• Yuen Ling Hue, LumLucy Chai SeeLCSDepartment of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia., Siti Hawa Ahmad, Soon Sin Tan, Shin Yee Wong, Anna Marie Nathan, Kah Peng Eg, and Melissa de Bruyne Ming May Choon.
• University Malaya Paediatric and Child Health Research Group, Kuala Lumpur, Malaysia.
• Singap Med J. 2022 Feb 1; 63 (2): 105-110.

IntroductionChest physiotherapy (CPT) may benefit children aged below five years who suffer from lower respiratory tract infection (LRTI). However, its effects depend on the technique used. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI.MethodsChildren aged five months to five years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid. Outcomes measured before intervention and two hours after intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score.ResultsAll 30 enrolled patients showed significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT.ConclusionChildren receiving both manual and mechanical CPT showed improvements in respiratory distress symptoms, with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements in moderately severe respiratory distress. The LEGA-Kid mechanical CPT method is superior to manual CPT in reducing the RR.Copyright: © Singapore Medical Association.

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