Effects of a respiratory physiotherapy session in patients with LRTI: a pre/post-test study

Abstract

Introduction The role of respiratory physiotherapy (RP) in lower respiratory tract infections (LRTI) has been questioned. However, studies have focused on hospitalised patients, and the presence/absence of an underlying disease has been neglected.

Objectives To assess the effects of a RP session in community patients with LRTI and to explore the differences between patients with pneumonia (restrictive disease – AR) and those with exacerbations of an obstructive disease (AO).

Methods A pre/post-test study was conducted. A RP session was applied to patients with LRTI and crackles, wheezes, dyspnoea, perception of sputum and oxygen saturation were collected pre/post session. Comparisons were performed using paired t-tests or Wilcoxon tests.

Results Thirty patients (14 males, 55.23 ± 17.78 years) with pneumonia (AR, n = 12), exacerbations of chronic obstructive pulmonary disease, acute bronchitis and asthma (AO, n = 18) were enrolled. After treatment, the total sample presented lower wheeze rates at trachea (P = 0.02; r = −0.54) and less sputum (P = 0.01; r = −0.47). AR patients presented a decrease in the number of crackles (P < 0.05; 0.30 < dz < 0.26) and number and rate of wheezes at chest locations (P < 0.05; −0.56 < r < −0.48). AO patients showed an increase in the number of crackles (P < 0.05; 0.20 <dz <0.31), wheeze frequency (P = 0.03; r = −0.27) and dyspnoea (P = 0.04; r = −0.55); and a decrease in the number of wheezes at trachea (P = 0.02; r = −0.54).

Conclusions RP seems effective in reducing wheezes and perception of sputum in patients with LRTI. However, when considering AR and AO diseases separately, further changes in respiratory sounds and dyspnoea emerged. This highlights the importance of considering subgroups of patients with LRTI to develop RP evidence-base practice.