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| Name | Class |
|---|---|
| Universidade Cidade de Sao Paulo | OTHER |
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This study evaluated whether physiotherapy is efficient in sputum induction and in evaluation of pulmonary inflammation in asthmatic children.
The hypertonic saline is a traditional technique to collect induced sputum, it´s safe and viable in asthmatic children, as well as the technique of sputum induction and processing has been standardized for schoolchildren.
Sometimes researchers have difficulties to obtain induced sputum in stable patients and it´s possible to use physiotherapy maneuvers to induced sputum. The manouvers are safe for adult and children asthmatics stable.
This study aimed to evaluate the effectiveness to collect induced sputum by physiotherapy maneuvers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| physiotherapists maneuvers | Experimental | physiotherapy techniques |
|
| hypertonic saline 3% | Active Comparator | four nebulizations with 3% hypertonic saline. |
|
| saline + physiotherapy maneuvers | Active Comparator | 1 nebulizations + physiotherapy techniques |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| physiotherapy techniques | Other | oscillating positive expiratory pressure during nonstop 5 minutes. After that more five minutes to a forced expiratory technique |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sputum induction by physiotherapists maneuvers | children were seated in a position where the thorax was inclined forwards by 45°, they were instructed to perform calm and long exhalations by oscillating positive expiratory pressure (OPEP) during nonstop 5 minutes holding a Flutter® (Scandipharm, Birmingham, AL, EUA). After that, children were positioned in supine zero degree and underwent for more five minutes to a forced exhalation with the open mouth/glottis (huffing) associated to acceleration by forced expiratory technique (FET), performed by the therapist by positioning a hand on xiphoid process and the other in the manubrium sternum. | 3 days |
| Measure | Description | Time Frame |
|---|---|---|
| Sputum induction by hypertonic saline 3% | children received until four nebulizations with 3% hypertonic saline, the aerosol was generated by an ultrasonic nebulizer (Ultraneb 99; DeVilbiss, Somerset, PA) each challenge was monitored with PEF between nebulizations. | 3 days |
| Measure | Description | Time Frame |
|---|---|---|
| Sputum induction by hypertonic saline 3% associated with physiotherapists maneuvers | Firstly, children underwent sputum induction by hypertonic saline at 3% for seven minutes. Second, they underwent five minutes OPEP and then five minutes of huffing and FET, as described above. | 3 days |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Beatriz s Romanholo, Dr | Universidade Cidade de Sao Paulo | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Institute of the Clinical Hospital of University of Sao Paulo | SĂŁo Paulo | SĂŁo Paulo | 01246903 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31994616 | Derived | Felicio-Junior EL, Barnabe V, de Almeida FM, Avona MD, de Genaro IS, Kurdejak A, Eller MCN, Verganid KP, Rodrigues JC, Tiberio IFLC, Martins MA, Saraiva-Romanholo BM. Randomized trial of physiotherapy and hypertonic saline techniques for sputum induction in asthmatic children and adolescents. Clinics (Sao Paulo). 2020 Jan 24;75:e1512. doi: 10.6061/clinics/2020/e1512. eCollection 2020. |
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| ID | Type | URL | Comment |
|---|---|---|---|
| references | View IPD |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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| ID | Term |
|---|---|
| D026741 | Physical Therapy Modalities |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
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Patients were randomized in first visits into crossover techniques: (i) hypertonic saline (3%) - HS technique; (ii) physiotherapy techniques (oscillatory positive expiratory pressure, forced expiration and acceleration of expiratory flow) - P technique; (iii) hypertonic saline + physiotherapy techniques - HSP technique. All children attended three visits and 90 samples were collected. All patients underwent induced sputum and pulmonary function before and after bronchodilator.
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| hypertonic saline 3% | Other | four nebulizations with 3% hypertonic saline, the aerosol was generated by an ultrasonic nebulizer |
|
| saline + physiotherapy maneuvers | Other | sputum induction by hypertonic saline at 3% for seven minutes. And more five minutes under physiotherapists maneuvers |
|
GINA. Global Strategy for Asthma Management and Prevention NHLBI/WHO Workshop Report 2012. 2012 ISAAC. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998; 12:315-335 Solé D, Wandalsen GF, Camelo-Nunes IC, et al. Prevalence of symptoms of asthma, rhinitis, and atopic eczema among Brazilian children and adolescents identified by the International Study of Asthma and Allergies in Childhood (ISAAC) - Phase 3. J Pediatr (Rio J) 2006; 82:341-346 Barnabé V, Saraiva B, Stelmach R, et al. Chest physiotherapy does not induce bronchospasm in stable asthma. Physiotherapy 2003; 89:714-719 ATS. Standardization of Spirometry - American Thoracic Society. Am J Respir Crit Care Med 1995; 152:1107-1136 Saraiva-Romanholo BM, Barnabe V, Carvalho AL, et al. Comparison of three methods for differential cell count in induced sputum. Chest 2003; 124:1060-1066 |
| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D017606 |
| Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |