A bstract Background With the Wuhan pandemic spread to India, more than lakhs of population were affected with COVID-19 with varying severities. Physiotherapists participated as frontline workers to contribute to management of patients in COVID-19 in reducing morbidity of these patients and aiding them to road to recovery. With infrastructure and patient characteristics different from the West and lack of adequate evidence to existing practices, there was a need to formulate a national consensus. Materials and methods Recommendations were formulated with a systematic literature search and feedback of physiotherapist experiences. Expert consensus was obtained using a modified Delphi method. Results The intraclass coefficient of agreement between the experts was 0.994, significant at p < 0.001. Conclusion This document offers physiotherapy evidence-based consensus and recommendation to planning physiotherapy workforce, assessment, chest physiotherapy, early mobilization, preparation for discharge planning, and safety for patients and therapist in acutec are COVID 19 setup of India. The recommendations have been integrated in the algorithm and are intended to use by all physiotherapists and other stakeholders in management of patients with COVID-19 in acute care settings. How to cite this article Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A, et al. Evidence-based National Consensus: Recommendations for Physiotherapy Management in COVID-19 in Acute Care Indian Setup. Indian J Crit Care Med 2020;24(10):905–913.

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INTRODUCTION: Peak expiratory flow rate (PEFR) is commonly used to monitor the progression of respiratory diseases as it gives good information about the status of airways. A good amount of research is going across the world to establish a local prediction equation. The joint task force of the American thoracic society and European Respiratory Society has promoted research in this regard. In India, data derived from the Caucasian population are still used for PEFR. OBJECTIVE: To verify the relationship between PEF levels and the variables age, sex, anthropometric and body surface area, and establish the regression equation for young Indian adults. METHODS:  A cross-sectional observational study was conducted in 15-25 years aged 1000 subjects from the Metropolitan region of Mumbai. Pearson’s correlation coefficient was used to understand the relation of anthropometric parameters and PEFR. Multivariate regression analysis was done for establishing a prediction equation (Alpha 5%).  RESULTS: Age and all anthropometric parameters were correlated with PEFR. The mean PEFR of the male population was 515 ml/sec, whereas, for females, it was 399 ml/sec, for PEFR highest correlation was observed with BSA (.696) followed by weight (.667), height (.630), age (.504) whereas BMI shown lowest correlation coefficient (.445). PEFR had the best significance with age, BSA, Height, and BMI. It had less significance with weight. In females, PEFR had the best significance with Height, weight, BMI, and Age. CONCLUSION: Gender-wise differences exist in PEFR. Hence gender-specific equations are needed for the estimation of PEFR.

The prevalence of lung diseases is increasing globally. Mortality, morbidity and respiratory disability are a growing health concern. The pulmonary function test is an accurate tool for detecting airway and lung abnormalities. Early diagnosis of respiratory disease is key to preventing mortality and morbidity. The current study has evaluated the relation of the anthropometric parameters and inspiratory parameters of pulmonary function test and also analyzed its behaviour over the growing age in Indian children. The current study included 2109 school-aged children aged 6 to 15. The height, weight, body mass index and body surface area were recorded. The spirometry was performed in accordance with the protocols. The parameters of the inspiratory flow volume loop were recorded. This study observed a good relation between the anthropometric parameters and inspiratory lung function parameters and the parameters were higher in males than in females. The behaviour of these parameters at various points of growing age was analyzed. This study revealed geographical, gender wise variation in the inspiratory parameters. The study also revealed different patterns of lung growth in boys and girls. Hence this study recommends to include inspiratory parameter assessment in the routine assessment of respiratory patients for early and accurate diagnosis of lung pathology in young children.

Background: The inspiratory parameters of pulmonary function test commonly used for various purposes in clinical practice including diagnosing airway obstruction. Expiratory portion of the flow volume loop of the pulmonary function test is studied in detail. The prediction equations for expiratory parameters are available for different population. However, the reference equation for inspiratory parameters is not available in Indian context. The current study derived the prediction equation for inspiratory parameters of pulmonary function test.Methods: The current study was carried out in school going 732 healthy girls and 1377 boys aged 6-15 years in India.  The children who meet the inclusion criteria were recruited in the study after detailed medical examination by registered medical practitioner. The lung function parameters were recorded by spirometry. The multivariate regression analysis was done to develop the prediction model.Results: The prediction equation for predicting inspiratory parameter were developed. This study revealed gender-wise and geographical variation in the inspiratory parameters. Hence this study recommends to derive gender wise prediction equations. The reference equations derived in this study can be used in population with similar background.Conclusions: Use of these equations for population having similar backgrounds will help for early and accurate diagnosis of the airway abnormalities in children. The inspiratory parameter assessment shall be included in the routine assessment of respiratory patient.