School of Physiotherapy, La Trobe University, Bundoora, Victoria, 3086, Australia.
Physiotherapy. 2013 Jun;99(2):101-6. doi: 10.1016/j.physio.2012.01.002. Epub 2012 Apr 1.
To identify airway clearance techniques (ACTs) used to treat patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and identify factors underpinning their utilisation, including therapists' knowledge of the literature.
Cross-sectional postal survey using Likert scales and multiple-choice responses.
112 'large' or 'principal referral' Australian public hospitals.
189 physiotherapists from 89 hospitals (response rate 81%).
Purpose designed survey measuring self-reported rate of ACT prescription; perception of ACT indications, aims, importance and effectiveness; factors influencing ACT choice; and knowledge of the evidence.
Most physiotherapists (123/189, 65%) prescribed ACTs for 60-100% of patients with AECOPDs. The most frequently prescribed ACTs were physical exercise (169/189, 89%), the forced expiratory technique (153/189, 81%) and the active cycle of breathing technique (149/189, 79%). Most were rated highly effective. Physiotherapists who perceived the role of ACTs to be important to patients' overall management (137/189, 73%) and those with less than 5 years cardiorespiratory experience (113/189, 60%) prescribed ACTs significantly more frequently than others. The main factors influencing ACT choice were precautions/contraindications to individual techniques (148/189, 78%) and degree of dyspnoea (136/189, 72%). The primary aim of ACT prescription was to clear sputum (178/189, 94%). Understanding of the evidence for ACTs in AECOPDs was mixed, with 43% citing it as supportive, 30% inconclusive and 19% unsure.
Australian physiotherapists frequently prescribe ACTs for patients with AECOPDs and perceive their role to be important. Physical exercise is frequently prescribed for airway clearance and warrants further investigation.
确定用于治疗慢性阻塞性肺疾病急性加重（AECOPD）患者的气道清除技术（ACT），并确定其使用的基础因素，包括治疗师对文献的了解。
使用李克特量表和多项选择回答的横断面邮政调查。
112 家“大型”或“主要转诊”澳大利亚公立医院。
来自 89 家医院的 189 名物理治疗师（应答率 81%）。
专门设计的调查，测量自我报告的 ACT 处方率；对 ACT 适应症、目的、重要性和有效性的看法；影响 ACT 选择的因素；以及对证据的了解。
大多数物理治疗师（123/189，65%）为 60-100%的 AECOPD 患者开具 ACT 处方。最常开的 ACT 是体育锻炼（169/189，89%）、强制呼气技术（153/189，81%）和主动呼吸循环技术（149/189，79%）。大多数被评为非常有效。认为 ACT 对患者整体管理很重要的物理治疗师（137/189，73%）和有不到 5 年心肺经验的物理治疗师（113/189，60%）比其他人更频繁地开具 ACT 处方。影响 ACT 选择的主要因素是个别技术的注意事项/禁忌症（148/189，78%）和呼吸困难程度（136/189，72%）。ACT 处方的主要目的是清除痰液（178/189，94%）。对 AECOPD 中 ACT 证据的理解参差不齐，43%的人认为有支持作用，30%的人认为不确定，19%的人不确定。
澳大利亚物理治疗师经常为 AECOPD 患者开具 ACT 处方，并认为他们的角色很重要。体育锻炼常用于气道清除，值得进一步研究。
