title: Chest physiotherapy in paediatric patients hospitalised with community-acquired pneumonia: a randomised clinical trial.
abstract: BACKGROUND
  Chest physiotherapy has been used to treat children hospitalised with pneumonia with no clear scientific evidence to support a beneficial effect. The objective of the current study was to evaluate the efficacy of chest physiotherapy as an adjuvant treatment in children hospitalised with acute community-acquired pneumonia.
  
  
  METHODS
  Children (aged 1-12 years) with a clinical and confirmed radiological diagnosis of pneumonia sequentially admitted to a tertiary children hospital were eligible for this study. Participants were randomly selected to receive a standardised respiratory physiotherapy (positioning, thoracic vibration, thoracic compression, positive expiratory pressure, breathing exercises and forced exhalation with the glottis open or 'huffing') three times daily in the 'intervention group' or a non-mandatory request to breathe deeply, expectorate the sputum and maintain a lateral body position once a day in the 'control group'. The primary outcomes were reduction in respiratory rate and severity score (respiratory rate, recession, fever, oxygen saturation and chest x-ray) from baseline to discharge. Secondary outcome was duration of hospitalisation.
  
  
  RESULTS
  In all, 72 patients were randomly allocated to the intervention (n=35) or control (n=37) groups. There were no differences at admission on severity of pneumonia between groups. Respiratory rate and severity score significant decreased between admission to discharge within each group; however, there were no differences when comparing groups. Also, there was no significant difference in duration of hospitalisation between the control and intervention groups (6 vs 8 days, p=0.11, respectively).
  
  
  CONCLUSIONS
  This clinical trial suggests that, in children hospitalised with moderate community-acquired pneumonia, chest physiotherapy did not have clinical benefits in comparison to control group.
authors.affiliation: Department of Physiotherapy, Universidade Federal de Ciências da Saúde de Porto Alegre, St. Sarmento Leite 245, Porto Alegre, Rio Grande do Sul, Brazil. jllukrafka@bol.com.br
authors.forename: Janice Luisa
authors.initials: JL
authors.lastname: Lukrafka
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Fuchs
authors.forename: Gilberto Bueno
authors.initials: GB
authors.lastname: Fischer
authors.forename: José A
authors.initials: JA
authors.lastname: Flores
authors.forename: Jandira M
authors.initials: JM
authors.lastname: Fachel
authors.forename: Jose A
authors.initials: JA
authors.lastname: Castro-Rodriguez
mesh_terms: D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D011014:Pneumonia / Q000628:therapy*; D012138:Respiratory Therapy / Q000379:methods*; D016896:Treatment Outcome