Pediatric physiotherapy management of airway clearance therapy and exercise: Data from the Australian Bronchiectasis Registry

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dc.contributor.authorWebb, E.M.
dc.contributor.authorHolland, A.E.
dc.contributor.authorChang, A.B.
dc.contributor.authorMiddleton, P.G.
dc.contributor.authorThomson, R.
dc.contributor.authorWong, C.
dc.contributor.authorJayaram, L.
dc.contributor.authorHolmes-Liew, C.L.
dc.contributor.authorMorgan, L.
dc.contributor.authorLee, A.L.
dc.date.issued2025
dc.description.abstractBackground Regular airway clearance techniques (ACTs) and exercise are recommended for children with bronchiectasis, but current clinical practice and their predictors are unknown. Objective We aimed to describe current use of ACTs and exercise among Australian children with bronchiectasis and identify associated predictors. Methods Physiotherapy-specific data of 397 children (median age = 8 were extracted from the Australian Bronchiectasis Registry. A multivariate analysis was undertaken to identify predictors associated with the use of regular ACTs and physical exercise. Results Regular ACTs were undertaken by 118 (30%) children while 192 (48%) engaged in regular exercise. Physical exercise was the most common ACT modality (n = 83, 20%). The likelihood of regular ACT increased in children whose sputum isolated Pseudomonas aeruginosa (OR = 3.88, 95% CI 1.69–8.89) and was 50% higher for every respiratory exacerbation in the previous 12-months that required hospitalization (OR = 1.50, 95% CI 1.15–1.95). For every year older in age, children had increased odds of engaging in physical exercise (OR = 1.21, 95% CI 1.08–1.34) or using an ACT device (OR = 1.21, 95% CI 1.05–1.34). Regular exercise was twice as likely in the presence of bibasal bronchiectasis (OR = 2.43, 95% CI 1.14-5.16), yet less likely in those with ≥1 hospitalizations in the previous 12-months (OR = 0.76, 0.95% CI 0.57–1.03). Conclusion Approximately one-third of children with bronchiectasis undertake regular ACTs while physical exercise was undertaken in approximately one in two children. Age, frequent respiratory exacerbations requiring hospitalization and the extent of disease are predictors of undertaking regular ACTs and exercise. Identification of these factors may assist in tailoring ACT, exercise and ACT modality prescription in clinical practice.
dc.description.statementofresponsibilityElizabeth M. Webb, Anne E. Holland, Anne B. Chang, Peter G. Middleton, Rachel Thomson, Conroy Wong, Lata Jayaram, Chien-Li Holmes-Liew, Lucy Morgan, Annemarie L. Lee
dc.identifier.citationPediatric Pulmonology, 2025; 60(1):e27370-1-e27370-9
dc.identifier.doi10.1002/ppul.27370
dc.identifier.issn8755-6863
dc.identifier.issn1099-0496
dc.identifier.urihttps://hdl.handle.net/2440/147909
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2025379
dc.rights© 2024 Wiley Periodicals LLC.
dc.source.urihttps://doi.org/10.1002/ppul.27370
dc.subjectairway clearance techniques
dc.subjectairway clearance therapy
dc.subjectbronchiectasis
dc.subjectchildren
dc.subjectexercise
dc.subjectpediatric
dc.subjectphysical activity
dc.subjectphysiotherapy
dc.subject.meshSputum
dc.subject.meshPseudomonas aeruginosa
dc.subject.meshExercise Therapy
dc.subject.meshRespiratory Therapy
dc.subject.meshPhysical Therapy Modalities
dc.subject.meshAirway Management
dc.titlePediatric physiotherapy management of airway clearance therapy and exercise: Data from the Australian Bronchiectasis Registry
dc.typeJournal article
pubs.publication-statusPublished

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