An observational study of physiotherapy for children with asthma
Introduction: There is minimal evidence on outpatient physiotherapy programs for children with asthma.
Aims: To examine whether physiotherapy improves asthma control and breathing dysfunction in children with asthma.
Method: We reviewed casenotes of all children with asthma who were referred, over a 12 month period, for a structured physiotherapy program of diaphragmatic and nasal breathing techniques at rest and with activity. The child or parent completed an asthma control test (ACT) and Nijmegen score (a validated measure of breathing dysfunction) before and after the program. We excluded children who dropped out of the program, and analysed separately those whose medication was changed during the intervention.
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Results: Of 48 eligible children (aged 6 to 17), 37/48 had no medication changes during the program. 30/37 completed ACT questionnaires before and after the program. Poor asthma control (ACT 19 or less) was reported by 20/30 (67%) children initially, and 10/30 (33%) after the program. 20/30 children (67%) demonstrated significant improvement in their ACT (a change of ≥3 points). 35/37 children completed Nijmegen scores before and after the program. 18/35 (51%) children had breathing dysfunction (Nijmegen score>20) before and 5/35 (14%) afterwards. 11/48 children had medication changes as well as physiotherapy. 10/11 (91%) had poor asthma control initially, and 4/11 (36%) afterwards. 5/11 (45%) had breathing dysfunction before and 1/11 (9%) afterwards.
Conclusion: Our observational study suggests that physiotherapy can improve asthma control and breathing dysfunction in children with asthma. An RCT examining a structured outpatient physiotherapy program for children with asthma is warranted.