Prospective Effects of Manual Diaphragmatic Release and Thoracic Lymphatic Pumping in Childhood Asthma

Abstract

BACKGROUND: Manual noninvasive respiratory techniques have traditionally been used to treat respiratory pathologies. The aim of this study was to analyze the effects of the diaphragmatic release technique and the thoracic lymphatic pump technique versus conventional respiratory retraining in children with asthma. METHODS: Using a quasi-experimental design, 60 children with asthma were allocated to undergo the diaphragmatic release technique (n ‫؍‬ 20), thoracic lymphatic pump technique (n ‫؍‬ 20), or conventional respiratory retraining (n ‫؍‬ 20) in this study. Serum immunoglobulin E levels, diaphragmatic mobility, pulmonary function, and P (A-a)O 2 were assessed before and after 12 treatment sessions that were conducted over nonconsecutive days in a 4-week program. RESULTS: After 12 treatments, the changes in the serum immunoglobulin E level for each group was not significantly different from the other groups. Compared with conventional respiratory retraining, the diaphragmatic release technique was associated with a significant improvement in FVC (P ‫؍‬ .001) and FEV 1 (P ‫؍‬ .002); the thoracic lymphatic pump technique showed no differences. With regard to diaphragmatic mobility, both the diaphragmatic release technique and the thoracic lymphatic pump technique yielded significantly favorable effects when compared with conventional respiratory retraining (P < .001 and P ‫؍‬ .01, respectively). Further, no significant between-group differences were detected in terms of the P (A-a)O 2 (P ‫؍‬ .07). CONCLUSIONS: The thoracic lymphatic pump technique and conventional respiratory retraining approaches were helpful interventions that could be used to alleviate the symptoms of childhood asthma. Nevertheless, the diaphragmatic release technique was a potentially more effective intervention.

Entrenamiento muscular respiratorio en el paciente pediátrico con enfermedad respiratoria crónica

“…Method Patients aged 4-18 years old with functional constipation according to the Rome III criteria were randomized to physiotherapy or medical treatment. In the physiotherapy group, exercises (isometric training of the abdominal muscles, diaphragmatic breathing exercises and abdominal massage (NE: 1+; GR: B), de igual forma, la aleación de entrenamiento de los músculos respiratorios y los ejercicios respiratorios es beneficioso para este tipo de pacientes (Elnaggar et al, 2019) (NE: 3; GR: D).…”

“…En el marco del diagnóstico precoz, el tratamiento rehabilitador intensivo y el seguimiento estrecho a los pacientes pediátricos con enfermedad respiratoria crónica se recomienda evaluar la resistencia, la fuerza y la función muscular, en el caso de los músculos respiratorios se utiliza la presión inspiratoria máxima (PIM), la presión espiratoria máxima (PEM), junto con la función pulmonar y el estado de la ventilación mediante la capacidad vital forzada (CVF, VEF1 y PFE) (Rodrigues et al, 2014;D. F. Prado et al, 2016;Torres et al, 2019;Elnaggar et al, 2019;Wenzel, 2019;Crisp et al, 2020;Lolascon et al, 2020) (NE: 3; GR: D).…”