The role of physiotherapy in the respiratory management of children with neuromuscular diseases: A South African perspective

Anri Human, Lieselotte Corten, Brenda Morrow

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: Respiratory morbidity is common in children with neuromuscular diseases (NMD) owing to chronic hypoventilation and impaired cough. Optimal, cost-effective respiratory management requires implementation of clinical practice guidelines and a coordinated multidisciplinary team approach. Objectives: To explore South African physiotherapists’ knowledge, perception and implementation of respiratory clinical practice guidelines for non-ventilated children with NMD. Methods: An online survey was conducted amongst members of the South African Society of Physiotherapy’s Cardiopulmonary Rehabilitation (CPRG) and Paediatric special interest groups and purposive sampling of non-member South African physiotherapists with respiratory paediatrics expertise (N = 481). Results: Most respondents worked in private healthcare, with 1–10 years’ experience treating patients with NMD. For acute and chronic management, most participants recommended nebulisation and 24-h postural management for general respiratory care. Percussions, vibrations, positioning, adapted postural drainage, breathing exercises and manually assisted cough were favoured as airway clearance techniques. In addition, participants supported non-invasive ventilation, oscillatory devices and respiratory muscle training for chronic management. Conclusion: Respondents seemed aware of internationally-endorsed NMD clinical practice guidelines and recommendations, but traditional manual airway clearance techniques were favoured. This survey provided novel insight into the knowledge, perspectives and implementation of NMD clinical practice guidelines amongst South African physiotherapists. Clinical implications: There is an urgent need to increase the abilities of South African physiotherapists who manage children with NMD, as well as the establishment of specialised centres with the relevant equipment, ventilatory support and expertise in order to provide safe, cost-effective and individualised patient care.

    Original languageEnglish
    Article numbera1527
    Pages (from-to)1-11
    Number of pages11
    JournalSouth African Journal of Physiotherapy
    Volume77
    Issue number1
    DOIs
    Publication statusPublished - 7 May 2021

    Bibliographical note

    © 2021. The Authors. Licensee: AOSIS. This work islicensed under the CreativeCommons Attribution License.

    Funding Information: This work forms part of a PhD study that was supported by the URC Equipment Grant (Western Cape), Sefako Makgatho Health Sciences University Research Development Grant and the South African Society of Physiotherapy (PhD grant).

    Keywords

    • respiratory management
    • Children and young people
    • airway clearance techniques
    • chest physiotherapy
    • neuromuscular diseases
    • Chest physiotherapy
    • Neuromuscular diseases
    • Airway clearance techniques
    • Respiratory management
    • Children

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