs 85.5 ± 18.7; P < 0.01), PEFR (51.5 ± 20.7 vs 77.1 ± 24.9; P < 0.001), MVV (64.4 ± 21.6 vs 97.2 ± 22.7; P < 0.001), MIP (27.7 ± 16.8 vs 50.1 ± 15.1; P < 0.001) and MEP (38.1 ± 18.7 vs 74.7 ± 16.0; P < 0.001), elevation of FEV1/PEFR (10.5 ± 2.8 vs 7.4 ± 2.1; P < 0.001), but no significant change of FEV1 and FEV1/FVC. FEV1/PEFR correlated positively with illness duration and MVV negatively with severity of illness. Conclusions,,, The present study showed subclinical restrictive type of pulmonary dysfunction in SCA, and possible presence of upper airway obstruction. Chest physiotherapy and breathing exercises should be introduced early in management of SCA. [source]

Chest physiotherapy and porencephalic brain lesions in very preterm infants

Effects of a short-term rehabilitation program on airway inflammation in children with cystic fibrosis,,

PEDIATRIC PULMONOLOGY, Issue 6 2010
Alexander Moeller MD
Abstract Background Respiratory therapy in cystic fibrosis (CF) consists of airway clearance, infection control, and reduction of airway inflammation. It is well recognized that physical activity as well as daily chest physiotherapy, enhance airway clearance. We investigated the effects of pulmonary rehabilitation, including physical activity and chest physiotherapy, on airway inflammation in children with CF. Methods Eighteen children with stable CF (six females), aged 8.2,16.2 years, participating in a 3-week multidisciplinary inpatient rehabilitation program were recruited. Assessment at the beginning and the end of the program included clinical score, pulmonary function test, exhaled breath condensate (EBC) and sputum analysis. Sputum supernatant and EBC were analyzed for interleukin (IL)-1b, 6, 8, 10, 12, tumor necrosis factor-alpha (TNF-,) and LTB4. Results Median (IQR) symptom scores decreased from 19 [23] to 16 [21], P,=,0.005. Vital capacity and FVC increased significantly (P,<,0.05). However no difference was found for the total sputum cells and sputum as well as EBC cytokines between the two visits. Significant correlations were found for sputum IL-1 (+), IL-6 (,), and IL-8 (+) to total sputum cell count and neutrophils and for IL-8 to TNF-,. Conclusions We have shown that a short-term inpatient rehabilitation for children with stable CF with intensive physical activity mainly improve subjective clinical symptoms and measures of lung function such as VC and FVC but does not influence airflow obstruction and airway inflammation as assessed by sputum and EBC analysis. Pediatr Pulmonol. 2010; 45:541,551. © 2010 Wiley-Liss, Inc. [source]

Cerebrospinal fluid outflow and intracranial pressure in hydrocephalic patients with external ventricular drainage

ACTA NEUROLOGICA SCANDINAVICA, Issue 2 2010
O. Klein
Klein O, Demoulin B, Jean Auque RT, Audibert G, Sainte-Rose C, Marchal J-C, Marchal F. Cerebrospinal fluid outflow and intracranial pressure in hydrocephalic patients with external ventricular drainage. Acta Neurol Scand: DOI: 2010: 122: 140,147. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Background and purpose,,, The aim of this study was to monitor the 24 h cerebrospinal fluid (CSF) outflow and intracranial pressure (ICP) in hydrocephalic adult patients with external ventricular drainage (EVD). Patients and methods,,, Twelve patients (5M/7F) aged 30,69 years suffering from acute hydrocephalus requiring EVD were admitted in the neuro-intensive care unit. The CSF collecting bag was continuously weighted using a high-precision scale, the filtered output of which was fed at 1 Hz to a computer and converted to flow (Q,extcsf). ICP was also recorded. Results,,, One patient was excluded because more than 80% of the Q,extcsf data were rejected by the system. The mean ± SD Q,extcsf and ICP were respectively 7.5 ± 3.4 ml/h (range 1.6,12.1 ml/h) and 12.4 ± 2.7 mmHg. Two patterns of Q,extcsf were identified: a continuous profile and a discontinuous one with numerous bursts frequently associated with manoeuvres such as cough or chest physiotherapy. The short-term variations of Q,extcsf and ICP were usually unrelated. Conclusion,,, The study stresses the important inter and intra-subject variability of Q,extcsf in patients with EVD. The mean Q,extcsf is lower than the reference production rate (21 ml/h), raising the question of persistent CSF absorption and/or depressed secretion. The independent changes of Q,extcsf and ICP on the short term is likely to be explained by the pressure,volume characteristics of the intracranial space. [source]