The role of physiotherapy in the respiratory management of children with neuromuscular diseases: A South African perspective.
Anri Human, Lieselotte Corten, Brenda M Morrow
PMID 34131595WHAT IT FOUND
South African physiotherapists largely recommend manual airway clearance techniques like assisted coughing and adapted postural drainage for children with neuromuscular diseases.
Mechanical devices such as cough assist machines and breath-stacking are rarely used or recommended, likely due to cost and limited training.
Key findings
01Respondents generally favoured traditional manual airway clearance techniques over mechanical devices.
02None of the physiotherapists who treated children with neuromuscular diseases in the previous six months used mechanical insufflation-exsufflation or lung volume recruitment techniques.
03Only a small minority of participants recommended mechanical insufflation-exsufflation for either acute or chronic management scenarios.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The response rate was low (13.3%), which limits the generalisability of the findings to all South African physiotherapists. The sample was drawn from a specific professional society (SASP) and may be biased towards those with a special interest in paediatrics or cardiopulmonary rehabilitation, underrepresenting general practitioners. Only six respondents reported recent clinical experience with this patient group, making it difficult to draw firm conclusions about actual implementation strategies. The survey used self-reported data, which may not accurately reflect clinical practice due to recall bias or social desirability bias. Attrition increased as the survey progressed, with fewer responses in later sections.
Declared interests
No specific funding sources or conflicts of interest are declared in the provided text.
The easy way to misread this
Do not interpret the low use of mechanical insufflation-exsufflation and lung volume recruitment as evidence that these techniques are ineffective or unsafe. The survey suggests these methods are underutilised likely due to resource constraints, cost, and lack of training in South Africa, rather than clinical judgement against their use. International guidelines still recommend these techniques for patients with progressive respiratory muscle weakness.