Pediatric physiotherapy management of airway clearance therapy and exercise: Data from the Australian Bronchiectasis Registry.

Autor: Webb EM; Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.; Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia., Holland AE; Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.; Respiratory Research@Alfred, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.; Institute of Breathing and Sleep, Melbourne, Victoria, Australia., Chang AB; Australian Centre for Health Services Innovation, Queensland Children's Hospital, Queensland University of Technology, Brisbane, Queensland, Australia.; Child and Maternal Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Darwin, Northern Territory, Australia., Middleton PG; CITRICA, Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, New South Wales, Australia., Thomson R; Gallipoli Medical Research Foundation and Greenslopes Clinical Unit, The University of Queensland, Brisbane, Queensland, Australia., Wong C; Respiratory Medicine, Middlemore Hospital, Te Whatu Ora, Auckland, New Zealand.; Department of Medicine, University of Auckland, Auckland, New Zealand., Jayaram L; Department of Respiratory and Sleep Medicine, Western Health, Melbourne, Victoria, Australia.; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia., Holmes-Liew CL; Department of Thoracic Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia., Morgan L; Department of Medicine and Health, Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia.; Department of Respiratory Medicine, Concord General Repatriation Hospital, Concord, New South Wales, Australia., Lee AL; Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.; Institute of Breathing and Sleep, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2024 Nov 06. Date of Electronic Publication: 2024 Nov 06.
DOI: 10.1002/ppul.27370
Abstrakt: Background: Regular airway clearance techniques (ACTs) and exercise are recommended for children with bronchiectasis, but current clinical practice and their predictors are unknown.
Objective: We aimed to describe current use of ACTs and exercise among Australian children with bronchiectasis and identify associated predictors.
Methods: Physiotherapy-specific data of 397 children (median age = 8 were extracted from the Australian Bronchiectasis Registry. A multivariate analysis was undertaken to identify predictors associated with the use of regular ACTs and physical exercise.
Results: Regular ACTs were undertaken by 118 (30%) children while 192 (48%) engaged in regular exercise. Physical exercise was the most common ACT modality (n = 83, 20%). The likelihood of regular ACT increased in children whose sputum isolated Pseudomonas aeruginosa (OR = 3.88, 95% CI 1.69-8.89) and was 50% higher for every respiratory exacerbation in the previous 12-months that required hospitalization (OR = 1.50, 95% CI 1.15-1.95). For every year older in age, children had increased odds of engaging in physical exercise (OR = 1.21, 95% CI 1.08-1.34) or using an ACT device (OR = 1.21, 95% CI 1.05-1.34). Regular exercise was twice as likely in the presence of bibasal bronchiectasis (OR = 2.43, 95% CI 1.14-5.16), yet less likely in those with ≥1 hospitalizations in the previous 12-months (OR = 0.76, 0.95% CI 0.57-1.03).
Conclusion: Approximately one-third of children with bronchiectasis undertake regular ACTs while physical exercise was undertaken in approximately one in two children. Age, frequent respiratory exacerbations requiring hospitalization and the extent of disease are predictors of undertaking regular ACTs and exercise. Identification of these factors may assist in tailoring ACT, exercise and ACT modality prescription in clinical practice.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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