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174 APPENDICES Physiotherapy KCE reports vol.40
Table 13 Bronchiolitis in infants and children: treatment modalities applied by Belgian ambulatory physiotherapists and evidence-based literature
Treatment modality
Frequency
(proportion
± accuracy)
Chest percussion 74 ± 09%
Education of the parents 74 ± 09%
Assisted coughing 67 ± 10%
Aerosol 64 ± 10%
Forced exhalation
techniques
Type of
evidence
No evidence
for
nor against
Evidence for
(weak)
No evidence
for
nor against
Evidence
against
(moderate to
strong)
except in
specific
situations
No evidence
for
nor against
Evidence available in the literature on physiotherapy of bronchiolitis in infants and children
There is weak to moderate evidence that chest percussion should not be recommended as it has
not been found to be helpful.
Weak evidence was found in educating the family on basic pathophysiology and expected clinical
course of bronchiolitis, on limiting exposure to contagious settings and siblings, and on importance
on hand washing in all settings.
Education of the family on calling the primary care provider when objective signs of worsening
clinical status are present is also recommended by an experts consensus.
Educating the family on eliminating exposure to tobacco smoke is also recommended.
There is weak to moderate evidence that assisting coughing should not be recommended as it
has not been found to be helpful.
Assisting coughing is however recommended by experts consensus from French-speaking
European countries.
There is moderate to strong evidence that scheduled or serial albuterol aerosol therapies should
not be routinely used. However, single administration trial inhalation of epinephrine or albuterol may
be considered when there is a family history of allergy, asthma or atopy.
Inhalation therapy should not be repeated nor continued in absence of clinical improvement
between 15 to 30 minutes after the first trial inhalation.
Aerosol therapy with saline and cool mist therapy should not be recommended as they have not
been found to be helpful.
61 ± 10% ? No information was available in the literature review.