Human Anri, Corten Lieselotte, Morrow Brenda M
Department of Physiotherapy, Faculty of Healthcare Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
S Afr J Physiother. 2021 May 7;77(1):1527. doi: 10.4102/sajp.v77i1.1527. eCollection 2021.
Respiratory morbidity is common in children with neuromuscular diseases (NMD) owing to chronic hypoventilation and impaired cough. Optimal, cost-effective respiratory management requires implementation of clinical practice guidelines and a coordinated multidisciplinary team approach.
To explore South African physiotherapists' knowledge, perception and implementation of respiratory clinical practice guidelines for non-ventilated children with NMD.
An online survey was conducted amongst members of the South African Society of Physiotherapy's Cardiopulmonary Rehabilitation (CPRG) and Paediatric special interest groups and purposive sampling of non-member South African physiotherapists with respiratory paediatrics expertise (= 481).
Most respondents worked in private healthcare, with 1-10 years' experience treating patients with NMD. For acute and chronic management, most participants recommended nebulisation and 24-h postural management for general respiratory care. Percussions, vibrations, positioning, adapted postural drainage, breathing exercises and manually assisted cough were favoured as airway clearance techniques. In addition, participants supported non-invasive ventilation, oscillatory devices and respiratory muscle training for chronic management.
Respondents seemed aware of internationally-endorsed NMD clinical practice guidelines and recommendations, but traditional manual airway clearance techniques were favoured. This survey provided novel insight into the knowledge, perspectives and implementation of NMD clinical practice guidelines amongst South African physiotherapists.
There is an urgent need to increase the abilities of South African physiotherapists who manage children with NMD, as well as the establishment of specialised centres with the relevant equipment, ventilatory support and expertise in order to provide safe, cost-effective and individualised patient care.
由于慢性通气不足和咳嗽功能受损，呼吸疾病在患有神经肌肉疾病（NMD）的儿童中很常见。最佳的、具有成本效益的呼吸管理需要实施临床实践指南并采用多学科协调团队方法。
探讨南非物理治疗师对非通气NMD儿童呼吸临床实践指南的知识、认知和实施情况。
对南非物理治疗师协会心肺康复（CPRG）和儿科特别兴趣小组的成员进行了在线调查，并对具有儿科呼吸专业知识的非会员南非物理治疗师进行了目的抽样（=481）。
大多数受访者在私立医疗保健机构工作，有1 - 10年治疗NMD患者的经验。对于急性和慢性管理，大多数参与者推荐雾化和24小时体位管理用于一般呼吸护理。叩击、振动、体位摆放、改良体位引流、呼吸锻炼和人工辅助咳嗽作为气道清理技术受到青睐。此外，参与者支持无创通气、振荡装置和呼吸肌训练用于慢性管理。
受访者似乎了解国际认可的NMD临床实践指南和建议，但更倾向于传统的手动气道清理技术。这项调查为南非物理治疗师对NMD临床实践指南的知识、观点和实施情况提供了新的见解。
迫切需要提高南非治疗NMD儿童的物理治疗师的能力，以及建立配备相关设备、通气支持和专业知识的专门中心，以便提供安全、具有成本效益和个性化的患者护理。
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