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KCE reports vol.40 APPENDICES Physiotherapy 173
The treatment modalities and the proportion of physiotherapists in our survey treating at least one elderly
patient with gait disorders are confronted in Table 4.12 with the results of the literature review on evidencebased
therapeutic modalities. Only a small number of evidence was available in the literature relative to the
physiotherapeutic modalities used to treat gait disorders in elderly people. Indeed, gait disorders in the elderly
are generally studied in the context of specific conditions rather than in a more general context. Weak to
moderate evidence was demonstrated for muscle strengthening and balance rehabilitation, the two most
common treatment modalities applied by Belgian ambulatory physiotherapists to treat gait disorders in elderly
people. The literature review has found that exercise programs in general seem efficacious in improving
walking performance and more specifically gait speed, walking independence and step height. Exercise
programs usually include muscle strengthening, balance exercises, mobilizations, stretching, coordination
exercises, transfer exercises, etc. Thus, these types of exercises could be effective in improving gait in elderly
people. Studies are however required to identify which of these exercises are actually effective in the
treatment of gait disorders in the elderly. Weak to moderate evidence was also found for aerobic exercises
and Tai Chi Quan. This latter is almost not used in ambulatory physiotherapy as it is not really a
physiotherapeutic modality treatment. Thus, Tai Chi Quan is probably not a technique within physiotherapists
province.
Bronchiolitis in infants and children
The most frequent treatment modalities applied by Belgian ambulatory physiotherapists to treat infants and
children with bronchiolitis were, from the most prevalent to the least: chest percussion, education of the
parents, assisting coughing, aerosol, forced exhalation techniques, postural drainage, and chest vibration. The
following treatment modalities were also common but to a lesser extent: acceleration of expiratory flow,
nasopharyngeal decongestion, and slow prolonged expiration. The treatment modalities rarely applied by
ambulatory physiotherapists include slow increase of expiratory flow and use of specific devices.
The treatment modalities and the proportion of physiotherapists in our survey treating at least one infant/child
with bronchiolitis are confronted in Table 4.13 with the results of the literature review on evidence-based
therapeutic modalities. A paucity of evidence was available in the literature relative to the physiotherapeutic
modalities used to treat bronchiolitis in infants and children.