Effectiveness of Respiratory Physiotherapy in Children With Neuromuscular Disease
Condition: Neuromuscular Diseases
MeSH terms: Neuromuscular Diseases
Study type: Interventional

Summary: 
      The main objective of this study is to determine whether the Respiratory Physiotherapy allows
      improvement or maintenance of respiratory function in children with Neuromuscular Diseases,
      against respiratory deterioration that occurs in the group of subjects who did not receive
      this treatment. And to determine whether decreasing the number of respiratory infections and
      secondly the need for antibiotics and the number of emergency room visits and hospital
      admissions related to these.
    

Detailed description: 
      Background:

      Many authors have demonstrated the efficacy of Physiotherapy in Respiratory attending
      respiratory difficulties associated with different types of pathologies (Chronic Obstructive
      Pulmonary Disease, cystic fibrosis, tumors), however the investigators did not find studies
      with scientific evidence demonstrating the effectiveness of these programs in children with
      Neuromuscular Diseases (NMD), whose quality and life expectancy depends largely on the proper
      handling of Bronchial secretions and delay the deterioration of respiratory function.

      The main objective of this study focuses on determining the effectiveness of physiotherapy
      for the treatment of respiratory breathing difficulties in children with NMD. Deducing other
      aspects such as the impact of this program on the number of visits to hospital emergencies
      department each year, hospital admissions and respiratory infections suffered by these
      children, and the need or not of antibiotics.

      Material and method:

      This research is an analytical, longitudinal, prospective, experimental, evaluator blinded
      study. It is controlled with two parallel groups, randomized clinical trial.

      The sample consisted of children diagnosed with NMD. For the evolution of different variables
      spirometric test was used for variables related to the function respiratory, and a tracking
      sheet designed by the researchers to collect the number hospital emergency visits each year,
      as well as hospital admissions, respiratory infections and need of antibiotics. These
      assessments were made before and after the start of program and during every four months.

      Patients were randomized to control or experimental group, no apply any Respiratory Physical
      Therapy treatment in subjects in the first group and performing a Respiratory Physical
      Therapy program in the second. This program was carried out once in week by the
      physiotherapist, and four times weekly at home, by family, during one year.
    

Intervention name(s): RESPIRATORY PHYSIOTHERAPY; USUAL THERAPIES
Intervention type(s): Other; Other
Intervention description(s): The protocol designed was composed of the following exercises:
supine position: inhalation and exhalation with abdominal and thoracic pressures. 5 times
lateral decubitus, with incentive spirometer lung inflation are made on right/left sides. 3 sets on each side
sitting position, with the body leaning slightly forward, head and shoulders bent inwardly directed. It inspire called for 3 times, sent off in air through the mouth, after that the child was coughing
diaphragmatic breathing in a sitting position: after a slow exhalation requested, child should steam a mirror with his mouth slightly open. 3 replications
in a sitting position, with help of an ambu bag, we made inflations. Repeated 3 times
exercises of upper member coupled to respiratory rhythm: shoulder flexion and extension was carried out during the inspiratory phase and the extension and adduction of them during expiration. 3 times
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Effectiveness; Physical therapy modalities; neuromuscular diseases