Infants hospitalised with acute respiratory tract infections. Mapping, description, and evaluation of physiotherapy treatment methods including frequent changes in body position and stimulation of physical activity.
Andersson Marforio, Sonja LU
(2022)
In Lund University, Faculty of Medicine Doctoral Dissertation Series
- Abstract
- The overall aim of this thesis was to increase knowledge about physiotherapy treatment for infants with lower respiratory tract infections, which is the most common reason for infant hospitalisation worldwide. Physiotherapy treatment for these infants is debated, and there is no clear consensus regarding the best treatment strategy.
To examine current treatment and evaluation methods in Sweden, we constructed and distributed a digital survey. The survey consisted of questions with listed answer options—chosen from literature and expert experience—in addition to the possibility of answering in free text. The treatment methods were analysed with descriptive statistics and Chi2 tests. The survey showed that physiotherapists in Sweden use... (More) - The overall aim of this thesis was to increase knowledge about physiotherapy treatment for infants with lower respiratory tract infections, which is the most common reason for infant hospitalisation worldwide. Physiotherapy treatment for these infants is debated, and there is no clear consensus regarding the best treatment strategy.
To examine current treatment and evaluation methods in Sweden, we constructed and distributed a digital survey. The survey consisted of questions with listed answer options—chosen from literature and expert experience—in addition to the possibility of answering in free text. The treatment methods were analysed with descriptive statistics and Chi2 tests. The survey showed that physiotherapists in Sweden use a wide range of treatment methods depending on the individual situation. The mostly used methods include frequent body position changes, stimulation of physical activity, and providing information to the parents.
To evaluate the effect of this treatment strategy, we planned and performed a randomised control trial (RCT) at two hospitals in southern Sweden. Infants aged 0–24 months without previous respiratory or cardiac diagnoses were included and individually randomised to a control group (standard care) or to one of two intervention groups (standard care with two varieties of additional interventions). Study procedures and design were thoroughly described in a study protocol. Furthermore, a safety analysis was performed in a feasibility study, showing no risk of harm. We also evaluated the feasibility of the study design, which enabled us to improve the analysis plan for the RCT. The feasibility study revealed some challenges about clinical research in acute hospital settings, including a low recruitment rate (19%) and more missing data than had been previously assumed. Scrutinising the data, we identified difficulties in utilising the intended primary outcome measure, which was consequently changed in the full RCT, and a new sample size calculation was performed.
The effect of the physiotherapy intervention was primarily analysed via Kaplan-Meier and an adjusted Cox regression model. No statistically significant differences were detected between the intervention group and the control group in the rate of improvement (p =0.46; p =0.69) or in the immediate changes in oxygen saturation, heart rate, or respiratory rate (p =0.28–0.92). Both strategies were found to be equally effective and safe, indicating that the current recommendation of minimal handling for these infants should be reconsidered.
(Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/042c902e-8b82-4c5b-a808-ad814871d354
- author
- Andersson Marforio, Sonja
LU
- supervisor
- opponent
-
- Associate Professor Nygren-Bonnier, Malin, Karolinska Institutet
- organization
- publishing date
- 2022
- type
- Thesis
- publication status
- published
- subject
- keywords
- physical therapy modalities, respiratory tract infections, bronchiolitis, pneumonia, infants, randomized controlled trial
- in
- Lund University, Faculty of Medicine Doctoral Dissertation Series
- issue
- 2022:67
- pages
- 92 pages
- publisher
- Lund University, Faculty of Medicine
- defense location
- Hörsal H01, Health Science Centre, Baravägen 3 i Lund. Join by Zoom: https://lu-se.zoom.us/j/61109633096
- defense date
- 2022-05-19 09:00:00
- ISSN
- 1652-8220
- ISBN
- 978-91-8021-228-1
- language
- English
- LU publication?
- yes
- id
- 042c902e-8b82-4c5b-a808-ad814871d354
- date added to LUP
- 2022-04-08 15:16:51
- date last changed
- 2024-03-26 13:56:51
@phdthesis{042c902e-8b82-4c5b-a808-ad814871d354,
abstract = {{The overall aim of this thesis was to increase knowledge about physiotherapy treatment for infants with lower respiratory tract infections, which is the most common reason for infant hospitalisation worldwide. Physiotherapy treatment for these infants is debated, and there is no clear consensus regarding the best treatment strategy.<br/>To examine current treatment and evaluation methods in Sweden, we constructed and distributed a digital survey. The survey consisted of questions with listed answer options—chosen from literature and expert experience—in addition to the possibility of answering in free text. The treatment methods were analysed with descriptive statistics and Chi2 tests. The survey showed that physiotherapists in Sweden use a wide range of treatment methods depending on the individual situation. The mostly used methods include frequent body position changes, stimulation of physical activity, and providing information to the parents. <br/>To evaluate the effect of this treatment strategy, we planned and performed a randomised control trial (RCT) at two hospitals in southern Sweden. Infants aged 0–24 months without previous respiratory or cardiac diagnoses were included and individually randomised to a control group (standard care) or to one of two intervention groups (standard care with two varieties of additional interventions). Study procedures and design were thoroughly described in a study protocol. Furthermore, a safety analysis was performed in a feasibility study, showing no risk of harm. We also evaluated the feasibility of the study design, which enabled us to improve the analysis plan for the RCT. The feasibility study revealed some challenges about clinical research in acute hospital settings, including a low recruitment rate (19%) and more missing data than had been previously assumed. Scrutinising the data, we identified difficulties in utilising the intended primary outcome measure, which was consequently changed in the full RCT, and a new sample size calculation was performed. <br/>The effect of the physiotherapy intervention was primarily analysed via Kaplan-Meier and an adjusted Cox regression model. No statistically significant differences were detected between the intervention group and the control group in the rate of improvement (p =0.46; p =0.69) or in the immediate changes in oxygen saturation, heart rate, or respiratory rate (p =0.28–0.92). Both strategies were found to be equally effective and safe, indicating that the current recommendation of minimal handling for these infants should be reconsidered.<br/>}},
author = {{Andersson Marforio, Sonja}},
isbn = {{978-91-8021-228-1}},
issn = {{1652-8220}},
keywords = {{physical therapy modalities, respiratory tract infections, bronchiolitis, pneumonia, infants, randomized controlled trial}},
language = {{eng}},
number = {{2022:67}},
publisher = {{Lund University, Faculty of Medicine}},
school = {{Lund University}},
series = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
title = {{Infants hospitalised with acute respiratory tract infections. Mapping, description, and evaluation of physiotherapy treatment methods including frequent changes in body position and stimulation of physical activity.}},
url = {{https://lup.lub.lu.se/search/files/116460218/e_spik_ex_Sonja.pdf}},
year = {{2022}},
}