ESSLei - Mestrado em Fisioterapia - Área de Especialização em Fisioterapia Pediátrica
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Percorrer ESSLei - Mestrado em Fisioterapia - Área de Especialização em Fisioterapia Pediátrica por autor "Magro, Mónica Sofia Frangão"
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- The role of physiotherapists in the management of pediatric asthmaPublication . Magro, Mónica Sofia Frangão; Cruz, Joana Patrícia dos Santos; Silva, Cândida Susana Gonçalves daAsthma is one of the most prevalent chronic diseases in childhood, associated with variable respiratory symptoms and airflow limitation. In Portugal, uncontrolled asthma accounts for an estimated annual cost of around 40 million euros, mainly due to increased use of emergency services. Although physiotherapy may contribute to improved lung function, inspiratory muscle strength, exercise tolerance, quality of life, and disease management, its role is not yet formally recommended by GINA guidelines. Furthermore, no published studies have explored the role of physiotherapists in the management of paediatric asthma in Portugal. The main aim of this study was to characterise the role of physiotherapists working in Portugal in managing asthma in children and adolescents, describing assessment criteria, intervention techniques/strategies, and educational approaches. As a secondary aim, the study sought to explore associations between these practices and factors such as asthma severity, follow-up phase, and professional experience. Methodology: This cross-sectional observational study was based on an online questionnaire. The survey was disseminated via social media and email to educational institutions, the Portuguese Order of Physiotherapists, and interest groups from the Portuguese Association of Physiotherapists. Data analysis included descriptive statistics and association tests (chi-square or Fisher’s exact test) between clinical practices and variables such as asthma severity, follow-up phase, and professional experience. Results: A total of 103 physiotherapists participated, most of whom had complementary training in paediatric respiratory physiotherapy (81.6%). In terms of assessment, 91.3% reported evaluating asthma symptom control, although using different criteria depending on disease severity and follow-up phase. Only one participant indicated assessing quality of life, without mentioning any specific scale, and 41.7% did not use standardised tools. Regarding intervention, respiratory control exercises stood out (95.1%), being more frequently used in moderate (p = 0.016) and severe (p = 0.035) asthma; aerobic exercise was reported by 63.1%, more frequently during the maintenance phase (p = 0.035), with considerable variability in the frequency, duration and intensity prescribed; inspiratory muscle training (34.0%) was associated with mild (p = 0.007) and moderate asthma (p = 0.048). Educational strategies were mainly directed at children/adolescents (97.1%) and parents/legal guardians (95.1%), with lower inclusion of formal caregivers/educators (47.6%). The most frequently reported discharge criteria were adequate symptom control (97.1%) and achievement of the intervention goals (69.9%). Statistically significant associations were also found between symptom control assessment, discharge criteria, and variables such as asthma severity, follow-up phase, and professional experience (p<0.05). Conclusion: The study revealed heterogeneous clinical practices in paediatric respiratory physiotherapy, influenced by asthma severity, follow-up phase, and professional experience. Weaknesses were identified in the use of standardised instruments, in aerobic exercise prescription, and in the inclusion of formal caregivers in educational strategies. These findings highlight the need to standardise practices and to integrate physiotherapy more effectively into school and community settings.