bronchiolitis

[cedric]

there is in europe a kind of "conflict" about the chest physiotherapy on bronchiolitis
so what's your opinion? and why?
clapping or forced expiratory?

[emad]

Cedric :

Personally , i do not practise chest physiotherapy , however i like very much to meet physios who have experience in chest physio .

During my undergraduate study , i taught that callping is used as part of postural driange to evacuate sputm, but i do not have experience at all in chest physiotherapy .

Why do not you search for an evidence regarding that point ?

Regards
Emad

[cedric]

in fact french, belgian are forced expiratory fanatic (i have my reason to believe in it)
i know that many anglo-saxon (brit, american...) trully believe in clapping..
so i was wondering why? and wanted to have experience feedback... from practisioners ;)

[emad]

Right cedric ;

here , my undergraduate study got the infection from USA .

Emad

[nari]

I have not got references handy, but PTs ceased treating bronchiolitis in paediatrics over ten years ago; on the evidence it did nothing and could make the condition worse.
Physiotherapy for respiratory conditions has been greatly refined over the years - getting the patient to MOVE (especially kids) is just as effective as any complex treatments. Exception is cystic fibrosis.

A search on PubMed might bring this to light.

Nari

[fapt]

Chest physical therapy in Taiwan
We do postural driange and clapping to evacuate sputms. And exercise prescriptions to improve the patients physical abilities and physical fitness.
Most kinds of patients in Chest physicl therapy here are CABG, pneumonia, pneumothorax, ischemia, and lung diseases....
And we do pre-op educations and post-op treatment....
It is so fun...:teeth:

[Marc]

Hi everybody
Found on Pubmed:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11093341&itool=iconabstr&query_hl=10&itool=pubmed_docsum

[Diane]

Wow, that takes me back. Get ready for a short story:
At a hospital where I worked 25 years ago, a Polish physiotherapist toured through. I can't remember his name, but I do remember he taught us very effective neuromodulatory techniques that facilitated lungs and breathing and expectoration; stroking, assisted expiration, springing.., no tipping. No coughing "uphill." He had a black belt in some martial art or other. I'll never forget him saying,"Remember you have a human being under your hands.. be gentle..!" We all tried out his ways, and they were so effective that at our hospital we never went back to the clapping/tipping practices inherited from the Brit tradition.

[nari]

I think Diane is referring to autogenic drainage? Where the patient does most of the treatment and the PT teaches and supervises occasionally.

There is very little evidence that tip and tap (as we call postural drainage and clapping) does anything more than some regular choreographed activity would do.

In fact, there is increasing indication that a lot of 'Chest physiotherapy' is not effective in the long term. It has been shown that the 'breathing exercises' post op and pre-op aren't much use either, unless the patient is immobilised in bed. A lot of 'chest physiotherapy' needs a big sweep of Occam's razor through it - it has clung too long to the physiology of 20-25 years ago.

but I am biased...I disliked chest physiotherapy because it seemed routine and mindless....:rolleyes:

Nari

[Diane]

I think Diane is referring to autogenic drainage? Where the patient does most of the treatment and the PT teaches and supervises occasionally Not exactly Nari.. never heard of "autogenic drainage" actually.. this was direct one-on-one hands-on contact, assistance with deep breathing, facilitatory. But nothing like traditional clapping/pounding/shaking/postural drainage.

I should think DB ex (abdominal) are still useful.. maybe not for getting rid of secretions, but rather for relaxation and for moving fluids about, especially if combined with foot/ankle/static quad ex...