Chest physiotherapy for pneumonia in children.

In 30 seconds

This Cochrane systematic review and meta-analysis assessed randomised trials of chest physiotherapy versus usual care in hospitalised children with pneumonia. The update included 12 trials involving 2863 children aged 29 days to 14 years; interventions ranged from conventional techniques to devices including CPAP and chest-wall oscillation. Six trials reported mortality, with contrasting results across three bCPAP studies and substantial heterogeneity (I² = 83%), preventing pooled analysis. Overall, the review judged that chest physiotherapy may make little or no difference to mortality; the abstract excerpt does not provide the remaining outcome results.

Key findings

• Six studies (2294 children) reported mortality; three reported no deaths, while three bCPAP trials found contrasting effects.
• The bCPAP mortality estimates ranged from RR 0.14 (95% CI 0.03 to 1.16) and RR 0.28 (95% CI 0.08 to 0.90) to RR 1.52 (95% CI 1.02 to 2.27).
• Mortality results were highly heterogeneous (I² = 83%), and the evidence was rated low certainty; pooling was not possible.
• Nine studies (2069 children) assessed hospital stay, but the supplied abstract excerpt does not report their results.

Why it matters

Chest physiotherapy is commonly used as an adjunct in paediatric pneumonia, yet this review found no clear mortality benefit overall and substantial inconsistency among bCPAP trial results. The findings underscore that effects may differ by intervention and study context, and that the evidence presented here is uncertain. Mortality alone does not establish whether other outcomes, such as recovery time or hospital stay, are affected.

What to keep in mind

The mortality evidence was low certainty and highly heterogeneous, precluding a pooled estimate. The included trials evaluated varied physiotherapy approaches, and the supplied abstract excerpt does not report results for hospital stay or clinical resolution.