Claire Hepworth1 and Ian Sinha2
Respiratory Paediatric Physiotherapist, Physiotherapy Department,
Alderhey Hospital, Eaton Road, Liverpool, United Kingdom, 2Consultant
Respiratory Paediatrician, Institute in the Park, Alderhey Hospital,
Eaton Road, Liverpool, United Kingdom
There is minimal evidence on outpatient physiotherapy programs for
children with asthma.
To examine whether physiotherapy improves asthma control and breathing
dysfunction in children with asthma.
We reviewed casenotes of all children with asthma who were referred,
over a 12 month period, for a structured physiotherapy program of
diaphragmatic and nasal breathing techniques at rest and with activity.
The child or parent completed an asthma control test (ACT) and Nijmegen
score (a validated measure of breathing dysfunction) before and after
the program. We excluded children who dropped out of the program, and
analysed separately those whose medication was changed during the
Of 48 eligible children (aged 6 to 17), 37/48 had no medication changes
during the program. 30/37 completed ACT questionnaires before and after
the program. Poor asthma control (ACT 19 or less) was reported by 20/30
(67%) children initially, and 10/30 (33%) after the program. 20/30
children (67%) demonstrated significant improvement in their ACT (a
change of ≥3 points). 35/37 children completed Nijmegen scores
before and after the program. 18/35 (51%) children had breathing
dysfunction (Nijmegen score>20) before and 5/35 (14%)
afterwards. 11/48 children had medication changes as well as
physiotherapy. 10/11 (91%) had poor asthma control initially, and 4/11
(36%) afterwards. 5/11 (45%) had breathing dysfunction before and 1/11
Our observational study suggests that physiotherapy can improve asthma
control and breathing dysfunction in children with asthma. An RCT
examining a structured outpatient physiotherapy program for children
with asthma is warranted.