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Cochrane Database of Systematic Reviews

Chest physiotherapy for pneumonia in adults

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Information

DOI:
https://doi.org/10.1002/14651858.CD006338.pub3Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 28 February 2013see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Acute Respiratory Infections Group

Copyright:
  1. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Ming Yang

    Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China

  • Yuping Yan

    Department of Cardiovascular Medicine, Affiliated Hospital, Medical College of Yanan University, Yanan, China

  • Xiangli Yin

    Department of Pathology, Affiliated Hospital, Medical College of Yanan University, Yanan, China

  • Bin Y Wang

    Department of Gerontology, West China Hospital, Sichuan University, Chengdu, China

  • Taixiang Wu

    Chinese Clinical Trial Registry, Chinese Ethics Committee of Registering Clinical Trials, West China Hospital, Sichuan University, Chengdu, China

  • Guan J Liu

    Chinese Cochrane Centre, Chinese Evidence‐Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China

  • Bi Rong Dong

    Correspondence to: Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China

    [email protected]

Contributions of authors

All authors have contributed to this review.
XL Yin (XLY) and BY Wang (BYW) searched the databases, extracted the data and reformed the tables.
BYW and YP Yan (YPY) screened trials.
M Yang (MY) and YPY appraised the quality of included trials and drafted the full text.
BR Dong (BRD) and TX Wu (TXW) were responsible for editing.
BRD also acted as an arbitrator.
GJ Liu (HGJL) was the consultant for data analysis.

Sources of support

Internal sources

  • Chinese Cochrane Center, Chinese Centre of Evidence‐Based Medicine, West China Hospital of Sichuan University, China.

External sources

  • No sources of support supplied

Declarations of interest

None.

Acknowledgements

We thank Elizabeth Dooley, the Managing Editor of the ARI Group, for her help with drafting the review; and Sarah Thorning, ARI Group Trials Search Co‐ordinator, for her useful comments on the search strategy. We also wish to thank the following people for commenting on the draft review: Sai Janani Sivashankar, George Ntoumenopoulos, Jan Poelaert, Teresa Neeman, and Johannes van der Wouden.

For this 2012 update, we deeply appreciate Sarah Thorning, ARI Group Trials Search Co‐ordinator, for her hard work updating database searches.

Version history

Published

Title

Stage

Authors

Version

2022 Sep 06

Chest physiotherapy for pneumonia in adults

Review

Xiaomei Chen, Jiaojiao Jiang, Renjie Wang, Hongbo Fu, Jing Lu, Ming Yang

https://doi.org/10.1002/14651858.CD006338.pub4

2013 Feb 28

Chest physiotherapy for pneumonia in adults

Review

Ming Yang, Yuping Yan, Xiangli Yin, Bin Y Wang, Taixiang Wu, Guan J Liu, Bi Rong Dong

https://doi.org/10.1002/14651858.CD006338.pub3

2010 Feb 17

Chest physiotherapy for pneumonia in adults

Review

Ming Yang, Yuping Yan, Xiangli Yin, Bin Y Wang, Taixiang Wu, Guan J Liu, Bi Rong Dong

https://doi.org/10.1002/14651858.CD006338.pub2

2007 Jan 24

Chest physiotherapy for pneumonia in adults

Protocol

Yuping Yan, Taixiang Wu, Xiangli Yin, Bin Y Wang, Guan Jian Liu, Bi Rong Dong

https://doi.org/10.1002/14651858.CD006338

Differences between protocol and review

Some secondary outcomes (duration of antibiotic therapy, duration of sputum production, in‐patient sputum weight, duration of leukocytosis, change in leukocyte count and mean leukocyte count), which were not included in the protocol, were assessed in the review.

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 1

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.1 Mortality.
Figures and Tables -
Figure 3

Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.1 Mortality.

Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.2 Cure rate.
Figures and Tables -
Figure 4

Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.2 Cure rate.

Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.1 Mortality.
Figures and Tables -
Figure 5

Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.1 Mortality.

Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.2 Cure rate.
Figures and Tables -
Figure 6

Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.2 Cure rate.

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 1 Mortality.
Figures and Tables -
Analysis 1.1

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 1 Mortality.

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 2 Cure rate.
Figures and Tables -
Analysis 1.2

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 2 Cure rate.

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 3 Duration of hospital stay.
Figures and Tables -
Analysis 1.3

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 3 Duration of hospital stay.

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 4 Duration of fever.
Figures and Tables -
Analysis 1.4

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 4 Duration of fever.

