Physiotherapists' use of airway clearance techniques during an acute exacerbation of bronchiectasis: a survey study.
Jennifer Phillips, Annemarie Lee, Rodney Pope and 1 others
PMID 33517917WHAT IT FOUND
Physiotherapists routinely prescribe airway clearance techniques during bronchiectasis exacerbations, favoring directed huffing, physical exercise, and oscillating PEP devices.
They base these choices on patient presentation and contraindications rather than evidence, despite perceiving these specific techniques as highly effective.
Key findings
01Most participants working with adults and all participants working in paediatrics reported they prescribed ACTs in 81 to 100% of instances in which they contributed to management of an acute exacerbation of bronchiectasis.
02The most commonly used ACTs with adults were directed huffing (92%), physical exercise (89%) and the ACBT (89%).
03The most commonly reported “extremely important factors” in choosing ACTs were ‘patient clinical presentation’ (72%) and ‘the presence/absence of contra-indications’ (72%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The response rate is unknown because the number of eligible physiotherapists who received the invitation is not defined. Data is self-reported and relies on perceived effectiveness rather than objective clinical outcomes or observed practice. The sample was predominantly Australian (88%), which may limit generalizability to other regions. Approximately 40% of participants had less than 5 years of respiratory experience, which may influence practice patterns compared to more senior clinicians. The survey did not allow for comparison between inpatient and outpatient management practices beyond frequency of prescription.
Declared interests
No conflicts of interest or funding sources are explicitly declared in the provided text.
The easy way to misread this
Do not interpret the high perceived effectiveness of techniques like physical exercise and oscillating PEP as evidence that they are clinically superior. The survey reports therapist beliefs, not patient outcomes, and the authors explicitly state that there is little evidence available for the use of these specific techniques during acute exacerbations.