ינהאַלט
Respiratory physiotherapy and bronchiolitis: the conclusions of the journal Prescrire and the response of a physiotherapist
The facts: in December 2012, the medical journal Prescrire affirming that nine studies, carried out with 891 infants hospitalized for bronchiolitis showed no difference between babies treated with respiratory physiotherapy and without physiotherapy, both in clinical terms and physiological (blood oxygenation, respiratory rate, duration of the disease, etc.).
Brice Mommaton: This study does not concern liberal physiotherapists. It was performed in infants hospitalized for bronchiolitis. We, we are fighting to avoid hospitalization. The most serious and fragile cases of bronchiolitis are analyzed in this work. Indeed, when a baby is hospitalized, the priority is to maintain oxygen saturation and fight against this inflammation of the bronchi. In addition, physiotherapy sessions can be done to unclog the nasal passages, but they must be very gentle so as not to weaken the child.
Is respiratory physiotherapy really useful in cases of bronchiolitis?
BM: Yes, she is helpful when the baby cannot expel the hypersecretion of phlegm accumulated in his bronchi. Because the most serious risk is the deterioration of respiratory function and therefore hospitalization. The work of the physiotherapist consists precisely in decluttering the bronchi to allow the child to breathe and eat. Ask parents, after a session, the baby does not spend the same night, he regains his appetite, coughs less. But bronchiolitis persists for at least 8-10 days, hence the importance of having several sessions.
Respiratory physiotherapy: what about adverse effects (vomiting, pain and rib fractures, etc.)?
BM: For 15 years that I have been practicing, I have never seen rib fractures. This is an extremely rare case. You should know that there is a great disparity between the different methods of respiratory physiotherapy. In France, we use the technique ofincreased expiratory flow. It has nothing to do with the jerky and abrupt gestures that can be seen on television. Respiratory physiotherapy is not painful. The child cries because the manipulation is uncomfortable for him. Vomiting is very rare. They happen when the baby has a build-up of indigestible mucus that he needs to evacuate. At any rate, the most important thing is to choose an experienced practitioner who was trained in this pediatric act with a reading of these clinical signs.