物理治疗师在支气管扩张急性加重期使用气道清除技术:一项调查研究。

IF 2.1 Q1 REHABILITATION
Jennifer Phillips, Annemarie Lee, Rodney Pope, Wayne Hing
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引用次数: 14

摘要

背景:对于处于稳定状态和急性加重期的支气管扩张患者,建议使用气道清除技术,然而目前气道清除技术在急性加重期个人管理中的应用尚不清楚。本研究的目的是确定当前支气管扩张急性加重期成人和儿科物理治疗临床实践的内容;确定物理治疗师对气道清除技术有效性的看法,并确定影响他们在该人群中的治疗决策的因素。方法:2016年8月至2017年4月,对澳大利亚物理治疗协会和新西兰物理治疗协会的会员进行匿名在线调查。结果:130名物理治疗师访问了调查问卷,其中121名认为自己符合条件并同意参与。大多数参与者(89%)报告说,81-100%的人在支气管扩张急性加重期间使用气道清除技术。成人最常用的气道清除技术是充气法(92%)、运动法(89%)和主动循环呼吸法(89%)。被认为对成人最有效的技术是体育锻炼(100%)、振荡呼气正压装置(97%)、定向充气(95%)、主动循环呼吸技术(90%)和呼气正压(90%)。儿科患者最常用的气道清除技术是:新生儿-3岁-叩击(85%)和改良体位引流(85%);4-10年——气喘(100%)和锻炼(85%);11-18岁-气垫(92%)和锻炼(77%),主动循环呼吸技术(77%)和呼气正压疗法(77%)。被认为对儿科患者最有效的技术是直接吹气(100%)、打击(100%)和通过口罩或吹嘴呼气正压(93%)。最常报道的影响技术选择的因素是患者的临床表现(72%)和有无禁忌症(72%)。结论:本研究表明,对于支气管扩张急性加重的个体,常规使用气道清除技术作为物理治疗管理的一部分,技术的选择和感知的有效性取决于患者的年龄。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Physiotherapists' use of airway clearance techniques during an acute exacerbation of bronchiectasis: a survey study.

Background: Airway clearance techniques are recommended for individuals with bronchiectasis both in stable state and during an acute exacerbation, however the current use of airway clearance techniques in the management of individuals during an acute exacerbation is unclear. The aims of this study were to establish what current physiotherapy clinical practice comprises for adults and paediatrics during an acute exacerbation of bronchiectasis; identify physiotherapist's perceptions of the effectiveness of airway clearance techniques and identify what factors influence their treatment decisions in this population.

Methods: An anonymous online survey was distributed to the members of the Australian Physiotherapy Association and Physiotherapy New Zealand between August 2016 and April 2017.

Results: The survey was accessed by 130 physiotherapists and 121 of those deemed themselves eligible and consented to participate. Most participants (89%) reported prescribing airway clearance techniques for 81-100% of individuals during an acute exacerbation of bronchiectasis. The most commonly used airway clearance techniques with adults were huffing (92%), exercise (89%) and the active cycle of breathing technique (89%). The techniques perceived most effective for adults were physical exercise (100%), oscillating positive expiratory pressure devices (97%), directed huffing (95%) the active cycle of breathing technique (90%) and positive expiratory pressure (90%). The most commonly used airway clearance techniques for paediatric patients were: newborn-3 years - percussion (85%) and modified postural drainage (85%); 4-10 years - huffing (100%) and exercise (85%); 11-18 years - huffing (92%) and exercise (77%), active cycle of breathing technique (77%) and positive expiratory pressure therapy (77%). The techniques perceived most effective for paediatric patients were directed huffing (100%), percussion (100%) and positive expiratory pressure via a mask or mouthpiece (93%). The most commonly reported factors influencing choice of technique were patient clinical presentation (72%) and the presence/absence of contra-indications (72%).

Conclusion: This survey demonstrates that airway clearance techniques are routinely used as part of physiotherapy management of individuals experiencing an acute exacerbation of bronchiectasis, and that choice of technique and perceived effectiveness varies depending on the age of the patient.

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