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Exploratory mixed methods study of respiratory physiotherapy for patients with lower respiratory tract infections
Oliveira A, Marques A
Physiotherapy 2016 Mar;102(1):111-118
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To assess the outcomes of respiratory physiotherapy for patients with lower respiratory tract infections (LRTI). DESIGN: Parallel group mixed-methods study. SETTING: Patients were recruited from a general hospital. Respiratory physiotherapy took place in a community setting. PARTICIPANTS: Fifty-four patients aged >= 18 years and diagnosed with LRTI completed the study. Twenty-seven patients were allocated to the control group (CG 10 male, mean age 53.3 (standard deviation (SD) 17.4) years) and 27 patients were allocated to the experimental group (EG 10 male, mean age 58.6 (SD 17.2) years). INTERVENTION: The CG received conventional medical treatment and the EG received conventional medical treatment plus respiratory physiotherapy for 3 weeks. OUTCOME MEASURES: Patients in both groups undertook the 6-minute walk test (6MWT), modified Borg scale (MBS), modified Medical Research Council questionnaire (mMRC), and Breathlessness, Cough and Sputum scale (BCSS) before and after the intervention. A telephone follow-up survey was performed 3 months after the first hospital visit. Interviews were conducted immediately after the intervention in the EG. RESULTS: In the EG, the distance walked in the 6MWT increased by more than the minimally important difference (p = 0.001), and significantly more than the CG (EG mean change 76m (standard deviation (SD) 63), 95% confidence interval (CI) 51 to 101; CG mean change 27m (SD 56), 95% CI 5 to 49; mean difference between groups 49m 95% CI 16 to 82; partial eta2 = 0.15). No differences in the MBS, mMRC and BCSS were found between the two groups. The EG reported high levels of satisfaction with the intervention (27/27; 100%) and with the physiotherapist (20/27; 74%). The intervention improved patients' symptoms (19/27; 70%) and their self-management skills to control/prevent future LRTI (19/27; 70%). Health service use was significantly less in the EG (p = 0.04). CONCLUSIONS: Respiratory physiotherapy appears to be effective for the management of patients with LRTI.

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