Physiotherapy
-
To explore and describe current UK physiotherapy practice relating to airway clearance techniques and mucoactive agents in critically ill adult patients with acute respiratory failure in the intensive care unit. ⋯ Standard UK physiotherapy practice of airway clearance techniques is variable, but patient-centred and targeted to individual need, with adjunctive use of mucoactive agents to enhance and optimise patient management if required. Based on this study, key features of airway clearance techniques have been summarised to help capture standard care, which could be used in future trials involving ACT as part of usual care.
-
Shared decision making is integral to high-quality, evidence-based, and patient-centred physiotherapy practice. It involves therapists and patients collaboratively making a health-related decision after having discussed the options, the likely benefits and harms of each option, and considered the patient's values, preferences and circumstances. Despite being a crucial part of the final step in evidence-based practice, the skills needed to facilitate shared decision making are rarely taught to physiotherapists. This Debate article explores the reasons for the importance of shared decision making to physiotherapy practice; its fundamental role in improving therapist-patient communication, informed decision-making, and evidence-based care; and illustrates some of the processes involved using clinical scenarios.
-
Randomized Controlled Trial
Impact of hypertonic saline nebulisation combined with oscillatory positive expiratory pressure on sputum expectoration and related symptoms in cystic fibrosis: a randomised crossover trial.
To evaluate the impact of combining nebulised hyaluronic acid plus hypertonic saline (HA+HS) with oscillatory positive expiratory pressure (oscillatory-PEP) on sputum expectoration and related symptoms in adults with cystic fibrosis (CF). ⋯ NCT02303808.
-
Randomized Controlled Trial Comparative Study
Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with non-specific low back pain: randomized controlled trial.
To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP). ⋯ NCT03113292.
-
To (1) determine whether short, 30-minute sessions of non-invasive ventilation (NIV) is associated with fewer postoperative pulmonary complications (PPC) following elective high-risk upper abdominal surgery and (2) measure feasibility and safety of this intervention when delivered by physiotherapists. ⋯ These findings suggest PPC reduction may be possible with postoperative NIV following high-risk elective upper abdominal surgery. Results should be seen as hypothesis-generating associations only considering the significant limitations to this study. Physiotherapy-led NIV was delivered safely to ICU and ward patients. However, the planned protocol was not feasible and appropriate physiotherapy staffing and/or a multidisciplinary approach may be required to provide this service successfully.