Sunday, March 18, 2012

CPT Sham

Why do we keep on performing Chest Physical Therapy?

This recent Cochrane Database review reinforces that CPT does not improve outcomes [1]. 


This is a further update of the original Cochrane review published in 2005 and updated in 2007. Acute bronchiolitis is the leading cause of medical emergencies during winter in children younger than two years of age. The main objective of the study was to determine the efficacy of chest physiotherapy in infants aged less than 24 months old with acute bronchiolitis. A secondary objective was to determine the efficacy of different techniques of chest physiotherapy. The researchers searched various past studies including the Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Cochrane Acute Respiratory Infections Group's Specialized Register.  Selection included randomized controlled trials (RCTs) in which chest physiotherapy were compared against no intervention or against another type of physiotherapy in bronchiolitis patients younger than 24 months of age. Finally, two review authors independently extracted data. The primary outcomes included respiratory parameters and improvement in severity of disease. The secondary outcomes included length of hospital stay, duration of oxygen supplementation and the use of bronchodilators and steroids. No pooling of data was possible.


Researchers observed no significant differences in the severity of disease. Results were negative for both types of physiotherapy. They observed no differences between groups in respiratory parameters, oxygen requirements, length of stay, or severe side effects. Differences in mild transient adverse effects were observed.


Since the last publication of this review new good-quality evidence has appeared, strengthening the conclusions of the review. Chest physiotherapy does not improve the severity of the disease, respiratory parameters, or reduce length of hospital stay or oxygen requirements in hospitalized infants with acute bronchiolitis not on mechanical ventilation. Chest physiotherapy modalities have shown equally negative results.

[1]. Roqué I. F. M., Giné-Garriga M., Granados R. C. & Perrotta, C., (2012). 

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