PhysiotherapyPub Date : 2025-04-02DOI: 10.1016/j.physio.2025.101791
J. Weblin , D. Parekh , J. Hodson , P. Guo , N. Efstathiou , D. McWilliams
{"title":"Efficacy of instilled saline in conjunction with chest physiotherapy on secretion clearance in adults diagnosed with a ventilator acquired pneumonia: a randomised crossover feasibility trial","authors":"J. Weblin , D. Parekh , J. Hodson , P. Guo , N. Efstathiou , D. McWilliams","doi":"10.1016/j.physio.2025.101791","DOIUrl":"10.1016/j.physio.2025.101791","url":null,"abstract":"<div><h3>Introduction</h3><div>Chest physiotherapy is routinely provided to mechanically ventilated (MV) patients in intensive care units (ICUs) to aid secretion clearance. Physiotherapists may instil saline down the endotracheal tube to aid secretion clearance. However, there is limited evidence and no UK guidelines on the use of saline instillation (SI).</div></div><div><h3>Objective</h3><div>To evaluate the feasibility of a definitive trial examining the efficacy of SI during chest physiotherapy on secretion yield in patients with ventilator-acquired pneumonia (VAP).</div></div><div><h3>Methods</h3><div>A randomised crossover feasibility trial was performed on patients with VAP at a large UK ICU. Patients underwent twice daily chest physiotherapy sessions, alternating between SI vs. Non-SI for three days or until extubation. Primary outcomes were feasibility measures: recruitment, retention, and protocol fidelity. Secondary outcomes included safety outcomes and secretion yield, assessed using two approaches: “adjusted wet sputum weight” and “sputum pellet weight”.</div></div><div><h3>Results</h3><div>Of 32 eligible patients, 94% (<em>N</em> = 30) were recruited, of whom 7% (<em>N</em> = 2) were subsequently withdrawn; 21 (70%) completed all six sessions. No adverse events occurred in SI sessions. The adjusted wet sputum weight appeared to underestimate secretion yield in SI sessions, resulting in a negative median value (−0.49 g; IQR: −2.39, 1.11), which was significantly lower than Non-SI sessions (median: 0.99 g; IQR: 0.26, 2.11; <em>p</em> < 0.001). Analysis using sputum pellet weight reversed the direction of this effect, with medians of 3.49 g (IQR: 1.96, 5.55) vs. 1.70 g (IQR: 0.99, 2.60) for SI vs. non-SI sessions (<em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>A trial of SI during chest physiotherapy for MV patients with VAP would be feasible. However, further validation of a method for processing sputum samples is required before proceeding to a definitive trial.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>A prospective study investigating the efficacy of saline instillation on secretion yield would be safe and feasible.</div></span></li><li><span>•</span><span><div>Adjusted wet sputum weight is not a reliable objective marker to quantify sputum yield.</div></span></li><li><span>•</span><span><div>Development and validation of a method for processing sputum samples to obtain an accurate sputum weight is a research priority.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"128 ","pages":"Article 101791"},"PeriodicalIF":3.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101687
Anderson A. , Flurey C. , Bradley S. , Richards S. , Siddle H.
{"title":"Supporting primary care clinicians to identify people at risk of rheumatoid arthritis by targeted anti-CCP testing: an intervention development study","authors":"Anderson A. , Flurey C. , Bradley S. , Richards S. , Siddle H.","doi":"10.1016/j.physio.2025.101687","DOIUrl":"10.1016/j.physio.2025.101687","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101687"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101746
Qashwa Y. , Gray H.
{"title":"Opening the black box of cognitive functional therapy: a review using the Template for Intervention Description and Replication (TIDieR) checklist","authors":"Qashwa Y. , Gray H.","doi":"10.1016/j.physio.2025.101746","DOIUrl":"10.1016/j.physio.2025.101746","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101746"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101719
Schofield J.
{"title":"The ‘Your Care Needs You’ intervention – learning from the Partners at Care Transitions (PACT) research project","authors":"Schofield J.","doi":"10.1016/j.physio.2025.101719","DOIUrl":"10.1016/j.physio.2025.101719","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101719"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101667
O'Sullivan J. , Miller C. , Bateman M. , Hill J.
{"title":"Exploring physiotherapy management of Neurogenic Thoracic Outlet Syndrome (NTOS): a online survey of United Kingdom (UK) therapy and medical professionals","authors":"O'Sullivan J. , Miller C. , Bateman M. , Hill J.","doi":"10.1016/j.physio.2025.101667","DOIUrl":"10.1016/j.physio.2025.101667","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101667"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101668
Warwick H, Burnham S, Carey W, Wall F, Raja M.
{"title":"Evaluating the efficacy of functional resistance training by sport and exercise professionals for inpatient deconditioning prevention: a service evaluation","authors":"Warwick H, Burnham S, Carey W, Wall F, Raja M.","doi":"10.1016/j.physio.2025.101668","DOIUrl":"10.1016/j.physio.2025.101668","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101668"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101730
Thompson P. , Perry D.C. , Cootes T.F. , Lindner C.
{"title":"A survey on the potential benefits and challenges of automating measurements on hip radiographs in children with cerebral palsy","authors":"Thompson P. , Perry D.C. , Cootes T.F. , Lindner C.","doi":"10.1016/j.physio.2025.101730","DOIUrl":"10.1016/j.physio.2025.101730","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101730"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhysiotherapyPub Date : 2025-03-27DOI: 10.1016/j.physio.2025.101752
Beard K.
{"title":"The impact of printed postpartum education materials on self-efficacy and readability: a mixed methods analysis","authors":"Beard K.","doi":"10.1016/j.physio.2025.101752","DOIUrl":"10.1016/j.physio.2025.101752","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101752"},"PeriodicalIF":3.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}