| Holding the baby: head downwards positioning for physiotherapy does not cause gastro-oesophageal reflux. | |
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MedLine Citation:
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PMID: 9817174 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The head-downwards tipped position for physiotherapy has been claimed to exacerbate gastro-oesophageal reflux (GOR) in infants with cystic fibrosis (CF). This was investigated using lower oesophageal pH monitoring during physiotherapy. Twenty-one infants (age range 1-27 months) with respiratory disorders (CF=11), undergoing lower oesophageal pH monitoring were recruited. Subjects received two physiotherapy episodes in random order, A/B or B/A, 12 h apart. A began the gravity-assisted positioning head downward tip for: right lower lobe, middle lobe, left lower lobe and lingula; then supine with no tip for anterior segments of the upper lobes followed by apical segments of upper lobes in a sitting position. B was in the reverse order. Intermittent chest clapping was carried out for 4 min in each position by a physiotherapist blinded to the pH data. During episode A, the median change in pH from baseline was -0.32 (range -2.07 to +1.0) in non-CF subjects (NS) and -0.52 (range -2.7 to +0.52) in CF subjects (p<0.02). During episode B, the median change in non-CF subjects was -0.1 (NS; range - 1.7 to -0.15) and in CF subjects was -0.05 (NS; range -0.67 to +0.5). There was no order effect for positioning. In the CF subjects the sitting position was twice as likely to have the lowest pH measurement during physiotherapy than the other positions (p<0.04). In conclusion, the head-downward tipped positioning for physiotherapy treatment neither induces nor aggravates gastro-oesophageal reflux. There is no justification for routinely changing the way in which infant physiotherapy is carried out. |
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Authors:
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G E Phillips; S E Pike; M Rosenthal; A Bush |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The European respiratory journal Volume: 12 ISSN: 0903-1936 ISO Abbreviation: Eur. Respir. J. Publication Date: 1998 Oct |
Date Detail:
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Created Date: 1999-02-04 Completed Date: 1999-02-04 Revised Date: 2013-05-23 |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: DENMARK |
Other Details:
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Languages: eng Pagination: 954-7 Citation Subset: IM |
Affiliation:
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Dept of Physiotherapy, Royal Brompton Hospital, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Cystic Fibrosis / rehabilitation* Esophagus / chemistry Female Gastroesophageal Reflux / diagnosis, epidemiology, etiology* Head-Down Tilt / adverse effects* Humans Hydrogen-Ion Concentration Incidence Infant Infant, Newborn Male Monitoring, Physiologic Physical Therapy Modalities / adverse effects* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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