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 5 Rate of improvement of chest X‐ray.
Figures and Tables -
Analysis 1.5

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 5 Rate of improvement of chest X‐ray.

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 1 Cure rate.
Figures and Tables -
Analysis 2.1

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 1 Cure rate.

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 2 Duration of hospital stay.
Figures and Tables -
Analysis 2.2

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 2 Duration of hospital stay.

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 3 Rate of improvement of chest X‐ray.
Figures and Tables -
Analysis 2.3

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 3 Rate of improvement of chest X‐ray.

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 4 Duration of antibiotic therapy.
Figures and Tables -
Analysis 2.4

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 4 Duration of antibiotic therapy.

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 5 Duration of sputum production.
Figures and Tables -
Analysis 2.5

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 5 Duration of sputum production.

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 6 In‐patient sputum weight.
Figures and Tables -
Analysis 2.6

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 6 In‐patient sputum weight.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 1 Mortality.
Figures and Tables -
Analysis 3.1

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 1 Mortality.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 2 Cure rate.
Figures and Tables -
Analysis 3.2

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 2 Cure rate.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 3 Duration of hospital stay.
Figures and Tables -
Analysis 3.3

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 3 Duration of hospital stay.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 4 Duration of fever.
Figures and Tables -
Analysis 3.4

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 4 Duration of fever.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 5 Rate of improvement of chest X‐ray.
Figures and Tables -
Analysis 3.5

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 5 Rate of improvement of chest X‐ray.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 6 Duration of oral antibiotic therapy.
Figures and Tables -
Analysis 3.6

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 6 Duration of oral antibiotic therapy.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 7 Duration of intervenous therapy.
Figures and Tables -
Analysis 3.7

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 7 Duration of intervenous therapy.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 8 Duration of total antibiotic therapy.
Figures and Tables -
Analysis 3.8

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 8 Duration of total antibiotic therapy.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 9 Duration of leukocytosis.
Figures and Tables -
Analysis 3.9

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 9 Duration of leukocytosis.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 10 Change in leukocyte count.
Figures and Tables -
Analysis 3.10

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 10 Change in leukocyte count.

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 11 Mean leukocyte count.
Figures and Tables -
Analysis 3.11

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 11 Mean leukocyte count.

Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 1 Duration of hospital stay.
Figures and Tables -
Analysis 4.1

Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 1 Duration of hospital stay.

Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 2 Duration of fever.
Figures and Tables -
Analysis 4.2

Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 2 Duration of fever.

Comparison 1. Chest physiotherapy plus routine treatment versus routine treatment alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

2

225

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.15, 7.13]

2 Cure rate Show forest plot

2

225

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.91, 1.04]

3 Duration of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Duration of fever Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Rate of improvement of chest X‐ray Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

Figures and Tables -
Comparison 1. Chest physiotherapy plus routine treatment versus routine treatment alone
Comparison 2. Active cycle of breathing techniques plus routine treatment versus routine treatment alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cure rate Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Duration of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Rate of improvement of chest X‐ray Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Duration of antibiotic therapy Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Duration of sputum production Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 In‐patient

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 Out‐patient

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 Total

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 In‐patient sputum weight Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

Figures and Tables -
Comparison 2. Active cycle of breathing techniques plus routine treatment versus routine treatment alone
Comparison 3. Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

2

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.27 [0.05, 1.57]

2 Cure rate Show forest plot

2

79

Risk Ratio (M‐H, Fixed, 95% CI)

1.54 [0.97, 2.46]

3 Duration of hospital stay Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

‐2.02 [‐3.46, ‐0.58]

4 Duration of fever Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Rate of improvement of chest X‐ray Show forest plot

2

75

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [0.77, 1.73]

6 Duration of oral antibiotic therapy Show forest plot

2

79

Mean Difference (IV, Random, 95% CI)

0.97 [‐1.25, 3.20]

7 Duration of intervenous therapy Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

‐2.11 [‐3.36, ‐0.87]

8 Duration of total antibiotic therapy Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

‐1.93 [‐3.12, ‐0.74]

9 Duration of leukocytosis Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

10 Change in leukocyte count Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

10.1 Change between Day 3 and 1 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 Change between Day 5 and 1 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Mean leukocyte count Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

11.1 Day 3 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 Day 5 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 3. Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment
Comparison 4. Positive expiratory pressure plus routine treatment versus routine treatment alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Duration of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Duration of fever Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

Figures and Tables -
Comparison 4. Positive expiratory pressure plus routine treatment versus routine treatment alone