Influence of bouncing and assisted autogenic drainage on acid gastro-oesophageal reflux in infants

Abstract

OBJECTIVES:To determine the influence of modern airway clearance techniques using assisted autogenic drainage (AAD), whether or not combined with bouncing, on acid gastro-oesophageal reflux (GOR) in infants <1 year. Methods: In this controlled trial with intra-subject design infants were studied using oesophageal pH monitoring over 24 h, during which they received one 15 min session of bouncing, AAD or bouncing combined with AAD (BAAD). The number of reflux episodes (RE) and the refluxindex (RI) were the outcome measures. The results obtained during (T15) and 15 min after the intervention (T30) were compared to a period of 15 min before treatment (T0). Results: The results of 150 infants, evenly distributed over the three treatment groups, were analyzed. No significant differences were found in number of RE at T15 and T30 compared to T0 in the bouncing group (P = 0.42), the AAD group (P = 0.14), and the BAAD group (P = 0.91). RI was significantly lower in the AAD group at T15 compared to T0 (P < 0.01). No differences in RI were found in the bouncing group (P = 0.28), nor in the BAAD group (P = 0.81).

Assisted autogenic drainage in infants and young children hospitalized with uncomplicated pneumonia, a pilot study

“…The effectiveness and safety of the use of AAD in children is unclear, as the technique has not been used in RCTs before. However, it has been reported that AAD does not increase gastro‐oesophageal reflux in children (Van Ginderdeuren et al, ).…”

Prolonged Slow Expiration Technique and Gastroesophageal Reflux in Infants Under the Age of 1 Year

“…In a previous study, our group investigated the influence of assisted autogenic drainage (AAD) on GER ( 29 ). Esophageal pH monitoring over 24 h was used to detect the RE and the patients were treated in a supine position.…”

“…These techniques have a negative influence on GER. IPV ( 30 ), PSE, and AAD whether or not combined with bouncing ( 29 ) are the three ACT's proven to be safe and efficient in the clearance of mucus in babies without exacerbating GER.…”

Benefícios da inserção do fisioterapeuta sobre o perfil de prematuros de baixo risco internados em unidade de terapia intensiva

“…From the results found, it is necessary to reflect on the evidenced of the contribution of physical therapy in the NICU [14][15][16][17] and the time of practice. It is known that neonatal physical therapy assists in the prevention and treatment of respiratory complications [14][15][16] and contributes to airway clearance with improvement of blood gases and vital signs [14][15][16][17] , without altering the cardiopulmonary and/ or neurological function nor causing pain or episodes of gastroesophageal reflux 18,19 . Despite all these advantages, there is still a lack of evidences that bring the description of the profiles according to the assistance times 16 , which gives this study a great relevance.…”