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An evaluation of chest physiotherapy in the management of acute bronchiolitis: changing clinical practice [with consumer summary]
Nicholas KJ, Dhouieb MO, Marshall TG, Edmunds AT, Grant MB
Physiotherapy 1999 Dec;85(12):669-674
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

AIMS: A clinical trial was undertaken to test the hypothesis that CPT may be of benefit to those infants with acute viral bronchiolitis whose disease on admission was severe enough to require nasogastric or intravenous feeding. The clinical impression that CPT does not increase respiratory distress was also investigated. METHOD: The treatment group (n = 26) receiving physiotherapy was compared with a control group (n = 24). Subjects in the control group were nursed in modified postural drainage positions with suction as required. Outcome was assessed by comparison of clinical score, duration of hospital stay, requirement for oxygen, and nasogastric feeding. RESULTS: There was no significant difference in overall outcomes between the two groups. Analysis of clinical scores suggested that less severely ill infants (score < 9.5 on admission) in the treatment group recovered at a slower rate than the equivalent infants in the control group. CONCLUSIONS: There was no increase in the respiratory distress of infants who received CPT according to the protocol, but chest physiotherapy is of no benefit in the management of acute viral bronchiolitis in the absence of other pathologies.

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