Evidence-based practice in the paediatric respiratory physiotherapy setting

Burelli, Kim
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INTRODUCTION: Physiotherapy in the field of paediatrics is a sector of the practice which is often overlooked, especially in the area of respiratory complications. This is a concern as these patients form a vulnerable population. Care should be taken to administer a safe yet effective treatment to ensure optimal health during their developing years. The aim of the study was to determine types of diagnoses being treated and conditions used, as well as the level of literature available and whether these physiotherapists are making use of evidence-based practice. METHODOLOGY: This study investigated paediatric physiotherapists treating respiratory patients across South Africa. The literature available was rated and reviewed. A survey was distributed to paediatric respiratory physiotherapists to investigate elements of their work in clinical practice. RESULTS: Ninety-eight (27.5%) participants responded to the survey. Pneumonia (35.9%) and bronchiolitis (27.9%) were the conditions most frequently treated with cystic fibrosis being the least common (8.8%) The most common age group treated was six months to one year and percussions and vibrations were the modalities most commonly used. The more supportive evidence was found on physiotherapy for cystic fibrosis and for more active techniques incorporating breathing exercises, cardiovascular exercises and advice and education. However, there was limited evidence on paediatric respiratory physiotherapy as a whole. Half of the participants often used evidence based practice (EBP) in clinical practice whilst the other half seldom did. Those that had received training in EBP had a significantly greater understanding of EBP (p=0.04) whilst there was no correlation between EBP knowledge and the number of years a participant had been qualified (r=0.02). The majority of the participants had a positive attitude towards EBP and would like to incorporate it more into their practice although most of them felt that clinical reasoning played a larger role. DISCUSSION: This study confirms that paediatric physiotherapists who have been trained in EBP have a better understanding of EBP although not all of them are incorporating it into practice. The conditions most commonly treated and the techniques used are not necessarily evidence-based although there is a definite shortage of literature available in this field of practice. CONCLUSION: The study highlights the need for more paediatric physiotherapists to become involved in EBP, in turn allowing for further research to be done in this specialised area of health care.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Science Physiotherapy. Johannesburg, 2016.